IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v25y2016i6p723-739.html
   My bibliography  Save this article

Conflicts of Interest in Medical Technology Markets: Evidence from Orthopedic Surgery

Author

Listed:
  • Fabrice Smieliauskas

Abstract

Financial relationships between physicians and industry are vital to biomedical innovation yet create the potential for conflicts of interest in medical practice. I consider an inducement model of the role of financial relationships in health care markets, where consulting payments induce physicians to use more devices of the firms that sponsor them. To test the model, I exploit a policy shock, whereby government monitoring of payments to joint replacement surgeons resulted in declines of over 60% in both total payments and in the number of physicians receiving payments from 2007 to 2008. Using hospital discharge data from three states, I find that the loss of payments leads physicians to switch 7 percentage points of their device utilization from their sponsoring firms' devices to other firms' devices, an effect which is concentrated among surgeons with low switching costs. These results offer support for the inducement model. I also find evidence of an increase in medical productivity following the policy intervention, which suggests conditions under which regulation of financial relationships would be socially beneficial. Copyright © 2015 John Wiley & Sons, Ltd.

Suggested Citation

  • Fabrice Smieliauskas, 2016. "Conflicts of Interest in Medical Technology Markets: Evidence from Orthopedic Surgery," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 723-739, June.
  • Handle: RePEc:wly:hlthec:v:25:y:2016:i:6:p:723-739
    DOI: 10.1002/hec.3177
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3177
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.3177?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Iain M. Cockburn & Rebecca M. Henderson, 1998. "Absorptive Capacity, Coauthoring Behavior, and the Organization of Research in Drug Discovery," Journal of Industrial Economics, Wiley Blackwell, vol. 46(2), pages 157-182, June.
    2. Ho, Vivian, 2002. "Learning and the evolution of medical technologies: the diffusion of coronary angioplasty," Journal of Health Economics, Elsevier, vol. 21(5), pages 873-885, September.
    3. A. Colin Cameron & Douglas L. Miller, 2010. "Robust Inference with Clustered Data," Working Papers 318, University of California, Davis, Department of Economics.
    4. A. Colin Cameron & Douglas L. Miller, 2010. "Robust Inference with Clustered Data," Working Papers 107, University of California, Davis, Department of Economics.
    5. Pei-Yu (Sharon) Chen & Lorin M. Hitt, 2002. "Measuring Switching Costs and the Determinants of Customer Retention in Internet-Enabled Businesses: A Study of the Online Brokerage Industry," Information Systems Research, INFORMS, vol. 13(3), pages 255-274, September.
    6. Stephan, Paula E., 2010. "The Economics of Science," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 1, chapter 0, pages 217-273, Elsevier.
    7. repec:bla:jindec:v:46:y:1998:i:2:p:157-82 is not listed on IDEAS
    8. Farrell, Joseph & Klemperer, Paul, 2007. "Coordination and Lock-In: Competition with Switching Costs and Network Effects," Handbook of Industrial Organization, in: Mark Armstrong & Robert Porter (ed.), Handbook of Industrial Organization, edition 1, volume 3, chapter 31, pages 1967-2072, Elsevier.
    9. Zucker, Lynne G & Darby, Michael R & Armstrong, Jeff, 1998. "Geographically Localized Knowledge: Spillovers or Markets?," Economic Inquiry, Western Economic Association International, vol. 36(1), pages 65-86, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sara Parker‐Lue, 2020. "The impact of reducing pharmaceutical industry payments on physician prescribing," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 382-390, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Denisa Mindruta, 2013. "Value creation in university-firm research collaborations: A matching approach," Strategic Management Journal, Wiley Blackwell, vol. 34(6), pages 644-665, June.
    2. Stephan, Paula E., 2010. "The Economics of Science," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 1, chapter 0, pages 217-273, Elsevier.
    3. Jarle Moen, 2005. "Is Mobility of Technical Personnel a Source of R&D Spillovers?," Journal of Labor Economics, University of Chicago Press, vol. 23(1), pages 81-114, January.
    4. Toole, Andrew A. & King, John L., 2011. "Industry-science connections in agriculture: Do public science collaborations and knowledge flows contribute to firm-level agricultural research productivity?," ZEW Discussion Papers 11-064, ZEW - Leibniz Centre for European Economic Research.
    5. Scherer, F.M., 2010. "Pharmaceutical Innovation," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 1, chapter 0, pages 539-574, Elsevier.
    6. Ernest Miguélez & Rosina Moreno, 2013. "Do Labour Mobility and Technological Collaborations Foster Geographical Knowledge Diffusion? The Case of European Regions," Growth and Change, Wiley Blackwell, vol. 44(2), pages 321-354, June.
    7. Ferretti, Marco & Guerini, Massimiliano & Panetti, Eva & Parmentola, Adele, 2022. "The partner next door? The effect of micro-geographical proximity on intra-cluster inter-organizational relationships," Technovation, Elsevier, vol. 111(C).
    8. Gábor Kézdi & Gergely Csorba, 2013. "Estimating Consumer Lock-In Effects from Firm-Level Data," Journal of Industry, Competition and Trade, Springer, vol. 13(3), pages 431-452, September.
    9. Jacob, Jojo & Belderbos, René & Lokshin, Boris, 2023. "Entangled modes: Boundaries to effective international knowledge sourcing through technology alliances and technology-based acquisitions," Technovation, Elsevier, vol. 122(C).
    10. Ingela Alger & Laura Juarez & Miriam Juarez-Torres & Josepa Miquel-Florensa, 2020. "Do Informal Transfers Induce Lower Efforts? Evidence from Lab-in-the-Field Experiments in Rural Mexico," Economic Development and Cultural Change, University of Chicago Press, vol. 69(1), pages 107-171.
    11. Nicola Lacetera, 2003. "Incentives and spillovers in R&D activities: an agency-theoretic analysis of industry-university relations," Microeconomics 0312004, University Library of Munich, Germany.
    12. Hirschauer, Norbert & Grüner, Sven & Mußhoff, Oliver & Becker, Claudia & Jantsch, Antje, 2020. "Can p-values be meaningfully interpreted without random sampling?," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 14, pages 71-91.
    13. Nola Hewitt-Dundas, 2013. "The role of proximity in university-business cooperation for innovation," The Journal of Technology Transfer, Springer, vol. 38(2), pages 93-115, April.
    14. Gianluca Fabiano & Andrea Marcellusi & Giampiero Favato, 2020. "Public–private contribution to biopharmaceutical discoveries: a bibliometric analysis of biomedical research in UK," Scientometrics, Springer;Akadémiai Kiadó, vol. 124(1), pages 153-168, July.
    15. Bürker, Matthias & Franco, Chiara & Minerva, G. Alfredo, 2013. "Foreign ownership, firm performance, and the geography of civic capital," Regional Science and Urban Economics, Elsevier, vol. 43(6), pages 964-984.
    16. Matthias Bürker & G. Alfredo Minerva, 2014. "Civic capital and the size distribution of plants: short-run dynamics and long-run equilibrium," Journal of Economic Geography, Oxford University Press, vol. 14(4), pages 797-847.
    17. Huseynov, Samir & Palma, Marco A., 2018. "Does California’s LCFS Reduce CO2 Emissions?," 2018 Annual Meeting, August 5-7, Washington, D.C. 274200, Agricultural and Applied Economics Association.
    18. Blind, Knut & Krieger, Bastian & Pellens, Maikel, 2022. "The interplay between product innovation, publishing, patenting and developing standards," Research Policy, Elsevier, vol. 51(7).
    19. Thursby, Marie & Thursby, Jerry & Gupta-Mukherjee, Swasti, 2007. "Are there real effects of licensing on academic research? A life cycle view," Journal of Economic Behavior & Organization, Elsevier, vol. 63(4), pages 577-598, August.
    20. Sumaryanto & Sri Hery Susilowati & Fitri Nurfatriani & Herlina Tarigan & Erwidodo & Tahlim Sudaryanto & Henri Wira Perkasa, 2022. "Determinants of Farmers’ Behavior towards Land Conservation Practices in the Upper Citarum Watershed in West Java, Indonesia," Land, MDPI, vol. 11(10), pages 1-21, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:25:y:2016:i:6:p:723-739. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.