Health, Risky Behaviour and the Value of Medical Innovation for Infectious Disease
Health, Risky Behaviour and the Value of Medical Innovation for Infectious Disease
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DOI：
10.1093/restud/rdv053
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发表时间：
2016-10-01
影响因子：
5.8
通讯作者：
Papageorge, Nicholas W.
中科院分区：
文献类型：
--
作者：
Chan, Tat Y.;Hamilton, Barton H.;Papageorge, Nicholas W.
我们提出了一个动态的框架来研究传染病背景下的医疗创新的价值。我们应用我们的框架来评估艾滋病毒治疗的突破，称为HAART。该模型捕捉如何，在降低预期成本和艾滋病毒感染的可能性，HAART降低了隐含的风险性行为的价格。具有前瞻性的代理人通过最佳地改变他们的行为来做出回应。该模型还施加了均衡约束，明确捕捉行为的最佳转变如何通过改变感染概率和寻找愿意从事危险性行为的伴侣的难易程度来影响均衡选择。使用估计的模型，我们进行反事实模拟计算HAART的价值从未感染的代理人的角度来看。这包括创新的选择价值沿着，以及由于采用高效抗逆转录病毒疗法而改变性行为所产生的价值。我们还从受感染和未受感染的代理人的角度计算了功能齐全的疫苗的附加值，其中受感染的代理人由于市场均衡的变化而从疫苗中受益。
We propose a dynamic framework to study the value of medical innovation in the context of infectious disease. We apply our framework to evaluate an HIV treatment breakthrough known as HAART. The model captures how, in lowering both the expected cost and likelihood of HIV infection, HAART reduced the implicit price of risky sex. Forward-looking agents responded by optimally shifting their behaviour. The model also imposes equilibrium constraints, explicitly capturing how optimal shifts in behaviour affect equilibrium choices by changing both infection probabilities and the ease of finding partners willing to engage in risky sex. Using the estimated model, we conduct counterfactual simulations to compute the value of HAART from the perspective of uninfected agents. This includes the option value of the innovation along with value accruing from changes in sex behaviour in response to HAART introduction. We also calculate the added value of a fully functional vaccine from the perspective of both infected and uninfected agents, where infected agents benefit from a vaccine due to resulting shifts in market equilibrium.