The Local Influence of Pioneer Investigators on Technology Adoption: Evidence from New Cancer Drugs

Agha, Leila; Molitor, David

doi:10.1162/rest_a_00670

Cited by 36 publications

(17 citation statements)

References 30 publications

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“…3 A previous study was performed on drugs (Agha and Molitor, 2015). 4 Research activities impact other sources of healthcare financing (i.e.…”

Section: Methods and Datamentioning

confidence: 99%

“…Second, researchers have lower adoption costs because they are more accustomed to exploring and absorbing new technologies (Cohen and Levinthal, 1989;Åstebro, 2004). Finally, researchers are more likely to be aware of the latest inventions or technological changes through research networks (Spangenberg et al, 1990;Escarce, 1996;Bobrowski, 2000;Cutler and Kadiyala, 2003;Estabrooks et al, 2008;Angst et al, 2010;Agha and Molitor, 2015).…”

Section: The Characteristics Of Adopters (Demand For Medical Technolomentioning

confidence: 99%

“…For example, irrespective of technology adoption, physicians in academic-based medical centres could prescribe more medications or lengthen hospital stay durations. The influence of researchers could be also indirect: Publishing physicians are opinion leaders (Nair et al, 2010) and are likely to influence other physicians' prescription behaviours (Escarce, 1996;Burke et al, 2007;Agha and Molitor, 2015). The literature has emphasized that academic centres provide more intensive treatment (Newhouse, 2003) after case-mix differences are controlled for.…”

Section: The Determinants Of Technology Adoptionmentioning

confidence: 99%

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Endogenous Technology Adoption and Medical Costs

Lamiraud

Lhuillery

2016

Health Economics

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Despite the claim that technology has been one of the most important drivers of healthcare spending growth over the past decades, technology variables are rarely introduced explicitly in cost equations. Furthermore, technology is often considered exogenous. Using 1996-2007 panel data on Swiss geographical areas, we assessed the impact of technology availability on per capita healthcare spending covered by basic health insurance whilst controlling for the endogeneity of health technology availability variables. Our results suggest that medical research, patent intensity and the density of employees working in the medical device industry are influential factors for the adoption of technology and can be used as instruments for technology availability variables in the cost equation. These results are similar to previous findings: CT and PET scanner adoption is associated with increased healthcare spending, whilst increased availability of percutaneous transluminal coronary angioplasty facilities is associated with reductions in per capita spending. However, our results suggest that the magnitude of these relationships is much greater in absolute value than that suggested by previous studies that did not control for the possible endogeneity of the availability of technologies. Copyright © 2016 John Wiley & Sons, Ltd.

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“…3 A previous study was performed on drugs (Agha and Molitor, 2015). 4 Research activities impact other sources of healthcare financing (i.e.…”

Section: Methods and Datamentioning

confidence: 99%

Section: The Characteristics Of Adopters (Demand For Medical Technolomentioning

confidence: 99%

Section: The Determinants Of Technology Adoptionmentioning

confidence: 99%

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Endogenous Technology Adoption and Medical Costs

Lamiraud

Lhuillery

2016

Health Economics

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“…[ 36 ] In addition, key opinion leaders, who also lead many RCTs, play an important role in the diffusion of innovation. [ 38 ] A study reported that such opinion leaders were based in urban areas, most of them in the Northeastern regions such as New York City and Boston. [ 38 ] These leaders encouraged use of innovative therapies in real-world settings.…”

Section: Discussionmentioning

confidence: 99%

“…[ 38 ] A study reported that such opinion leaders were based in urban areas, most of them in the Northeastern regions such as New York City and Boston. [ 38 ] These leaders encouraged use of innovative therapies in real-world settings. [ 38 ] Healthcare providers in various US regions should, therefore, evaluate the political influences in driving their prescribing practices and work with local opinion leaders in finding ways to improve adoption of newer therapies among patients.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with immune checkpoint inhibitor use among older adults with late-stage melanoma

et al. 2021

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Improvement in overall survival by immune checkpoint inhibitors (ICI) treatment in clinical trials encourages their use for late-stage melanoma. However, in the real-world, heterogeneity of population, such as older patients with multimorbidity, may lead to a slower diffusion of ICIs. The objective of this study was to examine the association of multimorbidity and other factors to ICI use among older patients with late-stage melanoma using real world data. A retrospective cohort study design with a 12-month baseline and follow-up period was adopted with data from the linked Surveillance, Epidemiology, and End Results cancer registry/Medicare database. Older patients (>65 years) with late-stage (stage III/IV) melanoma diagnosed between 2012 and 2015 were categorized as with or without multimorbidity (presence of 2 or more chronic conditions) and ICI use was identified in the post-index period. Chi-square tests and logistic regression were used to evaluate factors associated with ICI use. In the study cohort, 85% had multimorbidity, 18% received any treatment (chemotherapy, radiation, and/or ICI), and 6% received ICI. Only 5.5% of older patients with multimorbidity and 6% without multimorbidity received ICIs. Younger age, presence of social support, lower economic status, residence in northeastern regions, and recent year of diagnosis were significantly associated with ICI use; however, multimorbidity, sex, and race were not associated with ICI use. In the real-world clinical practice, only 1 in 18 older adults with late stage melanoma received ICI, suggesting slow pace of diffusion of innovation. However, multimorbidity was not a barrier to ICI use.

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Adoption of Innovative Therapies Across Oncology Practices—Evidence From Immunotherapy

et al. 2023

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ImportanceImmunotherapies reflect an important breakthrough in cancer treatment, substantially improving outcomes for patients with a variety of cancer types, yet little is known about which practices have adopted this novel therapy or the pace of adoption.ObjectiveTo assess adoption of immunotherapies across US oncology practices and examine variation in adoption by practice type.Design, Setting, and ParticipantsThis cohort study used data from Medicare fee-for-service beneficiaries undergoing 6-month chemotherapy episodes between 2010 and 2017. Data were analyzed January 19, 2021, to September 28, 2022, for patients with cancer types for which immunotherapy was approved by the US Food and Drug Administration (FDA) during the study period: melanoma, kidney cancer, lung cancer, and head and neck cancer.ExposuresOncology practice location (rural vs urban), affiliation type (academic system, nonacademic system, independent), and size (1 to 5 physicians vs 6 or more physicians).Main Outcomes and MeasuresThe primary outcome was whether a practice adopted immunotherapy. Adoption rates for each practice type were estimated using multivariate linear models that adjusted for patient characteristics (age, sex, race and ethnicity, cancer type, Charlson Comorbidity Index, and median household income).ResultsData included 71 659 episodes at 1732 oncology practices. Of these, 264 practices (15%) were rural, 900 (52%) were independent, and 492 (28%) had 1 to 5 physicians. Most practices adopted immunotherapy within 2 years of FDA approval, but there was substantial variation in adoption rates across practice types. After FDA approval, adoption of immunotherapy was 11 (95% CI, −16 to −6) percentage points lower at rural practices than urban practices and 27 (95% CI, −32 to −22) percentage points lower at practices with 1 to 5 physicians than practices with 6 or more physicians. Adoption rates were similar at independent practices and nonacademic systems; however, both practice types had lower adoption than academic systems (independent practice difference, −6 [95% CI, −9 to −3] percentage points; nonacademic systems difference, −9 [95% CI, −11 to −6] percentage points).Conclusions and RelevanceIn this cohort study of Medicare claims, practice characteristics, especially practice size and rural location, were associated with adoption of immunotherapy. These findings suggest that there may be geographic disparities in access to important innovations for treating patients with cancer.

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The Local Influence of Pioneer Investigators on Technology Adoption: Evidence from New Cancer Drugs

Cited by 36 publications

References 30 publications

Endogenous Technology Adoption and Medical Costs

Endogenous Technology Adoption and Medical Costs

Factors associated with immune checkpoint inhibitor use among older adults with late-stage melanoma

Adoption of Innovative Therapies Across Oncology Practices—Evidence From Immunotherapy

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