Sunday, July 12, 2020

Incorporating patient preferences into transplant decisions can improve welfare--Genie, Nicolo and Pasini in J Health Economics


The role of heterogeneity of patients’ preferences in kidney transplantation
by Mesfin G.GenieaeAntonio Nicol√≥bcGiacomo Pasini
Journal of Health Economics
Volume 72, July 2020, 102331

Abstract: We elicit time and risk preferences for kidney transplantation from the entire population of patients of the largest Italian transplant centre using a discrete choice experiment (DCE). We measure patients’ willingness-to-wait (WTW) for receiving a kidney with one-year longer expected graft survival, or a low risk of complication. Using a mixed logit in WTW-space model, we find heterogeneity in patients’ preferences. Our model allows WTW to vary with patients’ age and duration of dialysis. The results suggest that WTW correlates with age and duration of dialysis, and that accounting for patients’ preferences in the design of kidney allocation protocols could increase their welfare. The implication for transplant practice is that eliciting patients’ preferences could help in the allocation of “non-ideal” kidneys.
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Saturday, July 11, 2020

Economics and Computation 2020 updated program, July 13-16

Scott Kominers forwards this update on the EC conference program, including a shortcut to identify those sessions on market design.


Economics and Computation 2020
The main programming of EC 2020, the leading scientific conference on advances in theory, empirics, and applications at the interface of economics and computation, will be held next week from July 13 to July 16.  The program features invited speakers, a highlight of papers from other conferences and journals, a technical program of paper presentations and posters, workshops, tutorials, and ample opportunities for casual interactions and networking. The conference will be run virtually on the Gather platform, an innovative 2D world that facilitates spontaneous small-group conversations. 

Participation by members of related fields is strongly encouraged.  Registration is mandatory (register here) but complimentary with ACM/SIGecom membership of $10 ($5 for students).  Details on joining events will be emailed to registered participants.

All events are listed on this Google calendar.  Paper sessions are broken down by areas of interest in the Google calendars below.  You can add these calendars to your personal Google calendar by clicking the “+Google” button on the bottom right.

4.     Mechanism Design

Unanswered questions about EC’20 can be directed to the Conference Hosts at sigecom-virtual-EC2020@googlegroups.com.

Friday, July 10, 2020

Blockchain economics, by Catalini and Gans; and Halaburda, Haeringer, Gans and Gandal


Some Simple Economics of the Blockchain
By Christian Catalini and Joshua S. Gans
Communications of the ACM, July 2020, Vol. 63 No. 7, Pages 80-90

"we rely on economic theory to explain how two key costs affected by blockchain technology—the cost of verification of state, and the cost of networking—change the types of transactions that can be supported in the economy. These costs have implications for the design and efficiency of digital platforms, and open opportunities for new approaches to data ownership, privacy, and licensing; monetization of digital content; auctions and reputation systems."
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The Microeconomics of Cryptocurrencies
Hanna Halaburda, Guillaume Haeringer, Joshua S. Gans, Neil Gandal
NBER Working Paper No. 27477  July 2020

Abstract: Since its launch in 2009 much has been written about Bitcoin, cryptocurrencies and blockchains. While the discussions initially took place mostly on blogs and other popular media, we now are witnessing the emergence of a growing body of rigorous academic research on these topics. By the nature of the phenomenon analyzed, this research spans many academic disciplines including macroeconomics, law and economics and computer science. This survey focuses on the microeconomics of cryptocurrencies themselves. What drives their supply, demand, trading price and competition amongst them. This literature has been emerging over the past decade and the purpose of this paper is to summarize its main findings so as to establish a base upon which future research can be conducted.

Thursday, July 9, 2020

Safe injection sites: surreptitious harm reduction, in the NEJM

When healthcare interventions must be conducted secretly, it's likely that something is very wrong with the law.

A letter in the New England Journal of Medicine brings us up to date on safe injection sites, to combat deaths from drug overdoses.

by Alex H. Kral, Ph.D., Barrot H. Lambdin, Ph.D., Lynn D. Wenger, M.S.W., M.P.H., and 
Pete J. Davidson, Ph.D.    July 8, 2020

"Nearly 70,000 people in the United States die each year from a drug overdose.1 Opioid-involved overdose deaths may be preventable by the timely administration of naloxone. Eleven countries have responded to health concerns regarding people who use drugs by opening sanctioned safe consumption sites; however, no such sites exist yet in the United States. Safe consumption sites provide a space for people to bring preobtained drugs and use them with sterile supplies under clean conditions and with safe disposal of used drug equipment. These sites provide monitoring by staff equipped and trained in the use of naloxone to reverse overdose. Most sanctioned sites can also provide related services, including voluntary screening for infectious diseases, peer counseling, wound care, and referral to other social and medical services, such as substance use treatment. 
...
"In September 2014, in response to a local opioid overdose crisis, an organization in an undisclosed U.S. city opened an unsanctioned safe consumption site


"Although this evaluation was limited to one city and one site that is unsanctioned, and therefore the findings cannot be generalized, our results suggest that implementing sanctioned safe consumption sites in the United States could reduce mortality from opioid-involved overdose. Sanctioning sites could allow persons to link to other medical and social services, including treatment for substance use, and facilitate rigorous evaluation of their implementation and effect on reducing problems such as public injection of drugs and improperly discarded syringes."

Wednesday, July 8, 2020

Will curtailing early hiring/unraveling help diversity?

If you run a company that hires very early, you likely hire from familiar places.  If talented recruits from more diverse backgrounds are harder to identify very early, you might want to slow things down a bit.  Here's a WSJ story, about what might signal a change in the famously unraveled market for young analysts in private equity:


Blackstone to Bypass Scramble for Investment-Bank Talent in Bid to Diversify Hiring
On-campus recruiting will be expanded to 44 schools from nine in 2015
By Miriam Gottfried, June 24, 2020

"Blackstone Group Inc., ...one of the most coveted employers on Wall Street, is throwing out a key section of its recruiting playbook in a bid to improve its hiring process and increase diversity.

"The investing giant and its private-equity peers have long engaged in a yearly race to pluck junior investment bankers already trained in spreadsheet and PowerPoint wizardry from firms such as Goldman Sachs Group Inc. and Morgan Stanley. The prize for those lucky enough to make the jump: entry-level jobs that can pay as much as $300,000 a year at some firms.

"Now Blackstone officials say the firm plans to sit out that contest in favor of on-campus recruiting, already its main source of talent and one that it is expanding to bring in more candidates directly from schools, including historically black colleges and universities and women’s colleges. Blackstone, which has been working for years to extend its campus reach, says it will directly recruit from 44 schools this academic year. That is up from just nine in 2015.
...
"Blackstone, the largest buyout firm with $538 billion of assets, received nearly 15,000 applications for just 90 full-time analyst roles that started last year. It has two main sources of new junior talent: campuses and investment banks, which have their own hotly competitive entry-level hiring operations.

In the case of the latter, recruitment used to happen during the summer after applicants’ first year on the job, but it has steadily crept forward as private-equity firms jump the starting gun in hopes of securing the best candidates. In 2019, recruiting took place in September, just a couple months after candidates began working at banks—for roles that wouldn’t start until summer 2021."

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Here's an earlier related post (from long ago, before Covid-19 and George Floyd...):

Monday, December 9, 2019

Tuesday, July 7, 2020

Should deceased donors be allowed to donate sperm?

Deceased donor sperm donation is the subject of an article earlier this year, in light of the shortage of donated sperm in the UK:

Hodson N, Parker J. "The ethical case for non-directed postmortem sperm donation,"
Journal of Medical Ethics 2020;46:489-492.

Abstract: In this article we outline and defend the concept of voluntary non-directed postmortem sperm donation. This approach offers a potential means of increasing the quantity and heterogeneity of donor sperm. This is pertinent given the present context of a donor sperm shortage in the UK. Beyond making the case that it is technically feasible for dead men to donate their sperm for use in reproduction, we argue that this is ethically permissible. The inability to access donor sperm and the suffering this causes, we argue, justifies allowing access to sperm donated after death. Moreover, it is known that individuals and couples have desires for certain sperm donor characteristics which may not be fulfilled when numbers of sperm donors are low. Enacting these preferences contributes significantly to the well-being of intended parents, so we argue that this provides a pro tanto reason for respecting them. Finally, we explore the benefits and possible disadvantages of such a system for the various parties affected.

"The United Kingdom (UK) has a shortage of donor sperm. In 2016 there were 2273 donor insemination treatment cycles; 42% of the women registering had a male partner, 41% had a female partner and 17% were single.1 The average number of newly registered sperm donors per year between 2011 and 2013 was 586, an increase from 2004 where there were 237 donors.2 Yet this increase includes donations for specific use by a known individual to create one offspring. In 2016 the Human Fertilisation and Embryology Authority (HFEA) reported 4306 in vitro fertilisation (IVF) treatment cycles with ‘own eggs and donor sperm’ and 924 treatment cycles with ‘donor egg and donor sperm’.1 Clearly there is high demand for donor sperm and HFEA reports demonstrate this is increasing.1

"Commercial imports have been the mainstay of UK efforts to keep up with increasing demand for donor sperm.1 The Department of Health and Social Care estimates that 4000 samples were imported from the USA and 3000 from Denmark in addition to samples from other European Union (EU) countries.3 The HFEA highlights that imports are used to plug the gap because "the cost, time and resources required to recruit donors themselves is too high when there are specialist sperm banks who can carry out an efficient and reliable service".4 The Department of Health and Social Care has raised concerns that the UK's departure from the EU may worsen this state of affairs.3
...
"There are barriers to donating sperm in life that may prevent some men acting on their desire to help others or see their genes continue into future generations through donation. Posthumous sperm donation avoids most of these problems, allowing men to access the positives of sperm donation without the drawbacks. Living kidney donation provides an informative comparison between the motivations to donate in life versus after death. It is difficult to overestimate the value of donated kidneys to those individuals on the transplant list. Many people feel the pull of altruism and have a desire to help those who need a kidney transplant. Yet the potential costs of donating during life mean that individuals would rather donate after death when those costs are eliminated.16 Gamete donation after death parallels kidney donation by offering the same benefits as donation in life with fewer drawbacks, thereby both incentivising men to donate and providing greater opportunity to fulfil some of their reproductive and altruistic desires. This makes voluntary postmortem sperm donation an attractive addition to living donation.
...
"Given the potential impact of postmortem sperm donation on the family, policy decisions could be used to soften the implications of postmortem sperm donation for the family. For our purposes, the important point is that considerations of the family, including a romantic partner surviving the deceased man, do not justify a blanket ban on the use of sperm collected after death, especially if the donor has specified a desire to donate.
...
"The UK consensus is that gametes ought not to be bought although donor expenses should be covered.37 We do not take a view on this generally, but note the dissonance generated when sperm from countries such as Denmark where ‘vendors’ have been paid is used in the UK.38 In so far as society benefits from a coherent bioethical policy reflecting its shared values, using dead donors rather than donors who were paid in other countries to bolster supplies might provide a more coherent policy.

Monday, July 6, 2020

Netherlands now has opt out deceased donor registration

The Netherlands Times has the story:

NEW DONOR REGISTRY OPT-OUT RULE TAKES EFFECT TODAY
By Janene Pieters on Wednesday, 1 July 2020

"The Netherlands' new organ donation law takes effect today. From now on Dutch adults who haven't told the Donor Register their wishes for their organs after death will automatically be registered as "no objection to organ donation", instead of automatically being registered as a non-donor. This means their organs can go to a patient after their death, though their next of kin will first be consulted.
"According to the government, almost 7 million Netherlands residents have not registered their wishes with the Donor Register yet. They will be sent a letter, prompting them to do so. Residents of Noord-Holland will be the first to receive this letter in September and October. A second letter will be sent six weeks later. If no response is received after the two letters, the person will be registered as "no objection to organ donation".
"Of those who have registered their wishes with the Donor Register, 53 percent are registered as organ donors. About 36 percent are non-donors, and 11 percent decided to leave this decision up to their families. "
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In the U.S., almost 50% of drivers are registered donors, close to the Netherlands rate. But it looks like the 36 percent "non donors" have given a definite "no" to donation. It will be interesting to see how the deceased donor transplantation rate evolves in the Netherlands.