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The Economics of Medical Procedure Innovation (WP-21-49)

David Dranove, Craig Garthwaite, Christopher Heard, and Bingxiao Wu

This paper explores the economic incentives for medical procedure innovation. Using a proprietary dataset on billing code applications for emerging medical procedures, the researchers highlight two mechanisms that could hinder innovation. First, the administrative hurdle of securing permanent, reimbursable billing codes substantially delays innovation diffusion. The authors find that Medicare utilization of innovative procedures increases nearly nine-fold after the billing codes are promoted to permanent (reimbursable) from provisional (non-reimbursable). However, only 29% of the provisional codes are promoted within the five-year probation period. Second, medical procedures lack intellectual property rights, especially those without patented devices. When appropriability is limited, specialty medical societies lead the applications for billing codes. The researchers indicate that the ad hoc process for securing billing codes for procedure innovations creates uncertainty about both the development process and the allocation and enforceability of property rights. This stands in stark contrast to the more deliberate regulatory oversight for pharmaceutical innovations.

This paper is published in Journal of Health Economics.

David Dranove, Walter J. McNerney Professor of Health Industry Management and Professor of Strategy, Northwestern University

Craig Garthwaite, Professor of Strategy, Herman Smith Research Professor in Hospital and Health Services Management, and IPR Associate, Northwestern University

Christopher Heard, Department of Economics, Northwestern University

Bingxiao Wu, Assistant Professor of Economics, Rutgers University

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