CPPR Health Policy Seminar: "Medical Innovation and Health Inequality: Evidence from Direct-Acting Antivirals"

The CPPR Health Policy Seminars are a series of workshops that bring together faculty and distinguished speakers from numerous disciplines across Tulane’s campuses to connect with a network of professionals and produce interdisciplinary research that addresses critical policy issues. 

Organized by Mary Olson, Associate Professor of Economics at Tulane and leader of CPPR's Health Policy program, these working groups provide scholars with the opportunity to present new work to an incisive audience of researchers and practitioners. Papers are distributed beforehand to the participants who read the paper and prepare discussion questions for the presenter.

Kevin Callison, Ph.D., is an assistant professor in the Department of Health Policy and Management at the Tulane University School of Public Health and Tropical Medicine. He also has appointments in the Department of Economics and the Murphy Institute at Tulane. 

Callison's research primarily focuses on issues related to the fields of health economics, labor economics, and applied econometrics. He is particularly interested in evaluating policy interventions that aim to improve population health, including issues related to health insurance and health service use. In addition, he conducts research on health behaviors, health determinants, and substance use. He is currently working on projects that assess the various impacts of Medicaid expansion in Louisiana and the relationship between paid sick leave and health.

Abstract: 

We study the incidence of innovation-induced externalities by race and ethnicity using the introduction of direct-acting antivirals (DAAs) for hepatitis C (HCV). DAAs obviated the need for liver transplant for some HCV-positive end-stage liver disease (ESLD) patients and, as a result, increased organ availability for HCV-negative ESLD patients. We show that while liver transplants increased for non-Hispanic Black, Hispanic, and non-Hispanic white HCV-negative ESLD patients, these increases accrued disproportionately to white patients. Further, only white HCV-negative ESLD patients experienced an increase in the transplantation rate (defined as transplants per waiting list registrant), despite marginal white registrants having better liver health than marginal Black registrants. We conclude that although most HCV-negative ESLD racial and ethnic groups benefited from the externality generated by DAAs, their introduction likely widened disparities in transplant outcomes between white and non-white patients.