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Competition and Innovation: Evidence from Third-Party Reprocessing in the Medical Device Industry

By Varun Prasad   

Healthcare is projected to soon become the industry with the largest amount of spending on research and development in the world. While competition has the potential to catalyze the development of new healthcare technologies and drive down costs, increases in competition have also been thought to hinder innovation as a result of thinner profit margins and reduced incentives. I estimate whether and to what extent competition in the medical device industry promotes innovation. Using Food and Drug Administration data on medical device applications from 1976 to 2019, I examine how original equipment manufacturers respond to the entry of third-party reprocessed devices. I find that, when controlling for year and medical specialty, the introduction of a reprocessed device leads to an almost five-fold increase in new device applications by original manufacturers after both one and two years. These results suggest that an increase in competition within the medical device market has spurred innovation and the development of new technologies.

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Advisors: Professor James Roberts, Professor David Ridley | JEL Codes: L1, D22, L65

Evaluating The Forward Citations-Patent Value Relationship: The Role Of Competition

By Neelesh T. Moorthy

I assess whether forward citations—how often patents are cited by subsequent patents—reliably capture patent quality. A high-quality invention might lack forward citations if there are no competing, patenting firms. This introduces measurement error in using citations to measure patent value. I test whether greater competition makes forward citations better measures of patent quality, with eight and twelve-year patent renewal rates serving as my benchmark measures of patent quality. Patent data come from the manufacturing survey in Cohen, Nelson, and Walsh (2000). I conduct logit regressions of patent renewal on forward citations and the number of competitors faced by surveyed manufacturing labs. While the regression results do not support the competition hypothesis, they confirm that forward citations positively predict renewal. They also lend insight into firms’ strategic renewal decisions.

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Advisors: Wesley Cohen and Michelle Connolly | JEL Codes: O31, O34

The Effect of Competition on Strategic Discharge at Long-Term Acute-Care Hospitals

By Michael Karamardian

Because Medicare’s prospective payment system for long-term acute-care hospitals (LTCHs) makes a large lump-sum form of payment once patients reach a minimum length-ofstay threshold, LTCHs have a unique opportunity to maximize profits by strategically discharging patients as soon as the payment is received. This analysis explores how the level of competition between LTCHs in geographic markets affects the probability of a patient being strategically discharged. The results show that patients at LTCHs in more competitive markets have a lower probability of being strategically discharged than at those in less competitive markets, suggesting increased competition could help save Medicare funding.

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Advisors: Kent Kimbrough and James Roberts | JEL Codes: D22, I11, I18

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