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Motivated by current topics in health economics, we apply the theory of salience to consumer policy. If a government intends to encourage healthier diets without harming consumers by raising taxes, it could initiate information campaigns which focus consumers’ attention either on the healthiness of one item or the unhealthiness of the other item. According to our approach, both campaigns work, but it is more efficient to proclaim the unhealthiness of one product in order to present it as a “ bad.” Our findings imply that comparative advertisement is particularly efficient for entrant firms into established markets.

Demand-side barriers are known to be important toward explaining the limited purchase of private long-term care insurance (LTCI). In this study, we examine several factors associated with the demand for LTCI including the availability of less costly substitutes (e.g., Medicaid, family), consumer information, and risk perception. Using buyer surveys from 2000, 2005, and 2010, our results suggest that, among individuals not eliminated through medical underwriting, consumer risk perception and the presence of lower cost, imperfect substitutes are strongly associated with the limited purchase of LTCI. These factors were also predictive of the generosity of coverage purchased. If policymakers seek to stimulate demand for LTCI, new public policies might include Medicaid reform, integrating LTCI with Medicare Advantage plans, enhanced LTCI offerings through employers, and targeted informational campaigns.

Typically, research on the effect of ownership has considered health care providers in isolation of competitive interaction from other firms. This analysis considers how the selection of Medicare reimbursement codes for skilled nursing facilities varies by ownership and is influenced by the competitive spillovers from market dominance of for-profit institutions. We find evidence that not-for-profits are less likely to code patients into the highest reimbursement categories. Further, as the market becomes dominated by for-profits, both for-profit and not-for-profits increase the share of patients in these high reimbursement categories.

Background: Since the start of the War on Cancer there have been enormous investments in improving oncology treatment. The return to society generated by this investment is unknown. We estimate the returns generated over the previous four decades and extrapolate future returns from current investment in cancer R&D. Methods: Using data on cancer incidence, mortality, and treatment-specific R&D expenditures from 1973 to 2010, we used regression models and two-sided significance tests to relate investment in cancer treatment R&D to cancer mortality, by tumor type. For investment, we used a measure of the knowledge stock generated by cancer treatment R&D expenditures over the previous 25 years to capture the cumulative benefits of past innovations and advances in treatment. Results: Investment of an additional $1 million in cervical, breast, colorectal, and prostate cancer between 1973 and 1990 was associated with a cumulative return of more than $5 million from cancer R&D by 2010. Through 2010, investment in cancer R&D was associated with average benefits in excess of costs in all but two cancers, ovarian and pancreatic. Regarding future returns, we estimated that each additional $1 million invested in cancer treatment research and development in 2010 will produce over $28 million in value over the following 50 years. Conclusions: The return to society from spending on cancer treatment R&D is large, but varies across tumor types.

We estimate the marginal benefits of population-based cancer screening by comparing cancer test and detection rates on either side of US guideline-recommended initiation ages (age 40 for breast cancer and age 50 for colorectal cancer during the study period). Using a regression discontinuity design and self-reported test data from national health surveys, we find test rates for breast and colorectal cancer increase at the guideline age thresholds by 109% and 78%, respectively. Data from cancer registries in twelve US states indicate that cancer detection rates increase at the same thresholds by 50% and 49%, respectively. We estimate significant effects of screening on earlier breast cancer detection (1.2 cases/1000 screened) at age 40 and colorectal cancer detection (1.1 cases/1000 individuals screened) at age 50. Forty-eight and 73% of the increases in breast and colorectal case detection occur among middle-stage cancers (localized and regional) with most of the remainder among early-stage (in-situ). Our analysis suggests that the cost of detecting an asymptomatic case of breast cancer at age 40 via population-based screening is $107,000–134,000 and that the cost of detecting an asymptomatic case of colorectal cancer at age 50 is $473,000–485,000.

Introduction: There have been significant improvements in both treatment and screening efforts for many types of cancer over the past decade. However, the effect of these advancements on the survival of cancer patients is unknown, and many question the value of both new treatments and screening efforts. Methods: This study uses a retrospective analysis of SEER Registry data to quantify reductions in mortality rates for cancer patients diagnosed between 1997 and 2007. Using variation in trends in mortality rates by stage of diagnosis across cancer types, we use logistic regression to decompose separate survival gains into those attributable to advances in treatment versus advances in detection. We estimate the gains in survival due to gains in both treatment and detection overall and separately for 15 of the most common cancer types. Results: We estimate that 3-year cancer-related mortality of cancer patients fell 16.7% from 1997 to 2007. Overall, advances in treatment reduced mortality rates by approximately 12.2% while advances in early detection reduced mortality rates by 4.5%. The relative importance of treatment and detection varied across cancer types. Improvements in detection were most important for thyroid, prostate and kidney cancer. Improvements in treatment were most important for non-Hodgkins lymphoma, lung cancer and myeloma. Conclusion: Both improved treatment options and better early detection have led to significant survival gains for cancer patients diagnosed from 1997 to 2007, generating considerable social value over this time period.