Ayfer Ali, Health Policy Management PhD
Thesis Chair: Robert S. Huckman
Essays on the Economics of Innovation in Healthcare
Successful knowledge translation between the scientific and clinical domains is often seen as the necessary solution to the innovation crisis and ever slower R&D productivity in the pharmaceutical industry (Pammolli et al., 2011). Yet, despite the large amounts of money we spend on attempts at promoting translational research, our knowledge of what interventions are truly useful are extremely limited or missing altogether. In my dissertation I concentrate on the phenomenon of knowledge translation in healthcare at the individual, team and market levels of analysis while contributing to the literature on knowledge and innovation management.
In my job market paper, I expand our knowledge on the demand side of markets for ideas and early stage technologies by empirically linking, for the first time, buyer firm behavior to real innovation and commercialization outcomes of licensed products - a vast improvement over previous patent based outcome measures. I use the context of technology licensing from academic medical centers to find out whether firms license inventions that are similar to or different from their own research portfolio and whether the degree of similarity is related to commercialization success. I find that while firms tend to show interest in a wide variety of technologies, they end up licensing inventions that are close to their own technology portfolio. While this is true at the broadest proximity measure level, at the more granular level, conditional on high-level proximity, greater similarity between the licensee's patents and the AMC patent makes execution of a license agreement less likely. This implies that "close" fit is good but "very close" fit is detrimental for licensing. These findings provide a description of the structure of demand in markets for technology, something that has never been accomplished before. This paper is co-authored with Iain Cockburn of BU.
A sole-authored paper explores whether the integration of cross-domain (clinical and bench) knowledge on the inventing team influences the hazard of licensing and commercialization of inventions from academic medical centers. Results defy commonly accepted wisdom that knowledge integration is the solution to translation - I find that inventions by teams that combine individuals with MD/PhD degrees or MD and PhD degrees, are on average at a significantly lower hazard of licensing. I am currently testing a variance based outcome measure to understand whether cross-domain teams might produce a few more highly significant inventions even if on average not better than single-domain teams.
Two other papers study the role of clinicians in knowledge translation from the clinic to the bench, the so-called reverse translation. A paper co-authored with Eric von Hippel and Harold Demonaco titled: "The Major Role of Clinicians in the Discovery of Off-Label Drug Therapies," published in 2006 documents the important role of physicians in the discovery off new uses for existing drugs. Over 55% of widely recognized new off-label uses for existing drugs are originally proposed by clinicians. Another paper, with Rob Huckman looks at the link between the composition of clinical work among cardiac surgeons at academic medical centers and their research publications.
