Preventives Versus Treatments Redux: Tighter Bounds on Distortions in Innovation Incentives with an Application to the Global Demand for HIV Pharmaceuticals

Kremer and Snyder (Q J Econ 130:1167–1239, 2015) show that demand curves for a preventive and treatment may have different shapes though they target the same disease, biasing the pharmaceutical manufacturer toward developing the lucrative rather than the socially desirable product. This paper tightens the theoretical bounds on the potential deadweight loss from such biases. Using a calibration of the global demand for HIV pharmaceuticals, we demonstrate the dramatically sharper analysis achievable with the new bounds, allowing us to pinpoint potential deadweight loss at 62% of the global gain from curing HIV. We use the calibration to perform policy counterfactuals, assessing welfare effects of government policies such as a subsidy, reference pricing, and price-discrimination ban. The fit of our calibration is good: we find that a hypothetical drug monopolist would price an HIV drug so high that only 4% of the infected population worldwide would purchase, matching actual drug prices and quantities in the early 2000s before subsidies in low-income countries ramped up.     

Introduction to the Special Issue on “The Intersection Between Industrial Organization and Healthcare Economics”

This article introduces the special issue on the intersection between industrial organization and healthcare economics. This intersection has received increasing research interest, growing from 2% of the industrial-organization literature in 1991 to 6% in 2016. We describe the nine included articles, which cover a range of healthcare markets that include hospital services, insurance, and pharmaceuticals.     

The Production of Institutional Behaviour: A Constructive Comment on the Use of Institutionalization Theory in Organizational Analysis

I argue that the development of institutional theories of the formal structure of organizations have assumed that the implementation of institutional behaviours is a routine activity. This has resulted in a neglect of the problems facing organizations attempting to meet institutional demands. Data from a study of the adoption of professional institutions by accounting associations is used to identify four sources of problems in implementing institutional behaviours: (1) pragmatic difficulties; (2) conflicts with organizational “identities”; (3) inter-organizational conflicts; and, (4) intra-organizational conflicts. Résumé Cette étude soutient que les théories institutionnelles concernant les structures organisationnelles ont présumé que l'adoption de comportements institutionnels s'effectue de routine. Ceci a donc donnée lieu à un oubli des problèmes auxques doivent faire face les entreprises qui tentent de respecter les exigences institutionnelles. Les données d'une étude relative à l'adoption d'institutions professionnelles au sein d'associations comptables est utilisée pour identifier quatre sources de problèmes dans l'adoption de comportements institutionnels: (1) difficultés d'ordre pratique (2) conflits avec les diverses identités institutionnelles (3) conflits intra-organisationnels (4) conflits inter-organisationnels.     

Towards an understanding of social networks among organizational self-initiated expatriates: a qualitative case study of a professional services firm

Drawing on a qualitative case study of 51 organizational self-initiated expatriates (OSIEs) in a professional services firm, this article investigates the role of networks during expatriation and, specifically, in the development of learning that is beneficial to both the individual expatriate and the global operations of the firm. First, we investigate the extent to which individual motivations to engage in OSIE impact on the development of networks. Second, we investigate individual's experiences of network development. Third, we investigate individual perceptions of the benefits of networks for both organizations and individual actors. The paper will report that professionals initiating their own expatriation develop continually expanding and composite networks such that mobility and networks evolve in a seemingly symbiotic relationship. In doing so, it contributes to our understanding of the role of agency in network development and extends our understanding of organizational self-initiated expatriation as a relatively under-researched phenomenon.     

Perspective: Understanding the Nature and Measurement of the Lead User Construct

The lead user concept has attracted a lot of attention from scholars and practitioners alike. However, different studies apply different conceptualizations and measures of the lead user construct. Such variation in measurement of the construct make it almost impossible to consolidate findings from prior lead user research, which in turn hampers the accumulation of insights on the concept itself. This is also a challenge with respect to managerial practice: due to different interpretations of the concept, managers and R&D staff find it difficult to identify lead users for workshops and cooperation, and companies are often unable to transfer results from lead user projects to new product and business development. As a result, they only rarely repeat their work with lead users. The aim of this article is therefore to provide some thoughts and guidance on the conceptualization and measurement of the lead user construct.     

MONOPOLISTIC LOCATION CHOICE IN A TWO‐SIDED HOTELLING MODEL

We analyse the optimal location choice of a monopolistic firm that operates two arbitrarily located platforms on a two‐sided market. By extending the traditional Hotelling framework, we show that the optimal platform locations are equivalent to the one‐sided benchmark if both sides are either restricted to single‐ or multi‐homing. In the mixed case (one side single‐homes, the other one multi‐homes), the optimal platform locations are in line with the respective symmetric case. If the monopolist is restricted to choosing the same location on either side of the market, the optimal locations are determined by the relative profitability of the market sides.     

Managing five paradoxes of knowledge exchange in networked organizations: new priorities for HRM?

The life‐blood of most organizations is knowledge. Too often, the very mechanisms set up to facilitate knowledge flow militate against it. This is because they are instituted in a top‐down way, they are cumbersome to manage and the bridges of trust fail to get built. In their thirst for innovation, the tendency is for firms to set up elaborate transmission channels and governance systems. As a result, staff are drowned in a deluge of mundane intranet messages and bewildered by matrix structures, while off‐the‐wall ideas and mould‐breaking insights are routinely missed. Added to this is the challenge of operating across professional, cultural, regional and linguistic boundaries, where ways of sharing knowledge differ markedly, even within the same project team. Drawing upon extensive research with scientists in the ATLAS collaboration (a high‐energy particle physics experiment comprising 3,500 scientists from 38 countries), we explore five paradoxes associated with knowledge exchange in global networks. Each paradox leads to a proposition which takes the theory and practice of knowledge management in a fresh direction. We conclude by outlining a number of HRM priorities for international knowledge‐intensive organizations.     

Medical Malpractice Liability and Physician Migration

This paper uses national data on individual physicians and two control groups to provide evidence on the extent to which each of five medical malpractice reforms impacts the decision to move one's medical practice to another state. We find robust evidence that states that have implemented noneconomic damage caps experience less out-migration of physicians than states that do not have these reforms. In addition, we find some evidence that joint and several liability reforms and patient compensation funds also impact the migration decisions of physicians.     

‘Devolution’ of transport powers to Local Government: Impacts of the 2004 Traffic Management Act in England

The concept of ‘Devolution’—the transfer of powers away from the Central Government to more local bodies of Government, has been used across many different areas of policy and by many different national governments. This paper examines the devolution of transport powers to the existing Local Traffic Authorities in England via the 2004 Traffic Management Act. The paper first presents a summary of how several different nations have undertaken this process of devolving transport powers and responsibilities to either new or existing bodies. It then presents research from an electronic survey concerning how English Local Traffic Aut`horities are choosing to use some of the new powers available to them and their opinion on complementary areas of transport policy. Research is also presented from structured telephone interviews, concerning how individual Local Authorities perceive the efficacy and equity of the new legislation. Overall, the results show that only some of these new powers are likely to be used by English Local Authorities, with limited variation in how different types of LTA are choosing to implement these new powers. The structured telephone interviews provided some evidence that rural Authorities in particular are more dissatisfied with the legislation and consider some of the measures unhelpful. The results provide some insights on the formulation of devolved policy applicable to existing Local Government bodies and the varying benefits that can be perceived to apply to different types of Local Authority. Conclusions are drawn on some of the practical difficulties arising from the English experience, and lessons of relevance are drawn for other nations considering a similar devolution of transport powers.