The Innovation and Diffusion Podcast
S1 E4: Medical Innovations, Patents, and Exclusivities with Heidi Williams from Dartmouth College
This episode explores the intersection of innovation economics and health economics, focusing on the impact of medical technology on human health. It discusses biases in our systems that hinder technological development and explores controversies surrounding surrogate endpoints in drug trials. The role of patents and exclusivity periods in incentivizing innovation is examined, along with insights into effective collaboration and time management in research. The episode concludes with personal insights and work habits for maintaining productivity and work-life balance.
Improvements in medical technology have played a significant role in increasing life expectancy and improving health outcomes.
Heidi Williams emphasizes the importance of understanding the drivers behind improvements in human health over time and the role of medical technology in achieving these improvements.
Policies can have a significant impact on people's willingness to invest in technological development.
The podcast highlights the influence of policies on investments and technological development, using the example of COVID policies that incentivized quick action leading to the development of a vaccine.
Controversies exist regarding the use of surrogate endpoints in drug trials.
The discussion explores the challenges and resistance surrounding the use of controversial surrogate endpoints in evaluating the effectiveness of drugs, particularly in cancer trials.
Patents and exclusivity periods play a role in incentivizing innovation.
The episode examines the impact of patents and suggests that shifting the emphasis from patents to exclusivity periods could better align private incentives with social value.
Effective collaboration and clear communication are essential in research projects.
Insights are provided on building interest in important ideas, managing research collaborations, and setting realistic expectations for effective collaboration.
Time management strategies and work-life balance are crucial for productivity.
The episode offers insights into prioritizing projects, reflecting on time management, and finding a balance between guilt and productivity. It also discusses personal experiences and work habits related to work-life balance.
- Improvements in Human Health and Medical Technology
- Understanding the Intersection of Innovation Economics and Health Economics
- Biases in Systems and the Impact on Technological Development
- Controversies Surrounding Surrogate Endpoints in Drug Trials
- The Role of Patents and Exclusivity Periods in Incentivizing Innovation
- Building Interest in Important Ideas and Effective Collaboration
- Bottlenecks and Decision-Making Processes in Research Funding Agencies
- Effective Collaboration and Time Management in Research
- Time Management Strategies and Work-Life Balance
- Personal Insights and Work Habits
Improvements in Human Health and Medical Technology
00:00 - 07:27
- Heidi Williams is a professor of economics at Dartmouth College and the Director of Science Policy at the Institute of Progress. Her research focuses on medicine, science, and innovation.
- Williams believes that dramatic improvements in medical technology have played a significant role in increasing life expectancy and improving health outcomes.
- The stalling of improvements for life expectancy in the US may be attributed to factors like the opioid epidemic and misuse of medical technologies.
- Appropriate technology diffusion involves providing guidance or guardrails to ensure technologies are used appropriately.
- Ethical considerations are important when it comes to genetic engineering and managing technological advancements like the Human Genome Project.
- Policies should be implemented to guide technologies towards socially appropriate use.
Understanding the Intersection of Innovation Economics and Health Economics
06:57 - 13:20
- The speaker emphasizes the importance of considering policies to guide technologies in a socially appropriate way.
- They discuss the need for technical knowledge in fields like medicine and how they acquired it through reading and interdisciplinary collaboration.
- The speaker mentions studying the Human Genome Project and reading books that provided different perspectives on the same event, leading to research opportunities.
- They highlight the importance of feeling comfortable presenting research papers to scientists in the specialty being studied.
- The speaker shares their experience of engaging with scientists and getting feedback to ensure respectful use of data in their research.
- The speaker encourages open-mindedness and examines whether policies, institutions, and incentives bias investments away from certain areas.
Biases in Systems and the Impact on Technological Development
12:56 - 19:22
- The podcast discusses how certain biases in our systems discourage investments in specific areas and hinder the development of technologies.
- Policies can have a significant impact on people's willingness to invest and the number of technologies that are developed.
- During COVID, policies that incentivized quick action led to the development of a vaccine in a relatively short time compared to historical precedents.
- A study focused on cancer research revealed gaps where there was high patient demand but insufficient innovation.
- Clinical trials for new drugs take longer when patients take longer to show improvement, leading to less investment in those areas.
- There is a systematic bias where private firms underinvest in longer trials, resulting in welfare costs.
- The patent system may unintentionally disincentivize firms from investing in long-term clinical trials due to shorter market protection for drugs with longer trials.
Controversies Surrounding Surrogate Endpoints in Drug Trials
19:03 - 25:40
- Surrogate endpoints, which are intermediate outcomes correlated with changes in survival, can be used to evaluate the effectiveness of drugs. However, controversial surrogate endpoints lack sufficient evidence to support their use.
- Investment in discovering and validating more surrogate endpoints is worth considering, but resistance exists within the medical community.
- Other medical conditions have agreed-upon outcomes for treatment evaluation, such as patient discomfort and pain remission. It is surprising that there is resistance to using similar criteria for cancer trials.
- Brain scan measures as an outcome in Alzheimer's drug trials and HPV incidence as an endpoint for cervical cancer vaccines have faced heated discussions regarding their validity.
- Some firms have advocated for using controversial surrogate endpoints without strong evidence base, further complicating the issue.
- Political factors and concerns about conflicts of interest contribute to the reluctance to explore and invest in surrogate endpoints.
The Role of Patents and Exclusivity Periods in Incentivizing Innovation
25:15 - 32:07
- Private firms may not be interested in funding long clinical trials due to corporate termism, where they prioritize short-term gains over long-term benefits.
- The distortion in the trial selection process could be driven by patents or other distortions in the financing market.
- The social welfare gains of investing in technologies that allow for shorter clinical trials were quantified, regardless of whether patents were responsible for the distortion.
- Exclusivity periods provided by regulators can replicate the incentives provided by patents and offer more flexibility.
- Shifting the emphasis from patents to exclusivity periods could better align private incentives with social value.
- The FDA has a good track record with exclusivity periods in the US, and they are trusted by firms.
- Exclusivity periods have been used in targeted cases, but there is potential for broader use to incentivize socially valuable drugs.
- Designing alignment between incentives and social value requires careful consideration and planning from policymakers.
Building Interest in Important Ideas and Effective Collaboration
31:40 - 38:14
- The speaker is interested in focusing on policy in cases where there is a tractable opening and a potential solution to important problems.
- They have received hate mail from doctors for advocating for investing in technologies that would allow shorter clinical trials.
- It is important to build interest in ideas that are good but need careful handling and involve the right people in discussions.
- A paper from 2015 discussing investing in technologies for economic growth has gained more interest recently.
- Basic researchers should identify facts and ideas to improve welfare, and wait for the right opportunity to translate them into policy.
- Engaging enough as basic researchers is crucial to recognize windows of opportunity when they arise.
Bottlenecks and Decision-Making Processes in Research Funding Agencies
37:57 - 44:25
- Funding for basic scientific research is a fundamental issue, with different agencies having different mechanisms for granting money quickly.
- The National Science Foundation (NSF) has the ability to give out grants within two weeks, while the National Institutes of Health (NIH) does not have the same flexibility due to constraints from Congress.
- Understanding bottlenecks and decision-making processes within agencies is crucial for making real progress.
- The speaker took a leave from academia to work full-time with the Institute for Virus Research and plans to return to teaching in the future.
- There may be problems within team projects, such as free riding or disagreements between co-authors. Clear communication and setting expectations can help solve these issues efficiently.
Effective Collaboration and Time Management in Research
44:10 - 50:27
- The speaker met Alec and Caleb from the Institute for Virus and decided to focus on working with them in DC.
- They had to inform their co-authors that they would be taking leave from joint projects, causing some confusion.
- The speaker emphasized the importance of clear communication and setting realistic expectations when collaborating on projects.
- They mentioned the need to respect other people's time constraints, such as tenure clocks or PhD dissertation timelines.
- The speaker personally chooses projects that they find interesting enough to work on alone if necessary, but values the feedback received through co-authoring.
- Apologizing and making realistic plans when unexpected issues arise is important in maintaining good collaboration.
- It is recommended for young academics to choose topics they are genuinely interested in and capable of working on independently, as research projects can take years to complete.
- As team sizes grow larger in scientific research, effective management becomes crucial, including regular meetings and follow-ups.
- Managing personal relationships within a research team requires careful communication and understanding that different individuals have different interests and pressures.
- Collaboration in research is flexible, allowing for new relationships to form if current ones are not working out. However, there is a need for more professionalization in managing research collaborations.
Time Management Strategies and Work-Life Balance
50:22 - 56:37
- The speaker suggests prioritizing three important projects each quarter and making progress on them weekly. They also emphasize the need to avoid spending too much time on short-term tasks and instead focus on long-term priorities.
- The speaker encourages reflecting on how time is spent and feeling guilty if no progress is made on the prioritized projects. They mention different strategies, such as scheduling focused work times or pairing tasks to maximize productivity.
- The speaker advises finding a balance between feeling guilty about not meeting goals and not dwelling on it for too long. They suggest limiting guilt to five minutes before returning to work.
- The speaker acknowledges the flexibility researchers have in determining their work hours. They mention having intrinsic motivation and enjoying their work, which influences how they approach their working hours.
- The speaker shares personal experiences of how life events, such as having children, can impact their work schedule. They prioritize spending time with their kids and may end up working late as a result.
Personal Insights and Work Habits
56:07 - 59:27
- The speaker used to give talks to graduate students about the importance of sleep, but had to stop because they were not getting enough sleep themselves.
- The speaker prioritizes spending time with their kids over getting enough sleep.
- The speaker works late at night in order to have dinner with their kids every night.
- The speaker emphasizes the importance of setting priorities and structuring one's life accordingly.
- The speaker encourages people without kids to prioritize sleep.
- Both the host and the guest work on weekends, but have routines that include family time and exercise.
- The guest feels it is important to do data analysis regularly and considers it a waste if a week goes by without doing so.