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Lucy Msall

(last name pronounced ‘muh-sal’)

I am a PhD student in Economics at the University of Chicago’s Booth School of Business. My current research interests are in Public Finance. Prior to graduate school, I worked as a political campaign staffer, government employee, and NBER Research Assistant.

Work in Progress

 “Regulation & Innovation: Firm Responses to Allowing Women in Early Clinical Trials” with Valerie Michelman

Abstract: Regulatory policy has the potential to distort private investment decisions. In this project, we study the pharmaceutical industry’s response to the Food and Drug Administration’s 1977-1993 guidance that pre-menopausal women should not be used as human subjects in early stage clinical trials. We model a firm deciding whether to advance a novel drug candidate through stages of development under different stylized FDA policy regimes. At a high-level, the model predicts that the 1977-1993 guidance will induce firms to develop fewer drugs with a high female market share and that approved drugs developed under this regime will be, on average, of lower quality for women. To bring our theory to the data, we have acquired commercial data on the pipeline of drugs in development for the U.S. market from 1989-2020 and are working to use these data to test whether drugs targeting highly female diseases were developed at relatively low rates prior to the 1993 removal of the ban. Estimates of firms’ responsiveness to this policy will inform our understanding of the responsiveness of innovation to cost shocks and will also shed light on the extent to which regulators’ attempts to protect vulnerable populations can result in those populations being underserved by the regulated industry.

 

 

Pre-Doctoral Publications

Decreases In Readmissions Credited To Medicare’s Program To Reduce Hospital Readmissions Have Been Overstated” with Christopher Ody, Leemore Dafny, David Grabowski & David Cutler. Health Affairs, January 2019. Vol. 38, Issue 1. 
Abstract: Medicare’s Hospital Readmissions Reduction Program (HRRP) has been credited with lowering risk-adjusted readmission rates for targeted conditions at general acute care hospitals. However, these reductions appear to be illusory or overstated. This is because a concurrent change in electronic transaction standards allowed hospitals to document a larger number of diagnoses per claim, which had the effect of reducing risk-adjusted patient readmission rates. Prior studies of the HRRP relied upon control groups’ having lower baseline readmission rates, which could falsely create the appearance that readmission rates are changing more in the treatment than in the control group. Accounting for the revised standards reduced the decline in risk-adjusted readmission rates for targeted conditions by 48 percent. After further adjusting for differences in pre-HRRP readmission rates across samples, we found that declines for targeted conditions at general acute care hospitals were statistically indistinguishable from declines in two control samples. Either the HRRP had no effect on readmissions, or it led to a systemwide reduction in readmissions that was roughly half as large as prior estimates have suggested.

Popular Press Coverage: The New York Times, Chicago Booth Review