(last name pronounced ‘muh-sal’)
I am a PhD student in Economics at the University of Chicago’s Booth School of Business and a Master of Legal Studies candidate at the University of Chicago Law School.
My research interests are in Public Finance. Prior to graduate school, I worked as a political campaign staffer, government employee, and NBER Research Assistant.
I can be reached via email at lmsall [at] chicagobooth.edu
Work In Progress
Abstract: This paper considers the consequences of unequal representation in research. From 1977-1993, the Food and Drug Administration (FDA) issued guidance that “women of childbearing potential” should not be included as human subjects in early-stage clinical trials. We study how the pharmaceutical industry’s response to the guidance shaped the course of innovation serving men and women. We develop a model of drug development which predicts that the guidance leads to less innovation for female-focused drugs. Compliance with the guidance decreases the informativeness of clinical trials for drugs intended to treat predominantly female diseases, resulting in higher expected costs. To bring our theory to the data, we link biomedical patents, commercial data on drug development, and FDA records of approved drugs. By exploiting the contrast between drug and non-drug biomedical patents, we estimate that the guidance resulted in a sex-specific drug innovation gap of 14%. We test for downstream effects on drug development and approval. Our results inform current policy tradeoffs about underrepresentation of racial minorities, pregnant people, and older adults in clinical research.
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.