Mark Trusheim

Sloan School of Management
100 Main Street, E62-518
Cambridge, MA 02142
Tel: 617/253-2659

E-Mail: EmailAddress: hidden: you can email any NBER-related person as first underscore last at nber dot org
Institutional Affiliation: Massachusetts Institute of Technology

NBER Working Papers and Publications

April 2018The Information Pharms Race and Competitive Dynamics of Precision Medicine: Insights from Game Theory
with Ernst R. Berndt
in Economic Dimensions of Personalized and Precision Medicine, Ernst R. Berndt, Dana P. Goldman, and John W. Rowe, editor
Precision medicines inherently fragment treatment populations, generating small-population markets, creating high-priced “niche busters” rather than broadly prescribed “blockbusters”. It is plausible to expect that small markets will attract limited entry in which a small number of interdependent differentiated product oligopolists will compete, each possessing market power. Multiple precision medicine market situations now resemble game theory constructs such as the prisoners’ dilemma and Bertrand competition. The examples often involve drug developer choices created by setting the cut-off value for the companion diagnostics to define the precision medicine market niches and their payoffs. Precision medicine game situations may also involve payers and patients who attempt to change ...
June 2015An Overview of the Stratified Economics of Stratified Medicine
with Ernst R. Berndt: w21233
The economics of stratified medicine depend critically on setting the cut-off score of the companion diagnostic (CDx). This action integrates scientific, clinical, ethical and commercial considerations, and simultaneously determines the value of the stratified medicine to developers, providers, payers and patient. Setting a high cut-off ensures a larger response by excluding more non-responders but also denies treatment to patients who would respond. This creates ethical and clinical concerns, and limits market size. Setting a low cut-off includes more patients who can benefit but includes more non-responders with commensurate costs, side effects and lost time. CDx’s capture little value under current reimbursement and exclusivity protections. Combined with low CDx investment incenti...
May 2010Characterizing Markets for Biopharmaceutical Innovations: Do Biologics Differ from Small Molecules?
with Murray L. Aitken, Ernst R. Berndt: w16014
Much has been written about the seemingly less formal, more agile biotechnology industry and its extensive interactions with academia and startups, as well as its distinct scientific, manufacturing and regulatory profile. Employing a data base encompassing all 96 biologics and 212 small molecules newly launched in the U.S. between 1998Q1 and 2008Q4, we compare their downstream clinical and commercial characteristics -- therapeutic class concentration, launch delays following approval, Orphan Drug and priority review status, supplemental indications, black box warning and safety record, and pricing and revenue growth during the product life cycle. We conclude that the market dynamics of biologics differ substantially from those of small molecules, although therapeutic class composition pl...
January 2010Characterizing Markets for Biopharmaceutical Innovations: Do Biologics Differ from Small Molecules?
with Murray L. Aitken, Ernst R. Berndt
in Frontiers in Health Policy Research, volume 13, David Cutler, Alan Garber, Dana Goldman, and William Vogt, organizers
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