Working Paper: NBER ID: w31673
Authors: Kevin Callison; Michael E. Darden; Keith F. Teltser
Abstract: We evaluate the introduction of direct-acting antiviral (DAA) therapy for Hepatitis C (HCV) on liver transplant allocation in the United States. We develop a model of listing and organ acceptance behavior for patients with both HCV-positive and HCV-negative end-stage liver disease. In the model, DAAs obviate the need for transplant for some HCV-positive patients, which shortens the waiting list, potentially benefiting HCV-negative registrants and inducing marginal HCV-negative patients to list. Using data from the universe of transplants between 2005 and 2019, we find that DAA availability resulted in an additional 5,682 liver transplants to HCV-negative recipients between 2014 and 2019, driven in part by a 37% average annual increase in HCV-negative waiting list registrations. Our estimates imply that DAAs generated $7.52 billion in positive externalities for HCV-negative patients during this period.
Keywords: medical innovation; liver transplantation; hepatitis C; direct-acting antivirals
JEL Codes: I10; I11; I14; O3
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| DAAs (Y10) | liver transplants to HCV-negative recipients (I12) |
| DAAs (Y10) | HCV-negative waiting list registrations (I18) |
| DAAs (Y10) | positive externalities for HCV-negative patients (D62) |
| DAAs (Y10) | HCV liver transplants (I12) |
| DAAs (Y10) | HCV-positive liver transplants (I12) |
| HCV-positive patients (I13) | listing for transplant (Y60) |