Economist Cooper awarded Carnegie Fellowship for work on drug pricing

Yale health economist Zack Cooper has received a 2019 Andrew Carnegie Fellowship to support data-driven research on pharmaceutical pricing.

Cooper, associate professor of public health at the Yale School of Public Health and in the Department of Economics, is one of 32 recipients of this year’s fellowships, awarded by the Carnegie Corporation of New York. Each fellow will receive a grant of up to $200,000 to pursue research and writing in the social sciences and humanities. Cooper’s work focuses on rigorous, data-driven scholarship that can shape healthcare policy and make the U.S. health system more efficient.

The grant will help fund a project examining the pricing of biologic drugs — pharmaceuticals produced from living organisms instead of synthetic chemicals. Biologics are used to treat many diseases, including rheumatoid arthritis, diabetes, Crohn’s disease, and several forms of cancer. 

Although they only account for about 1% of the pharmaceutical drug market, biologics represent about 30% of drug spending, dominate the R&D pipelines at many major pharmaceutical companies, and will play a vital role in the future of the pharmaceutical industry, said Cooper.

“Biologic drugs are emblematic of the tensions we face in health care at the moment,” said Cooper, the director of health policy at Yale’s Institution for Social and Policy Studies. “Consumers are worried about the rising costs of biologics and other prescription drugs. On the flip side, many people rely on these innovative medications to protect their health. The question is how we make this sector of the economy more efficient, increase access to vital medications, and continue to drive innovation — what is the regulatory structure that makes the market work more effectively?”

There is robust policy to support the approval and adoption of generic drugs, which has transformed the pricing of traditional, small-molecule pharmaceutical products, said Cooper. However, policymakers are still working to develop a regulatory environment for bio-similar drugs, which are generic equivalents of biologics, he explained.

“Biologic drugs, simply stated, face less competition than branded, small molecule drugs,” he said. “The result is that biologics can have extremely high prices.”

Cooper’s project aims to characterize the market for one major class of biologics — TNF inhibitors — identifying how prices have increased over time and what has caused them to rise. From there, he will study how competition could affect prices in the sector. The goal is to provide evidence needed to shape effective public policy for lowering the prices of biologic drugs, he said.

“Policymakers are extremely interested in prescription drug spending, but there is a very thin evidence base due to a lack of available data,” he said. “We hope to fix that by producing data-driven evidence that can inform policymakers about how to regulate and structure incentives in the specialty drug.”

Cooper’s past research has examined the pricing of hospital care, the role of consumerism in the healthcare space, and the influence of politics on healthcare spending. He has presented his work at the White House, the Department of Justice, the Federal Trade Commission, and the Department of Health and Human Services. 

At least one Yale faculty member has received a Carnegie Fellowship each year since the corporation began awarding the grants in 2015.