Faculty Directory

Darius N. LakdawallaPhD

Darius N. LakdawallaPhD

Professor of Pharmaceutical Economics and Public Policy; Quintiles Chair in Pharmaceutical and Regulatory Innovation

Department of Pharmaceutical and Health Economics

Darius Lakdawalla is a widely published, award-winning researcher and a leading authority in both health economics and health policy. He also holds the Quintiles Chair in Pharmaceutical Development and Regulatory Innovation at USC, where he sits on the faculties of the school and the Price School of Public Policy. He is a senior fellow at the USC Leonard D. Schaeffer Center for Health Policy & Economics, one of the nation’s premier health policy research centers.

His research has focused primarily on the economics of risks to health, the value and determinants of medical innovation, the economics of health insurance markets and the industrial organization of healthcare markets.

Lakdawalla received his PhD in economics from the University of Chicago and his bachelor’s degree in mathematics and philosophy from Amherst College. His work has been published in leading journals of economics, medicine and health policy.

He is currently a research associate at the National Bureau of Economic Research and associate editor for the Review of Economics and Statistics, The American Journal of Health Economics and The Journal of Health Economics. He is also an editorial board member at the American Journal of Managed Care: Evidence-Based Diabetes and the American Journal of Managed Care: Evidence-Based Oncology.

Areas of Expertise

  • Health Economics
  • Health Policy
  • Economics
  • Medicines
  • Health Care
  • Education

    University of Chicago


    Amherst College


  • Links
  • Selected Articles

    Lifetime Economic Burden of Crohn’s Disease and Ulcerative Colitis by Age at Diagnosis

    Clinical Gastroenterology and Hepatology
    Gary R Lichtenstein, Ahva Shahabi, Seth A Seabury, Darius N Lakdawalla, Oliver Díaz Espinosa, Sarah Green, Michelle Brauer, Robert N Baldassano

    2019 Understanding the burden of Crohn’s disease (CD) and ulcerative colitis (UC) is important for measuring treatment value. We estimated lifetime healthcare costs incurred by patients with CD or UC by age at diagnosis.

    Read More

    Evaluation of Medical Technologies with Uncertain Benefits

    NBER Working Paper No. 26058
    Darius N. Lakdawalla, Charles E. Phelps

    2019 Cost-effectiveness analysis (CEA) remains the de-facto method of choice to evaluate and compare medical interventions. Standard approaches to CEA use the average (mean) outcomes from clinical effectiveness studies such as randomized controlled trials. This paper generalizes standard methods to include uncertainty in clinical outcomes and proposes a generalized version of the quality-adjusted life-year (QALY), referred to as a quality- and risk-adjusted life-year (QRALY). Our approach requires new information from clinical studies – not only means and variances of health outcomes, but also skewness. With that added parameter, this paper shows how Taylor Series expansions of expected utility can account for two distinct effects of uncertainty: the “insurance value” of reducing overall risks to health, and the “value of hope” produced by the presence of positively skewed outcomes. Simulations demonstrate that stochastic terms are particularly important when baseline disease severity is high, and mean treatment effects are low. They also demonstrate that the variance-based term has the greatest importance among the stochastic terms, although skewness- and kurtosis-based terms can be significant in some situations.

    Read More

    The Value of Progression-Free Survival in Metastatic Breast Cancer: Results From a Survey of Patients and Providers

    MDM Policy & Practice
    Joanna P. MacEwan, Jason Doctor, Karen Mulligan, Suepattra G. May, Katharine Batt, Christopher Zacker, Darius Lakdawalla, Dana Goldman

    2019 Value assessments and treatment decision making typically focus on clinical endpoints, especially overall survival (OS). However, OS data are not always available, and surrogate markers may also have some value to patients. This study sought to estimate preferences for progression-free survival (PFS) relative to OS in metastatic breast cancer (mBC) among a diverse set of stakeholders—patients, oncologists, and oncology nurses—and estimate the value patients and providers place on other attributes of treatment. Methods. Utilizing a combined conjoint analysis and discrete choice experiment approach, we conducted an online prospective survey of mBC patients and oncology care providers who treat mBC patients across the United States. Results. A total of 299 mBC patients, 100 oncologists, and 99 oncology nurses completed the survey. Virtually all patients preferred health state sequences with contiguous periods of PFS, compared with approximately 85% and 75% of nurses and oncologists, respectively. On average, longer OS was significantly (P < 0.01) preferred by the majority (75%) patients, but only 15% of nurses preferred longer OS, and OS did not significantly affect oncologists’ preferred health state. However, in the context of a treatment decision, whether a treatment offered continuous periods of stable disease holding OS constant significantly affected nurses’ treatment choices. Patients and providers alike valued reductions in adverse event risk and evidence from high-quality randomized controlled clinical trials. Conclusions. The strong preference for observed PFS suggests more research is warranted to better understand the reasons for PFS having positive value to patients. The results also suggest a range of endpoints in clinical trials may have importance to patients.

    Read More

    Understanding price growth in the market for targeted oncology therapies.

    The American Journal of Managed Care
    Sussell J, Vanderpuye-Orgle J, Vania D, Goertz HP, Lakdawalla D

    2019 The causes of oncology drug price growth remain unclear. Analyzing corresponding trends in revenue can help understand these causes. This study seeks to assess changes over time in prices, patient counts, and drug-level revenues in the US market for oncology therapies and to investigate whether price growth is driven by an increased ability by pharmaceutical firms to capture profits.

    Read More

    How Does Treating Chronic Hepatitis C Affect Individuals in Need of Organ Transplants in the United Kingdom?

    Value in Health
    Anupam Bapu Jena, Julia Thornton Snider, Oliver Diaz Espinosa, Andy Ingram, Yuri Sanchez Gonzalez, Darius Lakdawalla

    2019 To estimate the impact of cures for chronic hepatitis C (CHC) infection on organ donation in the United Kingdom. Curing CHC infection reduces the need for liver transplants and enables cured individuals to donate organs of all types.

    Read More

  • Affiliations
    • National Bureau of Economic Research : Research associate

    • Review of Economics and Statistics : Associate editor

    • American Journal of Health Economics : Associate editor

    • Journal of Health Economics : Associate editor

    • American Journal of Managed Care: Evidence-Based Diabetes : Editorial board member

    • American Journal of Managed Care: Evidence-Based Oncology : Editorial board member

    • American Economic Association : Member

    • International Health Economics Association : Member

    • American Law and Economics Association : Member

  • Accomplishments

    JMCP Award for Excellence

    2016Awarded annually to recognize an article that represents the best scholarly work in managed care pharmacy, for “Patterns of Adherence to Oral Atypical Antipsychotics Among Patients Diagnosed with Schizophrenia.”

    Eugene Garfield Economic Impact of Medical and Health Research Award

    2009Awarded annually to an outstanding paper demonstrating how medical and health research impacts the economy, for “US Pharmaceutical Policy in a Global Marketplace.”

  • Selected Media Appearances

    Health Care’s Killer App: Life Insurance

    The Wall Street Journal | 03/20/2019

    Imagine a scenario in which a 57-year-old man with an individual health-insurance policy is diagnosed with cancer. As soon as the diagnosis is made, the incentives of the man and those of his health insurer diverge...

    Read More

    White House advisers cite USC research as basis for potential drug price reforms

    USC News | 02/14/2018

    The council, comprised of 14 of the nation’s top economists advising the president, cites more than 40 peer-reviewed articles and white papers by leading U.S. health policy researchers and analysts. Three papers authored by Dana Goldman, Darius Lakdawalla and Neeraj Sood of the USC Schaeffer Center are prominently cited in this White House report...

    Read More

    Putting More Value Into Biopharmaceutical Value Assessments

    Health Affairs | 01/03/2018

    Calls for prescription drug pricing transparency currently echo through state legislatures. Vermont, Maryland, and California have passed legislation requiring various aspects of prescription drug pricing to be made public. Numerous other legislative bodies are considering related efforts...

    Read More

    Why America needs a ‘do-over’ on Medicaid reform

    The Conversation | 05/11/2017

    One of the most important pieces of the newly passed House health bill is a possible US$800 billion cut over 10 years to Medicaid, the federal program designed to provide insurance coverage to the poor...

    Read More

    How Republicans and Democrats can both keep their promises on health care

    The Conversation | 03/02/2017

    Republicans who want to repeal the Affordable Care Act (ACA) emphasize the importance of patient choice and market efficiency. Democrats opposing repeal focus on the need to protect the most vulnerable...

    Read More