Faculty Directory

Maddalena Ferranna

Maddalena Ferranna

Assistant Professor of Pharmaceutical and Health Economics

Department of Pharmaceutical and Health Economics

Maddalena Ferrana, PhD, is an assistant professor of pharmaceutical and health economics. She received a PhD in economics from Toulouse School of Economics and was a values and public policy postdoctoral fellow at Princeton University.

Prior to joining USC, she was a research associate at the Harvard T.H. Chan School of Public Health. Her main research interests are welfare economics, global health and climate change economics, particularly the development and application of methods to assess the equity implications of health and environmental interventions.

    Areas of Expertise

    • Benefit-Cost Analysis
    • Social Welfare Analysis
    • Vaccination
    • Type 1 Diabetes
    • Climate change and health
    • Links
    • Selected Articles

      The Benefits and Costs of U.S. Employer COVID-19 Vaccine Mandates

      Risk Analysis
      Maddalena Ferranna, Lisa A. Robinson, Daniel Cadarette, Mike R. Eber, David E. Bloom

      In 2021, the Biden Administration issued mandates requiring COVID-19 vaccinations for U.S. federal employees and contractors and for some healthcare and private sector workers. These mandates have been challenged in court; some have been halted or delayed. However, their costs and benefits have not been rigorously appraised. This study helps fill that gap. We estimate the direct costs and health-related benefits that would have accrued if these vaccination requirements had been implemented as intended. Compared with the January 2022 vaccination rates, we find that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population from 64% to 68%. The associated net benefits depend on the subsequent evolution of the pandemic-information unavailable ex ante to analysts or policymakers. In scenarios involving the emergence of a novel, more transmissible variant, against which vaccination and previous infection offer moderate protection, the estimated net benefits are potentially large. They reach almost $20,000 per additional vaccinated individual, with more than 20,000 total deaths averted over the 6-month period assessed. In scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates' benefits are unlikely to exceed their costs. Thus, mandates may be most useful when the consequences of inaction are catastrophic. However, we do not compare the effects of mandates with alternative policies for increasing vaccination rates or for promoting other protective measures, which may receive stronger public support and be less likely to be overturned by litigation.

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      The Full Health, Economic, and Social Benefits of Prospective Strep A Vaccination

      npj Vaccines
      Daniel Cadarette, Maddalena. Ferranna, Jeff W. Cannon, Kaja Abbas, Fiona Giannini, Leo Zucker, David E. Bloom

      Recent research has documented a wide range of health, economic, and social benefits conferred by vaccination, beyond the direct reductions in morbidity, mortality, and future healthcare costs traditionally captured in economic evaluations. In this paper, we describe the societal benefits that would likely stem from widespread administration of safe and effective vaccines against Streptococcus pyogenes (Strep A), which was estimated to be the fifth-leading cause of infectious disease deaths globally prior to the COVID-19 pandemic. We then estimate the global societal gains from prospective Strep A vaccination through a value-per-statistical-life approach. Estimated aggregate lifetime benefits for 30 global birth cohorts range from $1.7 to $5.1 trillion, depending on the age at which vaccination is administered and other factors. These results suggest that the benefits of Strep A vaccination would be large and justify substantial investment in the vaccines’ development, manufacture, and delivery.

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      COVID-19 Vaccine Allocation: Modeling Health Outcomes and Equity Implications of Alternative Strategies

      Engineering
      Maddalena Ferranna, Daniel Cadarette, David E. Bloom

      Given the scarcity of safe and effective COVID-19 vaccines, a chief policy question is how to allocate them among different sociodemographic groups. This paper evaluates COVID-19 vaccine prioritization strategies proposed to date, focusing on their stated goals; the mechanisms through which the selected allocations affect the course and burden of the pandemic; and the main epidemiological, economic, logistical, and political issues that arise when setting the prioritization strategy. The paper uses a simple, age-stratified susceptible–exposed–infectious–recovered model applied to the United States to quantitatively assess the performance of alternative prioritization strategies with respect to avoided deaths, avoided infections, and life-years gained. We demonstrate that prioritizing essential workers is a viable strategy for reducing the number of cases and years of life lost, while the largest reduction in deaths is achieved by prioritizing older adults in most scenarios, even if the vaccine is effective at blocking viral transmission. Uncertainty regarding this property and potential delays in dose delivery reinforce the call for prioritizing older adults. Additionally, we investigate the strength of the equity motive that would support an allocation strategy attaching absolute priority to essential workers for a vaccine that reduces infection-fatality risk.

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      Fair innings? The utilitarian and prioritarian value of risk reduction over a whole lifetime

      Journal of Health Economics
      Matthew Adler, Maddalena Ferranna, James Hammitt, Nicolas Treich

      The social value of risk reduction (SVRR) is the marginal social value of reducing an individual’s fatality risk, as measured by some social welfare function (SWF). This Article investigates SVRR, using a lifetime utility model in which individuals are differentiated by age, lifetime income profile, and lifetime risk profile. We consider both the utilitarian SWF and a “prioritarian” SWF, which applies a strictly increasing and strictly concave transformation to individual utility. We show that the prioritarian SVRR provides a rigorous basis in economic theory for the “fair innings” concept, proposed in the public health literature: as between an older individual and a similarly situated younger individual (one with the same income and risk profile), a risk reduction for the younger individual is accorded greater social weight even if the gains to expected lifetime utility are equal. The comparative statics of prioritarian and utilitarian SVRRs with respect to age, and to (past, present, and future) income and baseline survival probability, are significantly different from the conventional value per statistical life (VSL). Our empirical simulation based upon the U.S. population survival curve and income distribution shows that prioritarian SVRRs with a moderate degree of concavity in the transformation function conform to widely held views regarding lifesaving policies: the young should take priority but income should make no difference.

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      The Social Cost of Carbon: Valuing Inequality, Risk and Population for Climate Policy

      The Monist
      Marc Fleurbaey, Maddalena Ferranna, Mark Budolfson, Francis Dennig, Kian Mintz-Woo, Robert Socolow, Dean Spears, Stephane Zuber

      We analyze the role of ethical values in the determination of the social cost of carbon, arguing that the familiar debate about discounting is too narrow. Other ethical issues are equally important to computing the social cost of carbon, and we highlight inequality, risk, and population ethics. Although the usual approach, in the economics of cost-benefit analysis for climate policy, is confined to a utilitarian axiology, the methodology of the social cost of carbon is rather flexible and can be expanded to a broader set of social-welfare approaches.

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