= 27d567bc2d48d9f40e9ccc20ea370b15)
Forecasting health gaps
You're an average person.
You don't know what diseases you'll get in the future.
You know people get diseases and certain populations get diseases more than others, enough to say certain things cause diseases.
You're not quite the average person.
You have a strong preference against sickness and a strong belief in your ability to mitigate deleterious circumstances.
You have access to preventative research. You know if you don't work in a coal mine, overtrain when running, and eat healthy, you can stay healthier than those who take those risks.
You know that some disease outcomes are less than predictable, so you want to work towards the available of treatments that fill gaps in the availability of therapeutics. For instance, you might want a treatment for HIV to be developed, in case you become HIV infected, since there is a risk of HIV exposure for almost anyone exposed to unprotected sex, since they won't necessarily know their sexual partners entire serohistory (noologism?)
However, you don't know which diseases you will get. So how do you prioritise?
Perhaps, medical device and pharmaceutical company strategies could be ported to your situation.
Most people, including non-epidemiologist researchers, don't have access to epidemiology data sets.
Most people, don't have the patience to read a book on medical market research
You don't have the funds or connections to employ the world's only specialist in the area of medical market forecasting.
At least he's broken down the field into best practice questions:
- Where can we find epidemiological information/data?
- How do we judge/evaluate it?
- What is the correct methodology for using it?
- What's useful and what's not useful for pharma market researchers?
- How do we combine/apply it with MR data?
The only firm, other than Bill's, that appears to specialist in the area fortunately breaks down the techniques in the field for us:
- Integrated forecasts based on choice modeling or univariate demand research to ensure that the primary marketing research is aligned with the needs of forecast
- Volumetric new product forecasting to provide the accuracy required for pre-launch planning
- Combination epidemiology-/sales-volume-based forecast models that provide robust market sizing and trend information
- Custom patient flow models that represent the dynamics of complex markets not possible with cross-sectional methods
- Oncology-specific forecast models to accept the data and assumptions unique to cancer therapeutics and accurately forecast patients on therapy
- Subscription forecasting software for clients who would like to build their own forecasts using user-friendly functionality to save time and prevent calculation and logic errors
The generalisations in the industry, things that are applicable across particular populations, therapeutics or firms appears to be summarised here:
It's 36 pages long, but well worth it if area is interesting to you.
So now you know how this market operates, what are the outputs:
Mega trends are available here
A detailed review is available here
Do they answer the questions, use the techniques proposed, and answer the ultimate question of what gaps exist in the provision of medical therapeutics?
I don't know how to apply the techniques to tell. What do you think?
I know there are other ways to think about these problems.
For instance, if I put myself in a pharmaceutical company's position, I could use strategic tools like Porter's 4 forces and see whether a particular decision looks compelling.
The 2018 paper suggests that pain killers in developed countries are going to get lots of government investment.
So, does it makes sense to supply that demand?
There are a number of highly risky threats that might suggest say a potential poppy producer shouldn't proceed:
**technological**
Disruptive biotechnology, such as genetically modified yeast which can convert glucose to morphine. There have been suggestions that this invention is overhyped
**political**
Licensing poppy producers who currently supply illicit drug producers
This said, the whole thing is very underdetermined so I suspect actual organisations are far more procedural in their approaches. What do you think?
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Rationality and Cancer
Today, my dentist found a possible oral cancer.
I'm 31, a non-smoker, in good health. I know the research showing that doctors ignore base rates and overestimate your chances of cancer. (I asked the doctor the base rate, he didn't know.) I know that we grossly overprescribe biopsies and surgeries, when it would be better to just wait and see. But I'm having it removed and biopsied on Friday, even though I don't have dental insurance and it's costing me $1,000 of my own money.
Why?
I thought this would be an interesting case study: Introspectively, what's going on to make me ignore my rationalist training, ignore the external data, and choose what I know is probably the less optimal path?
My first thought is embarrassment: If I do nothing, and it turns out I have cancer, will my support network roll their eyes and blame me for not being more aggressive? My feeling is yes, that even though they wouldn't do it to my face, they would secretly blame me, and become less available.
My second thought is fear of the unknown: I roughly know what the biopsy will entail. It's a light anesthesia, a few stitches, and 1-2 days of recovery. No big deal. And $1,000 isn't tiny, but it's not a big deal for me, either. In contrast, what happens if I don't do the biopsy? Huge, scary unknown. And, even if I know that I only have a 0.01% chance of having cancer (to guess a number), I also know my emotional mind is bad at math, and I'll have great difficulty controlling its worry. And so, it's rational to buy some level of anti-worry insurance -- I don't know what the rational value of that anti-worry insurance is, and I don't know if that value exceeds $1,000, but clearly, anti-worry insurance has some positive value, and probably a fairly high value.
There are other considerations. I need some wisdom teeth removed, and we're doing them at the same time, so adding the biopsy doesn't affect the recovery time. And I have a 6-week trip to Australia coming up, and I'd hate to have problems while I'm traveling. But mostly, I think it's embarrassment and worry.
By the way, this is a personal matter than I'm choosing to share with you. Honest advice about how to handle it, particularly from people who've faced similar decisions, is welcome and appreciated. Flames about how I'm ignoring research are not. Thanks for understanding.
Update: I talked with a friend who does research in medical decision making. She explained that, for the specific population a doctor serves, he's usually fairly accurate in his estimates of how prevalent a disease is. She also encouraged me that I'm right to get the biopsy. I feel much more relaxed, and I realized that I was feeling guilty about being irrational. I'm sure there's some meta-lesson in there that I'll figure out someday.
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