Health Care Loans For Hep C Cure2016
"A new class of medications was recently approved that cures more than 95 percent of people with Hepatitis C in only six weeks at a cost of about $84,000 per person, and new therapies with price tags that are likely to exceed $1 million per person are now available or coming soon. How can patients possibly afford them?
"In an article published in the journal Science Translation Medicine, we outline a feasible market-based solution that could immediately expand access to transformative medications, including cures for Hepatitis C and cancer. The basic concept is to convert a large upfront medical expense into a series of more affordable payments, akin to getting a mortgage when buying a house. The challenge of curative medications that only require a short course of therapy is that the whole price is paid upfront — how many homeowners could buy their houses using only cash? Instead, most home buyers get a mortgage and make monthly payments for as long as they benefit from owning the house or until the full amount is paid. We propose the same solution to overcome the liquidity problem that prevents access to curative medications, which we call “health care loans,” or HCLs..."
Buying Cures Versus Renting Health: Financing Health Care with Consumer Loans2016
A crisis is building over the prices of new transformative therapies for cancer, hepatitis C virus infection, and rare diseases. The clinical imperative is to offer these therapies as broadly and rapidly as possible. We propose a practical way to increase drug affordability through health care loans (HCLs)—the equivalent of mortgages for large health care expenses. HCLs allow patients in both multipayer and single-payer markets to access a broader set of therapeutics, including expensive short-duration treatments that are curative. HCLs also link payment to clinical benefit and should help lower per-patient cost while incentivizing the development of transformative therapies rather than those that offer small incremental advances. Moreover, we propose the use of securitization—a well-known financial engineering method—to finance a large diversified pool of HCLs through both debt and equity. Numerical simulations suggest that securitization is viable for a wide range of economic environments and cost parameters, allowing a much broader patient population to access transformative therapies while also aligning the interests of patients, payers, and the pharmaceutical industry.
Financing Drug Discovery via Dynamic Leverage2016
We extend the megafund concept for funding drug discovery to enable dynamic leverage in which the portfolio of candidate therapeutic assets is predominantly financed initially by equity, and debt is introduced gradually as assets mature and begin generating cash flows. Leverage is adjusted so as to maintain an approximately constant level of default risk throughout the life of the fund. Numerical simulations show that applying dynamic leverage to a small portfolio of orphan drug candidates can boost the return on equity almost twofold compared with securitization with a static capital structure. Dynamic leverage can also add significant value to comparable all-equity-financed portfolios, enhancing the return on equity without jeopardizing debt performance or increasing risk to equity investors.
Lessons From Hollywood: A New Approach To Funding R&D2016
In this article, we suggest an alternative structure for undertaking the long-term, high-risk, highly capital-intensive R&D programs that typify science-based settings. We refer to this structure as a project-focused organization (PFO). PFOs are entities that are created with the sole purpose of conducting a specific R&D project. When the project is completed, the PFO is disbanded, residual returns (if there are any) are distributed to investors, and intellectual property and other assets are sold off. We think PFOs are an attractive alternative to both the traditional vertical integration model and the traditional venture capital/entrepreneurial startup model. We discuss how such PFOs could work in practice, using the example of biopharmaceutical R&D, although we argue that the structure has much broader applicability.
What Is An Index?2016
Technological advances in telecommunications, securities exchanges, and algorithmic trading have facilitated a host of new investment products that resemble theme-based passive indexes but which depart from traditional market-cap-weighted portfolios. I propose broadening the definition of an index using a functional perspective—any portfolio strategy that satisfies three properties should be considered an index: (1) it is completely transparent; (2) it is investable; and (3) it is systematic, i.e., it is entirely rules-based and contains no judgment or unique investment skill. Portfolios satisfying these properties that are not market-cap-weighted are given a new name: “dynamic indexes.” This functional definition widens the universe of possibilities and, most importantly, decouples risk management from alpha generation. Passive strategies can and should be actively risk managed, and I provide a simple example of how this can be achieved. Dynamic indexes also create new challenges of which the most significant is backtest bias, and I conclude with a proposal for managing this risk.
Risk and Risk Management in the Credit Card Industry2016
Using account level credit-card data from six major commercial banks from January 2009 to December 2013, we apply machine-learning techniques to combined consumer-tradeline, credit-bureau, and macroeconomic variables to predict delinquency. In addition to providing accurate measures of loss probabilities and credit risk, our models can also be used to analyze and compare risk management practices and the drivers of delinquency across the banks. We find substantial heterogeneity in risk factors, sensitivities, and predictability of delinquency across banks, implying that no single model applies to all six institutions. We measure the efficacy of a bank’s risk-management process by the percentage of delinquent accounts that a bank manages effectively, and find that efficacy also varies widely across institutions. These results suggest the need for a more customized approached to the supervision and regulation of financial institutions, in which capital ratios, loss reserves, and other parameters are specified individually for each institution according to its credit-risk model exposures and forecasts.
The Gordon Gekko Effect: The Role of Culture in the Financial Industry2016
Culture is a potent force in shaping individual and group behavior, yet it has received scant attention in the context of financial risk management and the recent financial crisis. I present a brief overview of the role of culture according to psychologists, sociologists, and economists, and then present a specific framework for analyzing culture in the context of financial practices and institutions in which three questions are answered: (1) What is culture?; (2) Does it matter?; and (3) Can it be changed? I illustrate the utility of this framework by applying it to five concrete situations—Long Term Capital Management; AIG Financial Products; Lehman Brothers and Repo 105; Société Générale’s rogue trader; and the SEC and the Madoff Ponzi scheme—and conclude with a proposal to change culture via “behavioral risk management.”
Where to From Here?2015
Ever since the Great Recession, the global financial regulatory system has undergone significant changes. But have these changes been sufficient? Have they created a new problem of over-regulation? Is the system currently in a better position than in the pre-Recession years, or have we not adequately addressed the basic causes of the financial crisis and resulting Great Recession These were the questions and issues addressed in the seventeenth annual international banking conference held at the Federal Reserve Bank of Chicago in November 2014. In collaboration with the Bank of England, the theme of the conference was to examine the state of the new global financial system as it has evolved in response to significant market changes and regulatory reforms triggered by the global financial crisis. The papers from that conference are collected in this volume, with contributions from an international array of government officials, regulators, industry practitioners and academics.
The Wisdom of Crowds Vs. the Madness of Mobs2015
Intelligence does not arise only in individual brains; it also arises in groups of individuals. This is collective intelligence: groups of individuals acting collectively in ways that seem intelligent. In recent years, a new kind of collective intelligence has emerged: interconnected groups of people and computers, collectively doing intelligent things. Today these groups are engaged in tasks that range from writing software to predicting the results of presidential elections. This volume reports on the latest research in the study of collective intelligence, laying out a shared set of research challenges from a variety of disciplinary and methodological perspectives. Taken together, these essays—by leading researchers from such fields as computer science, biology, economics, and psychology—lay the foundation for a new multidisciplinary field.
Pioneered by the Nobel Prize–winning economist Harry Markowitz over half a century ago, portfolio theory is one of the oldest branches of modern financial economics. It addresses the fundamental question faced by an investor: how should money best be allocated across a number of possible investment choices? That is, what collection or portfolio of financial assets should be chosen? In this article, we describe the fundamentals of portfolio theory and methods for its practical implementation. We focus on a fixed time horizon for investment, which we generally take to be a year, but the period may be as short as days or as long as several years. We summarize many important innovations over the past several decades, including techniques for better understanding how financial prices behave, robust methods for estimating input parameters, Bayesian methods, and resampling techniques.