From the moment Marie Curie announced the existence of radium, the strange new element captured the imagination of the American public. Radium, it seemed, could do anything. It gave off its own light and heat and appeared to realize the ancient alchemical dream of transmutation. It also showed promise as a medicine. The press ran with the idea that radium was a panacea that would cure everything from cancer to wife-beating. Soon it became impossible for the public to know what to believe when it came to radium and its effects on the body. Patent medicine companies exploited the murkiness surrounding ideas about radium, marketing a slew of products that claimed to harness the element’s healing and energizing powers. Meanwhile, physicians made slow, careful progress in defining the parameters of radium therapy, narrowing their focus to cancer. The popularity of radium patent medicines peaked in the 1920’s when hundreds of thousands of Americans purchased one or more of the dozens of radium products that proliferated at the time. Government regulators and members of the medical establishment sought to push these products from the market, but loopholes in the regulatory apparatus created under the Pure Food and Drug Act of 1906 allowed many of these companies to operate freely. Two scandals—the saga of the “Radium Girls” and the death of Eben Byers, a well-known industrialist who died after drinking over 1000 bottles of a radioactive tonic called Radithor—damaged radium’s image in the 1920’s and 1930’s. By the late 1930’s, strengthened regulatory laws helped push radioactive products from the marketplace. During World War II, scientists discovered artificial isotopes that proved more effective and less expensive than radium in the treatment of disease. For decades Americans had struggled to make sense of a scientific discovery that seemed to challenge fundamental ideas about the nature of the body and its relationship to the physical world. The ambiguities surrounding the element posed a unique challenge to progressive ideals of expertise and professionalization while providing a malleable image of energy and health that a variety of commercial interests could deploy. / text

In May 2004 there was a shake-up in the private pharmaceutical industry in South Africa. The National Department of Health (DOH) introduced a form of price control which for the first time attempted to regulate prices at every level of the pharmaceutical distribution chain. The price controls was immediately challenged and was not properly implemented until partially upheld by the Constitutional Court at the end of 2005. Throughout 2006 the DOH (through the Pricing Committee) reconsidered parts of the price controls, dealing with an appropriate dispensing fee for retailers, which were struck down by the Constitutional Court. In late 2006, a new dispensing fee was published and then immediately challenged. The DOH claims they had to do this to make sure that medicines remain affordable, and pharmacists at the end of the day get a reasonable income from each price band. The United South African Pharmacies (USAP) and the Pharmacy Stakeholders1 Forum (PSF) claim that implementation of the price controls would have pharmacies not being able to cover their expenses. The objectives of the study are to ascertain whether the price controls forced upon the healthcare industry by the DOH of South Africa is viable in small retail pharmacies and what the impact will be on small retail pharmacies and their communities. The actual annual income statements for 2006 of three typical pharmacies were obtained. The next step was to determine the effect that the price controls would have had on the total sales and key financial factors in the income statement if the price controls was already in force in 2006. A revised experimental income statement was then created for the pharmacies. The experimental statements were then compared to the actual statements to determine the effects of the price controls. The comparison showed that all the pharmacies were following the same trend and had a decrease in net profit. Two of the pharmacies would have had a net loss for the year while the third will continue to show a net profit although much lower. This net profit decreased from 7% to 3% following a decrease in gross profit (GP) from 33% to 30%. The GP of the front sales shop remained unchanged, while the GP percentage for the dispensary decreased by 5% from 30% to 25%. The DuPont model showed that the Return on Equity (ROE) decreased from 83% to 33%. Drug price regulations could force many pharmacies into bankruptcy and ensure that the distribution of drugs to rural and remote areas will be financially impracticable. Once in place, the drug price regulations are likely to become ever more complex and onerous to comply with. The price regulations may end up reducing price competition among manufacturers, and in the long run, will harm the consumer by fixing prices above what would otherwise have been achieved in an open competitive market. The drug price regulations distort the normal market clearing process and effectively increase demand for medicine without providing the economic incentives that serve to match demand with supply. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2008.

In May 2004 there was a shake-up in the private pharmaceutical industry in South Africa. The National Department of Health (DOH) introduced a form of price control which for the first time attempted to regulate prices at every level of the pharmaceutical distribution chain. The price controls was immediately challenged and was not properly implemented until partially upheld by the Constitutional Court at the end of 2005. Throughout 2006 the DOH (through the Pricing Committee) reconsidered parts of the price controls, dealing with an appropriate dispensing fee for retailers, which were struck down by the Constitutional Court. In late 2006, a new dispensing fee was published and then immediately challenged. The DOH claims they had to do this to make sure that medicines remain affordable, and pharmacists at the end of the day get a reasonable income from each price band. The United South African Pharmacies (USAP) and the Pharmacy Stakeholders1 Forum (PSF) claim that implementation of the price controls would have pharmacies not being able to cover their expenses. The objectives of the study are to ascertain whether the price controls forced upon the healthcare industry by the DOH of South Africa is viable in small retail pharmacies and what the impact will be on small retail pharmacies and their communities. The actual annual income statements for 2006 of three typical pharmacies were obtained. The next step was to determine the effect that the price controls would have had on the total sales and key financial factors in the income statement if the price controls was already in force in 2006. A revised experimental income statement was then created for the pharmacies. The experimental statements were then compared to the actual statements to determine the effects of the price controls. The comparison showed that all the pharmacies were following the same trend and had a decrease in net profit. Two of the pharmacies would have had a net loss for the year while the third will continue to show a net profit although much lower. This net profit decreased from 7% to 3% following a decrease in gross profit (GP) from 33% to 30%. The GP of the front sales shop remained unchanged, while the GP percentage for the dispensary decreased by 5% from 30% to 25%. The DuPont model showed that the Return on Equity (ROE) decreased from 83% to 33%. Drug price regulations could force many pharmacies into bankruptcy and ensure that the distribution of drugs to rural and remote areas will be financially impracticable. Once in place, the drug price regulations are likely to become ever more complex and onerous to comply with. The price regulations may end up reducing price competition among manufacturers, and in the long run, will harm the consumer by fixing prices above what would otherwise have been achieved in an open competitive market. The drug price regulations distort the normal market clearing process and effectively increase demand for medicine without providing the economic incentives that serve to match demand with supply. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2008.

<p>    </p> <p>I worked on two chapters studying the labor markets in Colombia and Iraq. My third chapter analyzed health outcomes in the US. </p> <p><br></p> <p>My first chapter examines whether the three-year gap between the announcement (in 2014) and the start (in 2017) of the Illicit Crop Substitution Program (ICSP) increased child labor in Colombia. My results from a difference-in-differences model using differences in historical coca production show that due to the ICSP announcement, children became four percentage points more likely to work in municipalities with historical coca production than in non–coca-growing areas. </p> <p><br></p> <p>My second chapter ran a randomized control trial and a double-incentivized resume rating to elicit the preferences of employers and job seekers for candidates and vacancies in Iraq. After revealing the ob offer rate for female job seekers, women applied for jobs by three more percentage points than the men in the control group. This paper highlights the value of revealing employers’ preferences to improve the match between female candidates and employers when women underestimate the chances of finding a job. </p> <p><br></p> <p>In my third paper, I study how removing the black box warning on Chantix, a prescription drug used to reduce nicotine consumption, affects veterans’ visits to smoking cessation therapy. Using a difference-in-differences model, I found that veterans schedule almost two more medical consultations in counties with high-quality hospitals than in places with low-quality medical care centers. </p>

Before the regulation of opium as a “narcotic” in Sweden in 1923, opium was not regulated for its intoxicating properties and was freely available. But not in any kind of shop. Opium was legally available only through the pharmacies. This thesis explores how this free availability of a narcotic was understood by its traders, the pharmacists. The title of this thesis – The Value of Poison – indicates how opium could be conceptualized both as a safe, everyday remedy essential to keep freely available and as a drug of intoxication. As a poison it could be articulated as a matter of primarily pharmacological, not moral or medical, concern. This also gave the pharmacists, with their special knowledge of pharmaka (drugs, poisons), an autonomous space of knowledge free from the ever more intruding “medical gaze”. But, in order to articulate this kind of understanding of opium, another kind of knowledge was needed to be acknowledged: that of the user. In this articulation a “sensus communis” was tied in with a broader cultural knowledge of drugs. Problems with opium were focused on the danger of acute poisoning, not recreational intoxication. Concepts that could have problematized this kind of use were rearticulated as problems either of illegitimate trade, unregulated markets and advertising or of draconian regulation by greedy or sloppy doctors. These rather opposite elements were made equivalent through the articulation of ignorance in both cases, thus further emphasizing the special knowledge of the pharmacist. The thesis locates a process of contradiction that contributes to the eventual diminishing of the discourse of poison towards the end of the period. The pharmaceutical knowledge that guaranteed the discourse was based on a “pharmaceutical gaze” on pharmaka. It pierced through the drug to identify its constituent parts. In this process it was promised that the different effects of opium would be separated. “Narcotic” could be a by-product, to be discarded or controlled, without dispensing of other therapeutic effects. With this ever deeper knowledge of opium, knowledge in the pharmacies was made insufficient for the full understanding or opium, and so too was that of the traditional user. The era of opium as a poison was over. / Före den första särlagstiftningen om narkotika i Sverige 1923 reglerades inte opiumets rusgivande egenskaper. Drogen var fritt tillgänglig i handeln. Men inte i vilken butik som helst. Opium kunde bara köpas lagligt på landets apotek. Den här avhandlingen undersöker hur denna fria tillgänglighet av narkotika förstods av droghandlarna själva, apotekarna. Titeln pekar på hur opium på en och samma gång kunde tänkas som en säker husmedicin vars tillgänglighet var avgörande för folkhälsan och som en rusgivande drog. Som ”gift” artikulerades det som en i första hand farmakologisk angelägenhet, inte en moralisk eller medicinsk. När de talade på detta sätt upprättade apotekarna, genom sin särskilda kunskap om farmaka, ett eget rum för sitt vetande, fritt från läkarnas allt mer genomträngande ”kliniska blick”. Men för att kunna artikulera denna förståelse av opium krävdes också att en annan typ av kunskap vidkändes: brukarens. Genom denna artikulation knöts brukarnas ”sensus communis” samman med en bredare kulturell kunskap om droger. De av opiumets problem som lyftes fram handlade om akut förgiftning, inte rekreationellt rusbruk. De begrepp som hade varit möjliga att användas för att problematisera denna senare form av bruk reartikulerades: antingen förpassades de till den olagliga handeln, de oreglerade marknaderna och reklamen, eller också till de drakoniska regleringarna som giriga och slarviga läkare stod bakom. Apotekarna artikulerade dessa båda helt motstående element som ekvivalenta genom en brist på kunskap, vilket i sin tur ytterligare stärkte deras egen kunskapsmakt. Avhandlingen lokaliserar även en processande motsägelse som sker när giftets diskurs tynar bort vid slutet av den undersökta perioden. Den farmaceutiska kunskap som underbyggde diskursen vilade på en ”farmaceutisk blick” på farmaka. Denna genomborrade drogämnet för att avslöja dess beståndsdelar. Genom denna process utlovades att opiumets olika effekter skulle kunna skiljas från varandra. ”Narkotikan” kunde ses som en bieffekt, som kunde kastas åt sidan eller kontrolleras separat, utan att opiumets kvarvarande terapeutiska effekter minskade. Denna allt djupare kunskap medförde att de enskilda apotekarnas eget vetande på apoteken inte räckte till för att fullt ut förstå opium, och därmed bröts även samartikulationen med brukarnas kunskap. Tidseran när opium var ett gift tog därmed slut under mellankrigsperioden.