Chiara Gardenghi


NYU, Stern School of Business

Dept. Economics


Welcome!  

I am a Ph.D. candidate in Economics at the New York University Stern School of Business. 

I work on industrial organization and health economics. My JMP examines how bundled discounts offered by pharmaceutical companies affect physician decision-making and the resulting welfare outcomes. 

My CV is available here.

You can reach me at cg3454@stern.nyu.edu


I am on the 2024/2025 job market.

References:




Working Papers

In many industries, multi-product sellers offer bundled loyalty discounts to buyers who refrain from purchasing competing products from rivals. These contracts can increase sales volumes by helping sellers establish a strong customer base across their product portfolios, but they also risk foreclosing competing sellers, even those offering superior products. I examine the welfare implications of bundled loyalty discounts in the context of physician-administered vaccines, which medical providers purchase and administer directly to their patients. I use prior antitrust cases involving vaccines to recover the proprietary terms of bundled discount contracts. I then develop a model of medical providers’ demand and pharmaceutical companies’ supply of vaccines. Using all-payer claims data from Colorado to estimate the model, I recover medical providers’ preferences, vaccines’ marginal costs, and the magnitude of bundled discounts that rationalizes providers’ observed purchasing patterns. I use the model to evaluate the equilibrium and welfare effects of banning bundled discounts, allowing sellers and buyers to re-optimize their choices. I show that, in the absence of discounts, providers purchase fewer and lower-quality products, particularly at the expense of optional vaccines not required for school access. Insurers benefit in the short term through lower immunization coverage costs. The effect on pharmaceutical companies varies, depending on the scope and composition of their vaccine portfolios.

Under submission

Black Americans suffer strikingly worse health outcomes than White Americans. This study investigates one plausible reason for Black Americans' inferior health outcomes: under-investment by the private and public sectors in developing treatments for conditions that predominantly affect Black populations. Using longitudinal data from 2000 to 2019, we provide evidence that the private and public sectors act as imperfect substitutes. Specifically, we find that the U.S. private sector undertakes significantly fewer clinical trials for treatments of diseases that affect primarily Black Americans. This finding holds, after accounting for differences among diseases in terms of factors like mortality, research productivity, and market size of treatments. In contrast to the private sector, the U.S. public sector, through the National Institutes of Health, allocates more funding for research on conditions that harm Black Americans more, but not sufficiently enough to offset the private sector's under-investment. Policies that provide incentives to increase private sector efforts in disease areas that primarily affect Black populations could significantly reduce racial disparities.

I provide novel evidence that physicians respond to changes in insurance reimbursement for in-office treatments, though responses vary and can be unexpected. To estimate physician elasticity to private insurance reimbursement, I exploit a plausibly exogenous regulatory change in Medicare payment. Specifically, I document how private reimbursement typically follows Medicare reimbursement (Clemens and Gottlieb, 2016; Chan and Dickstein, 2019) and use the estimated payer-specific relationship between the two prices to construct a valid instrument. My findings show that supply generally exhibits a positive slope—lower reimbursement reduces treatment provision. However, for certain treatments, e.g. flu vaccines, the supply curve is negatively sloped. I provide suggestive evidence that physicians compensate for reduced reimbursement by increasing provision of these and related treatments that can be easily combined in single patient visits.



Work in Progress

Idea: How do typical insurance payment schemes influence price competition and pharmaceutical innovation?


Teaching


Industrial Organization - TA for Prof. Luís Cabral and Chris Conlon, NYU Stern (Spring 2023)

PhD Math Camp - Instructor, NYU Stern (Summer 2024)


Healthcare Markets - TA for Prof. Michael Dickstein, NYU Stern (Spring 2022)


Health Economics - TA for Prof. Michael Dickstein, NYU Stern (Spring 2022)

Microeconomics with Algebra - TA for Prof. Luís Cabral, NYU Stern (Fall 2021, 2022)

Microeconomics - TA for Prof. Maristella Botticini, Bocconi University (Fall 2018)