Core Concepts
Regulators should design statistical contracts that account for the strategic incentives of agents, ensuring that ineffective proposals are not profitable.
Abstract
The paper discusses a framework for designing statistical contracts between a regulator (the principal) and an experimenter (the agent), such as a pharmaceutical company. The key insight is that the statistical protocol used to establish efficacy affects the behavior of a strategic, self-interested agent - a lower standard of statistical evidence incentivizes the agent to run more trials that are less likely to be effective.
The authors propose a decision-theoretic framework that explicitly accounts for the agent's incentives, such that ineffectual proposals are not profitable. They model this as a game between the principal and the agent, where the agent wishes to make a profit by selling a product, but must seek regulatory approval from the principal, who wishes to ensure that only legitimate products are on the market.
The authors show that the set of incentive-aligned statistical contracts, where null agents cannot profit, is exactly the set of e-values (a measure of statistical evidence). They prove that an incentive-aligned statistical contract is maximin optimal, meaning it performs well across many distributions of agent types. Furthermore, if the principal's utility is linear in the license value, the menu of all e-values is the optimal incentive-aligned contract.
The authors also discuss how the FDA's current protocols may not be incentive-aligned for highly profitable drugs, potentially incentivizing clinical trials for ineffective candidates. They emphasize the importance of designing statistical protocols that account for agent incentives to ensure high social utility.
Stats
The probability that a placebo drug is approved under the standard FDA protocol is 0.000625.
The probability that a placebo drug is approved under the modernized FDA protocol is 0.005.
The probability that a placebo drug is approved under the high-discretion accelerated FDA protocol is 0.0494.
The typical cost of a Phase III clinical trial is estimated to be $50 million.
Quotes
"Clearly, the effectiveness of a statistical protocol depends on the incentives of the agents."
"Regulators, on the other hand, have a mandate to set up a trustworthy system that not only performs valid statistical inference but also delivers high social utility."
"By formalizing the bet the researcher is already taking, the regulator establishes an economic basis for statistical inference."