Scaling for Economists: Lessons from the Non-Adherence Problem in the Medical Literature

Abstract

Economists often conduct experiments that demonstrate the benefits to individuals of modifying their behavior, such as using a new production process at work or investing in energy saving technologies. A common occurrence is for the success of the intervention in these small-scale studies to diminish substantially when applied at a larger scale, severely undermining the optimism advertised in the original research studies. One key contributor to the lack of general success is that the change that has been demonstrated to be beneficial is not adopted to the extent that would be optimal. This problem is isomorphic to the problem of patient non-adherence to medications that are known to be effective. The large medical literature on countermeasures furnishes economists with potential remedies to this manifestation of the scaling problem.