About

David W. Hutton holds a PhD from Stanford University's department of Management Science and Engineering, with a focus on health policy modeling. Prior to his doctoral studies, he gained experience working for a consulting company specializing in mathematical modeling and for several Silicon Valley software companies. His current research centers on health policy and medical decision making, particularly the use of mathematical models to assist with resource allocation for health interventions. His work has had influence on national and international hepatitis B policy, earning him the first place prize in the 'Doing Good with Good OR student paper competition' from the Institute for Operations Research and Management Science. Dr. Hutton has served as a consultant, advisor, and collaborator with prominent organizations including the World Health Organization, the US Department of Health and Human Services, and the Centers for Disease Control and Prevention. His research interests include evaluating the cost-effectiveness of public health policies, drugs, and medical devices, especially in contexts involving uncertain or complex outcomes. He has conducted analyses related to infectious and chronic diseases, as well as new pharmaceutical and medical interventions. His expertise encompasses health policy, modeling, and decision analysis, contributing to the development of strategies for resource allocation and health intervention evaluation.

Research topics

• Medicine
• Internal medicine
• Risk analysis (engineering)
• Psychiatry

Selected publications

• Systematic Review of Nonmedical Costs of Firearm Injury

  American Journal of Preventive Medicine · 2026-01-21

  articleOpen access1st authorCorresponding

  INTRODUCTION: To evaluate the impact of firearm injury prevention programs and policies, it is important to characterize firearm injury costs. A prior review evaluated medical-specific firearm injury costs, but nonmedical societal costs have not been previously reviewed. This study explicitly reviews the nonmedical costs of both fatal and nonfatal firearm injury. METHODS: A systematic review of studies conducted from 2000 to 2023 in English reporting nonmedical costs of U.S. firearm injury in Embase, PubMed, the Cochrane Library, EconLit, JSTOR, and gray literature was performed. The methods, data quality, types of nonmedical costs, and the relationship between nonmedical and medical costs were extracted. Bias was assessed using a modified Newcastle-Ottawa Scale and synthesized on the basis of the SWiM (Synthesis Without Meta-analysis) guidelines. RESULTS: Nineteen studies analyzing national, state, city, and individual costs were identified. Studies generally used modeling approaches (13 studies) to calculate costs, but 4 used a cohort approach, and 2 used a willingness-to-pay approach. Studies evaluated wide ranges of costs: medical, productivity, intangible (quality of life), criminal justice, and other costs. In studies evaluating both medical and nonmedical costs, nonmedical costs were much higher, with criminal justice costs being 1.5-3.9 times larger, productivity costs being 14-25 times larger, and intangible costs being 29-175 times larger than medical costs. DISCUSSION: The literature on nonmedical costs is relatively underdeveloped, leading to wide ranges in results. Studies consistently show that nonmedical costs are in orders of magnitude larger than medical costs of firearm injury with total costs potentially in the millions of dollars per injury. More research on nonmedical costs of firearm injury will help quantify and clarify the magnitude of these costs as well as be used to understand the cost-savings of specific prevention policies or programs.

  PublisherOA PDFDOI

• When Cost-Effectiveness Crosses Borders—Nirsevimab as an Example

  JAMA Pediatrics · 2026-04-13

  articleSenior author
  PublisherDOI

• The cost-effectiveness of universal hepatitis B screening in Vietnam

  International Journal of Infectious Diseases · 2026-03-19

  articleOpen access

  OBJECTIVES: Chronic hepatitis B (CHB) remains a major public health challenge in Vietnam, with an estimated 7.5% of the population infected. The aim was to evaluate the cost-effectiveness of a one-time universal CHB screening strategy. METHODS: A Markov model was used to assess the clinical health impact and cost-effectiveness of a one-time universal screening in Vietnam, with subsequent CHB monitoring and treatment, compared to the current practice. Sensitivity analyses were performed to identify thresholds for cost-effectiveness based on a willingness-to-pay threshold of $12,000/quality-adjusted life year (QALY). Scenario analysis was performed to assess what the cost-effectiveness of screening would be if treatment rates were to increase. RESULTS: The incremental cost-effectiveness ratio was calculated to be $3609 per QALY, with an incremental cost difference of $162,730 and an incremental effect difference of 45.1 QALYs per 100,000 adults screened. Compared to current practice, universal screening would avert an additional 0.5 cases of newly developed cirrhosis, 1.1 cases of newly developed decompensated cirrhosis, 1.3 cases of newly developed hepatocellular carcinoma, 0.5 liver transplantations and 5.7 chronic hepatitis B virus-related deaths, per 100,000 adults screened. CONCLUSION: A one-time universal screening is likely to be cost-effective under the current willingness-to-pay threshold. Clinical impact would be increased if linkage to care and treatment rates were to be improved.

  PublisherDOI

• Economic evaluation of implementation strategies for school-based universal prevention: Insights from a pilot study

  Mental Health & Prevention · 2026-03-02

  articleOpen accessSenior author
  PublisherOA PDFDOI

• The Estimated Impact of Respiratory Syncytial Virus Lower Respiratory Tract Disease and Prevention on Chronic Lung Disease in Children in the United States

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01

  article

  Abstract Introduction/Rationale: Respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is a common cause of hospitalization in young children. Newly licensed preventive interventions, including maternal vaccines and extended half-life RSV monoclonal antibodies (mAb), are recommended to prevent RSV-LRTI during the first year of life. Early childhood RSV-LRTI is associated with the subsequent development of recurrent wheezing illness and asthma (wheeze/asthma) although this relationship may be confounded in part by genetic predisposition. We modeled the potential impact of RSV-LRTI disease and prevention on pediatric wheeze/asthma in the United States. Methods: We adapted a national birth cohort model with 12 monthly cohorts which integrated demographics, RSV-LRTI incidence, prevention efficacy from clinical trials, and vaccine coverage to estimate health outcomes averted during the first year of life by RSV-LRTI mAb programs. We expanded the model to incorporate the asthma prevalence at 6 years (8.8%) from the National Health Interview Survey, and the relative risk (2.45) of developing wheeze/asthma given RSV-LRTI during the first year of life, as calculated by a 2020 systematic review. We projected RSV-LRTI and wheeze/asthma outcomes under three scenarios: 1) no preventive interventions, 2) pre-seasonal RSV-LRTI mAb immunoprophylaxis (mAb), and 3) a counterfactual scenario assuming no RSV-LRTI events (no RSV-LRTI). Results: In the simulated birth cohort (n=3645942), the frequencies of RSV-LRTI events during the first year of life was 534,895 (no intervention scenario) and 448,964 (mAb scenario), and 0 (no RSV-LRTI scenario). The estimated prevalence per 10,000 children of all-cause wheeze/asthma at age six was 880 (no intervention scenario), 855 (mAb scenario), and 726 (no RSV-LRTI scenario). At the same age, the prevalence per 10,000 children of RSV-LRTI-attributable wheeze/asthma was 154 (no intervention scenario) and 129 (mAb scenario), and 0 (no RSV-LRTI scenario). We estimate that RSV-LRTI mAb programs can decrease all-cause wheeze/asthma prevalence at 6 years by 2.8% and RSV-LRTI-attributable wheeze/asthma at 6 years by 16.1%. We estimate that 17.5% of all wheeze/asthma at 6 years of age was attributable to RSV-LRTI. Conclusion: While RSV-LRTI immunoprophylaxis programs in the United States will substantially decrease severe respiratory infections in young children, they may also meaningfully decrease wheeze/asthma prevalence. We estimate RSV-LRTI prevention programs may reduce nearly 9,000 cases of pediatric wheeze/asthma annually. Future analyses will incorporate uncertainty into our estimates. Our modeling of all-cause wheeze/asthma attributable to RSV-LRTI suggests that improvements in RSV-LRTI prevention coverage, effectiveness, and duration of protection can lead to even greater impacts.

  PublisherDOI

• Understanding risk and protective factors associated with opioid misuse among at-risk adolescents and young adults in the emergency department

  Drug and Alcohol Dependence · 2025-07-30

  articleOpen access
  PublisherOA PDFDOI

• Cost effectiveness of mosunetuzumab and CAR-T cell therapy in relapsed/refractory follicular lymphoma

  Leukemia & lymphoma/Leukemia and lymphoma · 2025-06-09

  articleOpen access

  T cell redirecting therapies, including mosunetuzumab (mosun), axicabtagene ciloleucel (axi-cel), and tisagenlecleucel (tisa-cel), are FDA-approved for relapsed refractory follicular lymphoma (FL) in the 3rd line and beyond. There's no head-to-head clinical trial data to compare their effectiveness. These products differ in administration, hospitalization requirements, and toxicity profiles, impacting therapy selection. We developed a Markov model spanning one to 10 years from a US payer perspective, using parameters from clinical trials, quality utilities, and billing costs. Our base case analysis over 10 years showed that mosun provided $67,654 more Net Monetary Benefit (NMB) per patient than axi-cel and $111,709 more than tisa-cel. These findings suggest mosun is cost-effective at a $150,000 willingness-to-pay per QALY.

  PublisherDOI

• Center-Level Analysis of Donation After Circulatory Death Kidney and Liver Transplantation: Utilization Patterns and Influential Utilization Factors

  American Journal of Transplantation · 2025-08-01

  article
  PublisherDOI

• Cost-effectiveness of novel diagnostic tools for idiopathic pulmonary fibrosis in the United States

  BMC Health Services Research · 2025-03-15

  articleOpen accessSenior author

  OBJECTIVES: Novel non-invasive machine learning algorithms may improve accuracy and reduce the need for biopsy when diagnosing idiopathic pulmonary fibrosis (IPF). We conducted a cost-effectiveness analysis of diagnostic strategies for IPF. METHODS: We developed a decision analytic model to evaluate diagnostic strategies for IPF in the United States. To assess the full spectrum of costs and benefits, we compared four interventions: a machine learning diagnostic algorithm, a genomic classifier, a biopsy-all strategy, and a treat-all strategy. The analysis was conducted from the health sector perspective with a lifetime horizon. The primary outcome measures were costs, Quality-Adjusted Life-Years (QALYs) gained, and Incremental Cost-Effectiveness Ratios (ICERs) based on the average of 10,000 probabilistic runs of the model. RESULTS: Compared to a biopsy-all strategy the machine learning algorithm and genomic classifer reduced diagnostic-related costs by $14,876 and $3,884, respectively. Use of the machine learning algorithm consistently reduced diagnostic costs. When including downstream treatment costs and benefits of anti-fibrotic treatment, the machine learning algorithm had an ICER of $331,069 per QALY gained compared to the biopsy-all strategy. The genomic classifier had a higher ICER of $390,043 per QALY gained, while the treat-all strategy had the highest ICER of $3,245,403 per QALY gained. Results were sensitive to changes in various input parameters including IPF treatment costs, sensitivity and specificity of novel screening tools, and the rate of additional diagnostics following inconclusive results. High treatment costs were found to drive overall cost regardless of the diagnostic method. As treatment costs lowered, the supplemental diagnostic tools became increasingly cost-effective. CONCLUSIONS: Novel tools for diagnosing IPF reduced diagnostic costs, while overall incremental cost-effectiveness ratios were high due to treatment costs. New IPF diagnosis approaches may become more favourable with lower-cost treatments for IPF.

  PublisherOA PDFDOI

• Cost-Effectiveness of Universal Routine Depression Screening for Adolescents in Primary Care

  JAMA Health Forum · 2025-05-02 · 4 citations

  articleOpen access

  Importance: Approximately one-fifth of adolescents in the US experience a major depressive episode each year. Universal depression screening for adolescents is recommended as part of routine pediatric primary care, but its cost-effectiveness is unclear. Objective: To evaluate the cost-effectiveness of universal routine depression screening in adolescent primary care compared with usual care. Design, Setting, and Participants: This economic evaluation used a decision-analytic model with an embedded state-transition submodel and annual transitions. A hypothetical population of 1000 adolescents and young adults from ages 12 to 22 years, including 12 demographic groups of disaggregated combinations of sex (female and male) and race or ethnicity (American Indian or Alaska Native; Asian, Native Hawaiian, or Pacific Islander; Black or African American; Hispanic, Latino, or Spanish; White; and multiracial or other race or ethnicity) was simulated in pediatric primary care settings. Exposures: Universal depression screening of varying frequencies, including annual, biennial, and single-time screening at age 12 years, compared with usual care, defined as 20% annual screening rate. Main Outcomes and Measures: Costs, health effects as measured by quality-adjusted life-years (QALYs) and depression-free days, and incremental cost-effectiveness ratios (ICERs) from the health care sector and limited societal perspectives. Results: A universal annual screening policy had an ICER of $66 822 per QALY or $84 per depression-free day gained compared with single-time screening from the limited societal perspective, including caregiver time costs. Universal single-time screening had an ICER of $44 483 per QALY and $62 per depression-free day gained compared with usual care. Targeted universal depression screening was more cost-effective for female individuals and those who identified as Hispanic, Latina, or Spanish, multiracial, or other race or ethnicity. Results were sensitive to treatment recovery rates, depression health state utility scores, treatment costs involving psychotherapy, suicide-related hospitalization costs, and initial depression prevalence at age 12 years. In approximately 99.8% of probabilistic simulations, universal annual screening had an ICER less than $150 000 per QALY threshold. Conclusions and Relevance: The study results suggest that universal annual depression screening for adolescents in primary care is cost-effective compared with a $100 000 per QALY willingness-to-pay threshold. Universal annual screening may be more cost-effective if health systems invest in efforts to enhance family access to telemedicine behavioral health, decrease treatment costs, or improve treatment effectiveness. Future analyses could examine whether additional potentially associated demographic factors, such as gender orientation, sexual identity, rurality, or comorbidities, affect cost-effectiveness outcomes.

  PublisherOA PDFDOI

Recent grants

• Joint Initiative in Vaccine Economics 5

  NIH · $899k · 2015–2018

Frequent coauthors

• Douglas K Owens

  Stanford University

  87 shared

• Alan M. Garber

  Harvard University Press

  85 shared

• Patricia García

  Universidad Peruana Cayetano Heredia

  73 shared

• Geoffrey D. Barnes

  University of Michigan–Ann Arbor

  67 shared

• James V. Freeman

  Yale University

  67 shared

• Mintu P. Turakhia

  Stanford University

  66 shared

• Ruo P. Zhu

  University of California, San Francisco

  66 shared

• Alan S. Go

  Stanford University

  66 shared

Education

• PhD, Management Science and Engineering

  Stanford University

  2010

• MS, Industrial Engineering

  Stanford University

  1999

• BS, Industrial Engineering

  Stanford University

  1998

• BA, Economics

  Stanford University

  1998

Awards & honors

• First place prize in the "Doing Good with Good OR student pa…