IDEAS home Printed from https://ideas.repec.org/a/bpj/fhecpo/v16y2013i1p1-33n1.html
   My bibliography  Save this article

The Effect of Pharmaceutical Innovation on Longevity: Patient Level Evidence from the 1996–2002 Medical Expenditure Panel Survey and Linked Mortality Public-use Files

Author

Listed:
  • Lichtenberg Frank R.

    (Columbia University, 504 Uris Hall, 3022 Broadway, New York, 10027 NY, USA)

Abstract

This study uses patient-level data to analyze the effect of technological change embodied in pharmaceuticals on the longevity of elderly Americans. Previous patient-level studies could not control for important patient attributes such as education, income, and race; they did not provide estimates of the effect of using newer drugs on life expectancy, or of the overall cost-effectiveness of new drugs relative to old drugs; and they were not based on nationally representative samples of individuals. Our data, primarily derived from the Medical Expenditure Panel Survey and the Linked Mortality Public-use Files, enable us to overcome those limitations.We investigate the effect of the vintage (year of U.S. Food and Drug Administration approval) of the prescription drugs used by an individual on his or her survival and medical expenditure, controlling for a number of demographic characteristics and indicators and determinants of health status. When we control only for age, sex, and interview year, we estimate that a 1-year increase in drug vintage increases life expectancy by 0.52%. Controlling for a much more extensive set of other attributes (the mean year the person started taking his or her medications, and dummy variables for activity limitations, race, education, family income as a percent of the poverty line, insurance coverage, Census region, body mass index, smoking, and more than 100 medical conditions) has virtually no effect on the estimate of the effect of drug vintage on life expectancy. Between 1996 and 2003, the mean vintage of prescription drugs increased by 6.6 years. This is estimated to have increased the life expectancy of elderly Americans by 0.41–0.47 years. This suggests that not less than two-thirds of the 0.6-year increase in the life expectancy of elderly Americans during 1996–2003 was due to the increase in drug vintage. The 1996–2003 increase in drug vintage is also estimated to have increased annual drug expenditure per elderly American by $207, and annual total medical expenditure per elderly American by $218. This implies that the incremental cost-effectiveness ratio (cost per life-year gained) of pharmaceutical innovation was about $12,900. This estimate of the cost per life-year gained from the use of newer drugs is a small fraction of leading economists’ estimates of the value of (willingness to pay for) an additional year of life. It is also consistent with estimates from clinical trials.

Suggested Citation

  • Lichtenberg Frank R., 2013. "The Effect of Pharmaceutical Innovation on Longevity: Patient Level Evidence from the 1996–2002 Medical Expenditure Panel Survey and Linked Mortality Public-use Files," Forum for Health Economics & Policy, De Gruyter, vol. 16(1), pages 1-33, January.
    • Handle: RePEc:bpj:fhecpo:v:16:y:2013:i:1:p:1-33:n:1
    DOI: 10.1515/fhep-2012-0032
    as

    Download full text from publisher

    File URL: https://doi.org/10.1515/fhep-2012-0032
    Download Restriction: For access to full text, subscription to the journal or payment for the individual article is required.
    File URL: https://libkey.io/10.1515/fhep-2012-0032?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Frank R. Lichtenberg & Gautier Duflos, 2008. "Pharmaceutical innovation and the longevity of Australians: A first look," Advances in Health Economics and Health Services Research, in: Beyond Health Insurance: Public Policy to Improve Health, pages 95-117, Emerald Group Publishing Limited.
    2. Douglas Almond & Bhashkar Mazumder, 2006. "How did schooling laws improve long-term health and lower mortality?," Working Paper Series WP-06-23, Federal Reserve Bank of Chicago.
    3. Frank Lichtenberg, 2011. "The quality of medical care, behavioral risk factors, and longevity growth," International Journal of Health Economics and Management, Springer, vol. 11(1), pages 1-34, March.
    4. Timothy F. Bresnahan & Robert J. Gordon, 1996. "Introduction to "The Economics of New Goods"," NBER Chapters, in: The Economics of New Goods, pages 1-26, National Bureau of Economic Research, Inc.
    5. Duggan Mark G & Evans William N, 2008. "Estimating the Impact of Medical Innovation: A Case Study of HIV Antiretroviral Treatments," Forum for Health Economics & Policy, De Gruyter, vol. 11(2), pages 1-39, January.
    6. Timothy F. Bresnahan & Robert J. Gordon, 1996. "The Economics of New Goods," NBER Books, National Bureau of Economic Research, Inc, number bres96-1.
    7. Bresnahan, Timothy F. & Gordon, Robert J. (ed.), 2008. "The Economics of New Goods," National Bureau of Economic Research Books, University of Chicago Press, number 9780226074184, August.
    8. Adriana Lleras-Muney, 2005. "The Relationship Between Education and Adult Mortality in the United States," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 189-221.
    9. Kevin M. Murphy & Robert H. Topel, 2006. "The Value of Health and Longevity," Journal of Political Economy, University of Chicago Press, vol. 114(5), pages 871-904, October.
    10. Frank Lichtenberg, 2012. "Contribution of Pharmaceutical Innovation to Longevity Growth in Germany and France, 2001–7," PharmacoEconomics, Springer, vol. 30(3), pages 197-211, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Lane, Julia I. & Owen-Smith, Jason & Rosen, Rebecca F. & Weinberg, Bruce A., 2015. "New linked data on research investments: Scientific workforce, productivity, and public value," Research Policy, Elsevier, vol. 44(9), pages 1659-1671.
    2. Hostenkamp, Gisela & Lichtenberg, Frank R., 2015. "The impact of recent chemotherapy innovation on the longevity of myeloma patients: US and international evidence," Social Science & Medicine, Elsevier, vol. 130(C), pages 162-171.
    3. Joan Costa‐Font & Cristina Vilaplana‐Prieto, 2020. "‘More than one red herring'? Heterogeneous effects of ageing on health care utilisation," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 8-29, October.
    4. Frank R. Lichtenberg & Billie Pettersson, 2014. "The impact of pharmaceutical innovation on longevity and medical expenditure in Sweden, 1997-2010: evidence from longitudinal, disease-level data," Economics of Innovation and New Technology, Taylor & Francis Journals, vol. 23(3), pages 239-273, April.
    5. Eric Budish & Benjamin N. Roin & Heidi Williams, 2015. "Do Firms Underinvest in Long-Term Research? Evidence from Cancer Clinical Trials," American Economic Review, American Economic Association, vol. 105(7), pages 2044-2085, July.
    6. Eric Budish & Benjamin Roin & Heidi Williams, 2013. "Do fixed patent terms distort innovation? Evidence from cancer clinical trials," Discussion Papers 13-001, Stanford Institute for Economic Policy Research.
    7. Frank R. Lichtenberg, 2015. "Pharmaceutical Innovation, Longevity, and Medical Expenditure in Greece, 1995-2010," International Journal of the Economics of Business, Taylor & Francis Journals, vol. 22(2), pages 277-299, July.
    8. Joshua Krieger & Danielle Li & Dimitris Papanikolaou, 2022. "Missing Novelty in Drug Development," The Review of Financial Studies, Society for Financial Studies, vol. 35(2), pages 636-679.
    9. Frank R. Lichtenberg, 2017. "How Cost-Effective Are New Cancer Drugs in the U.S.?," CESifo Working Paper Series 6683, CESifo Group Munich.
    10. Lichtenberg, Frank R., 2014. "The impact of pharmaceutical innovation on longevity and medical expenditure in France, 2000–2009," Economics & Human Biology, Elsevier, vol. 13(C), pages 107-127.
    11. Frank R. Lichtenberg, 2017. "The impact of pharmaceutical innovation on cancer mortality in Mexico, 2003–2013," Latin American Economic Review, Springer;Centro de Investigaciòn y Docencia Económica (CIDE), vol. 26(1), pages 1-22, December.
    12. Frank R. Lichtenberg, 2017. "The Impact of Pharmaceutical Innovation on Premature Mortality, Hospital Separations, and Cancer Survival in Australia," The Economic Record, The Economic Society of Australia, vol. 93(302), pages 353-378, September.
    13. Nishimura, Junichi & Nagaoka, Sadao & Yoneyama-Hirozane, Mariko, 2022. "The impact of science-intensive drugs on longevity and cure rate: Evidence from new prescription drugs launched in Japan," Journal of the Japanese and International Economies, Elsevier, vol. 64(C).
    14. Rebecca McKibbin & Bruce A. Weinberg, 2021. "Does Research Save Lives? The Local Spillovers of Biomedical Research on Mortality," NBER Working Papers 29420, National Bureau of Economic Research, Inc.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lichtenberg, Frank R. & Tatar, Mehtap & Çalışkan, Zafer, 2014. "The effect of pharmaceutical innovation on longevity, hospitalization and medical expenditure in Turkey, 1999–2010," Health Policy, Elsevier, vol. 117(3), pages 361-373.
    2. Frank R. Lichtenberg, 2015. "Pharmaceutical Innovation, Longevity, and Medical Expenditure in Greece, 1995-2010," International Journal of the Economics of Business, Taylor & Francis Journals, vol. 22(2), pages 277-299, July.
    3. Frank Lichtenberg, 2011. "The quality of medical care, behavioral risk factors, and longevity growth," International Journal of Health Economics and Management, Springer, vol. 11(1), pages 1-34, March.
    4. Lichtenberg, Frank R., 2014. "The impact of pharmaceutical innovation on longevity and medical expenditure in France, 2000–2009," Economics & Human Biology, Elsevier, vol. 13(C), pages 107-127.
    5. Frank R. Lichtenberg, 2012. "Pharmaceutical Innovation and Longevity Growth in 30 Developing and High-income Countries, 2000-2009," NBER Working Papers 18235, National Bureau of Economic Research, Inc.
    6. Dora L. Costa, 2015. "Health and the Economy in the United States from 1750 to the Present," Journal of Economic Literature, American Economic Association, vol. 53(3), pages 503-570, September.
    7. Lichtenberg, Frank R., 2013. "The impact of therapeutic procedure innovation on hospital patient longevity: Evidence from Western Australia, 2000–2007," Social Science & Medicine, Elsevier, vol. 77(C), pages 50-59.
    8. Nishimura, Junichi & Nagaoka, Sadao & Yoneyama-Hirozane, Mariko, 2022. "The impact of science-intensive drugs on longevity and cure rate: Evidence from new prescription drugs launched in Japan," Journal of the Japanese and International Economies, Elsevier, vol. 64(C).
    9. Frank Lichtenberg, 2012. "Contribution of Pharmaceutical Innovation to Longevity Growth in Germany and France, 2001–7," PharmacoEconomics, Springer, vol. 30(3), pages 197-211, March.
    10. Redding, Stephen J. & Weinstein, David E., 2016. "A unified approach to estimating demand and welfare," LSE Research Online Documents on Economics 67681, London School of Economics and Political Science, LSE Library.
    11. Chen, Li-Shiun & Wang, Ping & Yao, Yao, 2018. "Power of personalized smoking cessation: A unified lifecycle framework for policy evaluation," Working Paper Series 20333, Victoria University of Wellington, School of Economics and Finance.
    12. Kai Hong & Peter A. Savelyev & Kegon T. K. Tan, 2020. "Understanding the Mechanisms Linking College Education with Longevity," Journal of Human Capital, University of Chicago Press, vol. 14(3), pages 371-400.
    13. Schultz, T. Paul, 2010. "Population and Health Policies," Handbook of Development Economics, in: Dani Rodrik & Mark Rosenzweig (ed.), Handbook of Development Economics, edition 1, volume 5, chapter 0, pages 4785-4881, Elsevier.
    14. Strulik, Holger, 2018. "The return to education in terms of wealth and health," The Journal of the Economics of Ageing, Elsevier, vol. 12(C), pages 1-14.
    15. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    16. Pierre Koning & Dinand Webbink & Nicholas Martin, 2015. "The effect of education on smoking behavior: new evidence from smoking durations of a sample of twins," Empirical Economics, Springer, vol. 48(4), pages 1479-1497, June.
    17. Anderberg, Dan & Chevalier, Arnaud & Wadsworth, Jonathan, 2011. "Anatomy of a health scare: Education, income and the MMR controversy in the UK," Journal of Health Economics, Elsevier, vol. 30(3), pages 515-530, May.
    18. Tran, Thi Bich & Grafton, Quentin & Kompas, Tom, 2009. "Contribution of productivity and firm size to value-added: Evidence from Vietnam," International Journal of Production Economics, Elsevier, vol. 121(1), pages 274-285, September.
    19. Rachel Soloveichik, 2024. "Radio Spectra as Telecommunications Assets," BEA Papers 0133, Bureau of Economic Analysis.
    20. Kerry Hickson, 2014. "The GDP Value of Twentieth-Century Health Improvements in Developed Economies: Initial Estimates for England," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 60(2), pages 385-399, June.

    More about this item

    Keywords

    pharmaceuticals; longevity; innovation; mortality; prescription drugs;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bpj:fhecpo:v:16:y:2013:i:1:p:1-33:n:1. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Peter Golla (email available below). General contact details of provider: https://www.degruyter.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.