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The impact of pharmaceutical innovation on premature mortality, cancer mortality, and hospitalization in Slovenia, 1997-2010.

Abstract：

BACKGROUND:In Slovenia during the period 2000-2010, the number of years of potential life lost before the age of 70 years per 100,000 population under 70 years of age declined 25 %. OBJECTIVE:The aim of this study was to test the hypothesis that pharmaceutical innovation played a key role in reducing premature mortality from all diseases in Slovenia, and to examine the effects of pharmaceutical innovation on the age-standardized number of cancer deaths and on hospitalization from all diseases. Estimates and other data were used to calculate the incremental cost effectiveness of pharmaceutical innovation in Slovenia. METHOD:Longitudinal disease-level data was analyzed to determine whether diseases for which there was greater pharmaceutical innovation-a larger increase in the number of new chemical entities (NCEs) previously launched-had larger declines in premature mortality, the age-standardized number of cancer deaths, and the number of hospital discharges. My methodology controls for the effects of macroeconomic trends and overall changes in the healthcare system. RESULTS:Premature mortality from a disease is inversely related to the number of NCEs launched more than 5 years earlier. On average, the introduction of an additional NCE for a disease reduced premature mortality from the disease by 2.4 % 7 years later. The age-standardized number of cancer deaths is inversely related to the number of NCEs launched 1-6 years earlier, conditional on the age-standardized number of new cancer cases diagnosed 0-2 years earlier. On average, the launch of an NCE reduced the number of hospital discharges 1 year later by approximately 1.5 %. CONCLUSIONS:The estimates imply that approximately two-thirds of the 2000-2010 decline in premature mortality was due to pharmaceutical innovation. If no NCEs had been launched in Slovenia during 1992-2003, the age-standardized number of cancer deaths in 2008 would have been 12.2 % higher. The NCEs launched in Slovenia during 2003-2009 are estimated to have reduced the number of hospital discharges in 2010 by 7 %. If we assume that pharmaceutical expenditure was the only type of expenditure affected by pharmaceutical innovation, the cost per life-year saved was 3,953, which is well below even the lowest estimates of the value of a life-year saved. Moreover, 85 % of the increase in drug expenditure may have been offset by a reduction in hospital expenditure; therefore. the cost per life-year saved may have been only €611.

journal_name

Appl Health Econ Health Policy

journal_title

Applied health economics and health policy

authors

Lichtenberg FR

doi

10.1007/s40258-014-0144-3

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

207-22

issue

eissn

1175-5652

issn

1179-1896

journal_volume

pub_type

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The impact of pharmaceutical innovation on premature mortality, cancer mortality, and hospitalization in Slovenia, 1997-2010.