Fewer Drugs, Shorter Lives, Less Prosperity: The Impact of Comparative Effectiveness Research on Health and Wealth
Advocates of comparative effectiveness re search (CER) claim it can be used to reduce health care spending because a large portion pays for medical technologies that add little health or social beneft. This assumption runs counter to evidence that medical innovation is associated with lower and greater longevity.
To the extent that CER is used to reduce the development and use of new drugs, devices, and diagnostics, it is important to estimate what impact the reduced rate of innovation would have on quality of life and life expec tancy.
Using empirical models that establish a di rect relationship between pharmaceutical re turns on investment and clinical development costs, we developed an estimate of the cost of CER and its impact on rates of R&D.
We found that CER could conservatively in crease R&D costs by an amount equal to 50 percent of the most complex and time-consum ing part of drug development. The added cost would reduce R&D spending by $32 billion over 10 years.
Based on research that quantifed the rela tionship between increased R&D and greater life expectancy and well-being, we conclude that CER would cost Americans 81 million life years and $4 trillion.
CER advocates ignore the impact of such re quirements at the possible expense of longer life and economic growth.
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- 1.CBO research on the comparative effectiveness of medical treatments: issues and options for an expanded federal role. December 2007.Google Scholar
- 2.Berwick D. Interview. Biotechnol Healthcare. June 2009.Google Scholar
- 3.Institute of Medicine. Meeting agenda. January 11–12, 2011; http://iom.edu/Activities/Health-Services/EssentialHealthBenefts/2011-JAN-12/Agenda.aspx.Google Scholar
- 4.Lichtenberg F. The quality of medical care, behavioral risk factors, and longevity growth. NBER WP 15068. http://www.nber.org/papers/ w15068.Google Scholar
- 8.Mason A, et al. Comparison of anti-cancer drug coverage decisions in the United States and United Kingdom: does the evidence support the rhetoric? J Clin Oncol. http://jco.ascopubs.org/ content/28/20/3234.abstract.Google Scholar
- 9.O’Donnell P. One step closer to the fourth hurdle: drug evaluation criteria could soon include an intrusive health technology assessment. Appl Clin Trials. March 1, 2010.Google Scholar