Promotion, Innovation, and Health: Personalized Medicine or Comparative Effectiveness Research

  • John Vernon
  • Robert Goldberg
Reference work entry
Part of the Health Services Research book series (HEALTHSR)


Comparative effectiveness research (CER) is a proposed response to what proponents regard as the market’s failure to produce the quantity of comparative assessments of medical technology consumer value. We discuss this claim in terms of prospect theory. We find that CER creates a different frame for making decisions about risk and gains that, in turn, changes perspectives on the expected returns and effective patent life of medical research and development. Further, we compare CER’s impact on rates of innovation to the effect of choices framed by biomarker-based information or personalized medicine has on research and development (R&D). We estimate that the shift in frames will cause a decline and loss in R&D innovation over 10 years in terms of between $38 and $74 billion and would reduce the number of 57 new products over the decade. We conservatively estimate that the foregone social value of biomarker-based innovation would be $10 trillion over 10 years.


Cash Flow Personalized Medicine Prospect Theory Comparative Effectiveness Research Narrow Frame 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Douglas F. The case for entrepreneurship in R&D in the pharmaceutical industry. Nat Rev Drug Discov. 2010;9:683–9.CrossRefPubMedGoogle Scholar
  2. Fogel R. The Escape from Hunger and Premature Death, 1700–2100: Europe, America, and the Third World, Cambridge studies in population, economy and society in past time. Cambridge: Cambridge University Press; 2004 [Paperback].CrossRefGoogle Scholar
  3. Garber A, Tunis S. Does comparative-effectiveness research threaten personalized medicine? N Engl J Med. 2009;360:1925–7.CrossRefPubMedGoogle Scholar
  4. Grabowski H. The determinants of industrial research and development: a study of the chemical, drug, and petroleum industries. J Polit Econ. 1968;76(2):292–306.CrossRefGoogle Scholar
  5. Horn SD. Invited commentary. Phys Ther. 2010;90(11):1673-5; author reply 1675–6. doi: 10.2522/ptj.20090424.ic.CrossRefPubMedGoogle Scholar
  6. Horn SD Ph.D., Gassaway J R.N., M.S. Practice-based evidence study design for comparative effectiveness research. Med Care. 2007;45(10):S50–7.Google Scholar
  7. Jasper JD, et al. Effects of framing on teratogenic risk perception in pregnant women. Lancet. 2001;358(9289):1237–8.CrossRefPubMedGoogle Scholar
  8. Kahneman D. Thinking, fast and slow. New York: Farrar, Straus and Giroux; 2011.Google Scholar
  9. Lichtenberg F. Pharmaceutical-embodied technical progress, longevity, and quality of life: drugs as “equipment for your health”, NBER working paper no. w9351. Cambridge, MA: National Bureau of Economic Research; 2002.CrossRefGoogle Scholar
  10. Meltzer DO, Basu A, Meltzer HY. Comparative effectiveness research for antipsychotic medications: how much is enough? Health Aff (Millwood). 2009;28(5):w794-808. doi: 10.1377/hlthaff.28.5.w794. Epub 21 Jul 2009.CrossRefGoogle Scholar
  11. Murphy K, Topel R. The value of health and longevity. J Polit Econ. 2006;14(5):871–904.CrossRefGoogle Scholar
  12. Orszag P. Research on the comparative effectiveness of medical treatments: issues and options for an expanded federal role. Washington, DC: CBO; 2007.Google Scholar
  13. PhRMA: The 2011 Industry Profile, Apr 2011.
  14. Saha A, Grabowski H. Generic competition in the U.S. pharmaceutical industry. Int J Econ Bus. 2006;13(1):15–38.CrossRefGoogle Scholar
  15. Scherer F. Industry structure, strategy and public policy (Greenman J, editor). New York: Harper Collins College Publishers; 1996.Google Scholar
  16. Thaler R, Barbieri N. A survey of behavioral finance, NBER working paper no. 9222. Cambridge, MA: National Bureau of Economic Research; 2002.Google Scholar
  17. Thomas L. The lives of a cell: notes of a biology watcher. New York: Viking; 1974.Google Scholar
  18. Trusheim MR, Burgess B, Xinghua Hu S, Long T, Averbuch SD, Flynn AA, Lieftucht A, Mazumder A, Milloy J, Shaw PM, Swank D, Wang J, Berndt ER, Goodsaid F, Palmer MC. Quantifying factors for the success of stratified medicine. Nat Rev Drug Discov. 2011;10:11. Nov 2011.
  19. Tversky A, Kahneman D. Rational choice and the framing of decisions. J Bus. 1986;59:S251–78.CrossRefGoogle Scholar
  20. Vernon JA, Goldberg RM, Dash Y, Muralimohan G. Alzheimer’s disease and cost-effectiveness analyses: ensuring good value for money? 2007
  21. Vernon JA, Golec JH, Lutter R, et al. An exploratory study of FDA new drug approval times, prescription drug user fees, and R&D spending. Q Rev Econ Finance. 2009;49:1260–75.CrossRefGoogle Scholar
  22. Vernon JA, Goldberg RM, Pitts P. Fewer drugs, shorter lives, less prosperity; the impact of comparative effectiveness research on health and wealth. Drug Inf J. 2011;45:699–703.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Health Policy and ManagementUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Center for Medicine in the Public InterestSpringfieldUSA

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