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PharmacoEconomics
Published in: PharmacoEconomics 3/2012

01-03-2012 | Leading Article

Contribution of Pharmaceutical Innovation to Longevity Growth in Germany and France, 2001–7

Author: Dr Frank R. Lichtenberg

Published in: PharmacoEconomics | Issue 3/2012

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Abstract

This paper investigates the contribution of pharmaceutical innovation to recent longevity growth in Germany and France. The effect of the vintage of prescription drugs (and other variables) on the life expectancy and ageadjusted mortality rates of residents of Germany is examined, using longitudinal, annual, state-level data during the period 2001v7. The estimates imply that about one-third of the 1.4–year increase in German life expectancy during the period 2001–7 was due to the replacement of older drugs by newer drugs. The effect of the vintage of chemotherapy treatments on age-adjusted cancer mortality rates of residents of France is also investigated, using longitudinal, annual, cancer-site-level data during the period 2002–6. The estimates imply that chemotherapy innovation accounted for at least one-sixth of the decline in French cancer mortality rates, and may have accounted for as much as half of the decline.
Footnotes
1
Growth may also be driven by technological change arising from R&D investment by public organizations, e.g. the National Institutes of Health.
 
2
I hypothesize that innovations may be embodied in nondurable goods (e.g. drugs) and services as well as in durable equipment.
 
3
In 1997, “medical substances and devices firms had by far the highest combined R&D intensity at 11.8 percent, … well above the 4.2-percent average for all 500 top 1997 R&D spenders combined. The information and electronics sector ranked second in intensity at 7.0 percent.”[17] The pattern of 1997 R&D spending per employee is similar to that for R&D intensity, with medical substances and devices again the highest at $US29 095 per employee. Information and electronics is second at $US16 381. Combined, the top 500 R&D firms in 1997 spent $US10 457 per employee.
 
4
European Pharmaceutical Market Research Association (EphMRA) drug classification codes are shown in parentheses. The EphMRA classification is a modified version of the Anatomical Therapeutic Chemical (ATC) classification. See http://​www.​ephmra.​org/​classification/​anatomical-classification.​aspx.​
 
5
Population-weighted averages of my state-level life expectancy estimates were verified as being very consistent with published estimates for Germany as a whole.
 
6
In the Federal Republic of Germany, health authorities must be informed about cases of certain notifiable diseases, which are listed in the Infection Protection Act.[21] Data on the incidence and prevalence of other diseases were not available.
 
7
Data on educational attainment by state and year were not available.
 
8
Lichtenberg found that diagnostic imaging innovation as well as pharmaceutical innovation increased life expectancy in the US during the period 1991–2004.[26]
 
9
The CEA Registry is produced by the Center for the Evaluation of Value and Risk in Health, part of the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston, MA, USA.
 
10
As shown in table II, the average prescription is for a drug launched about 20 years earlier.
 
11
The Eurocare 3 and Eurocare 4 databases[32] provide data on survival rates of French cancer patients diagnosed during the following periods: 1983–5, 1986–8, 1989–91, 1992–4 and 1995–9.
 
12
Data on non-pharmaceutical innovation are not available for any period. According to the European Cancer Observatory, annual data on cancer incidence, by site, are only available during the period 1983–1997.[34]
 
13
If a patient was treated with n chemotherapy agents, that patient would be counted n times.
 
14
The age distribution of the French population in 2002 was used to obtain age-adjusted mortality rates.
 
15
GERS provides data on the quantity of each drug, by year, but not by cancer site.
 
16
The GERS vintage measures are based on the year each drug was first commercialized in France, rather than the world launch year, which is not available for all drugs. For the 11 drugs for which both dates were available, there is generally a close correspondence between the two dates. For 8 of the 11 drugs, the year of commercialization in France was 0–2 years after the world launch year.
 
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Metadata
Title
Contribution of Pharmaceutical Innovation to Longevity Growth in Germany and France, 2001–7
Author
Dr Frank R. Lichtenberg
Publication date
01-03-2012
Publisher
Springer International Publishing
Published in
PharmacoEconomics / Issue 3/2012
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.2165/11587150-000000000-00000

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