The Long-Run Impact of Changes in Prescription Drug Sales on Mortality and Hospital Utilization in Belgium, 1998–2019

Objectives: We investigate the long-run impact of changes in prescription drug sales on mortality and hospital utilization in Belgium during the first two decades of the 21st century. Methods: We analyze the correlation across diseases between changes in the drugs used to treat the disease and changes in mortality or hospital utilization from that disease. The measure of the change in prescription drug sales we use is the long-run (1998–2018 or 2000–2019) change in the fraction of post-1999 drugs sold. A post-1999 drug is a drug that was not sold during 1989–1999. Results: The 1998–2018 increase in the fraction of post-1999 drugs sold is estimated to have reduced the number of years of life lost before ages 85, 75, and 65 in 2018 by about 438 thousand (31%), 225 thousand (31%), and 114 thousand (32%), respectively. The 1995–2014 increase in in the fraction of post-1999 drugs sold is estimated to have reduced the number of hospital days in 2019 by 2.66 million (20%). Conclusions: Even if we ignore the reduction in hospital utilization attributable to changes in pharmaceutical consumption, a conservative estimate of the 2018 cost per life-year before age 85 gained is EUR 6824. We estimate that previous changes in pharmaceutical consumption reduced 2019 expenditure on inpatient curative and rehabilitative care by EUR 3.55 billion, which is higher than the 2018 expenditure on drugs that were authorized during the period 1998–2018: EUR 2.99 billion.