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The impact of pharmaceutical innovation on premature cancer mortality in Canada, 2000–2011

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  • Frank Lichtenberg

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Abstract

The premature cancer mortality rate has been declining in Canada, but there has been considerable variation in the rate of decline across cancer sites. I analyze the effect that pharmaceutical innovation had on premature cancer mortality in Canada during the period 2000–2011, by investigating whether the cancer sites that experienced more pharmaceutical innovation had larger declines in the premature mortality rate, controlling for changes in the incidence rate. Premature mortality before age 75 is significantly inversely related to the cumulative number of drugs registered at least 10 years earlier. Since mean utilization of drugs that have been marketed for less than 10 years is only one-sixth as great as mean utilization of drugs that have been marketed for at least a decade, it is not surprising that premature mortality is strongly inversely related only to the cumulative number of drugs that had been registered at least ten years earlier. Premature mortality before age 65 and 55 is also strongly inversely related to the cumulative number of drugs that had been registered at least ten years earlier. None of the estimates of the effect of incidence on mortality are statistically significant. Controlling for the cumulative number of drugs, the cumulative number of chemical subgroups does not have a statistically significant effect on premature mortality. This suggests that drugs (chemical substances) within the same class (chemical subgroup) are not therapeutically equivalent. During the period 2000–2011, the premature (before age 75) cancer mortality rate declined by about 9 %. The estimates imply that, in the absence of pharmaceutical innovation during the period 1985–1996, the premature cancer mortality rate would have increased about 12 % during the period 2000–2011. A substantial decline in the “competing risk” of death from cardiovascular disease could account for this. The estimates imply that pharmaceutical innovation during the period 1985–1996 reduced the number of years of potential life lost to cancer before age 75 in 2011 by 105,366. The cost per life-year before age 75 gained from previous pharmaceutical innovation is estimated to have been 2730 USD. Most of the previously-registered drugs were off-patent by 2011, but evidence suggests that, even if these drugs had been sold at branded rather than generic prices, the cost per life-year gained would have been below 11,000 USD, a figure well below even the lowest estimates of the value of a life-year gained. The largest reductions in premature mortality occur at least a decade after drugs are registered, when their utilization increases significantly. This suggests that, if Canada is to obtain substantial additional reductions in premature cancer mortality in the future (a decade or more from now) at a modest cost, pharmaceutical innovation (registration of new drugs) is needed today. Copyright The Author(s) 2015

Suggested Citation

  • Frank Lichtenberg, 2015. "The impact of pharmaceutical innovation on premature cancer mortality in Canada, 2000–2011," International Journal of Health Economics and Management, Springer, vol. 15(3), pages 339-359, September.
  • Handle: RePEc:kap:ijhcfe:v:15:y:2015:i:3:p:339-359
    DOI: 10.1007/s10754-015-9172-2
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    File URL: http://hdl.handle.net/10.1007/s10754-015-9172-2
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    References listed on IDEAS

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    1. Bo E. Honoré & Adriana Lleras-Muney, 2006. "Bounds in Competing Risks Models and the War on Cancer," Econometrica, Econometric Society, vol. 74(6), pages 1675-1698, November.
    2. Frank R. Lichtenberg, 2014. "Has Medical Innovation Reduced Cancer Mortality?," CESifo Economic Studies, CESifo, vol. 60(1), pages 135-177.
    3. Lichtenberg, Frank R., 2014. "The impact of pharmaceutical innovation on longevity and medical expenditure in France, 2000–2009," Economics & Human Biology, Elsevier, vol. 13(C), pages 107-127.
    4. Romer, Paul M, 1990. "Endogenous Technological Change," Journal of Political Economy, University of Chicago Press, vol. 98(5), pages 71-102, October.
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    Cited by:

    1. Dubois, Pierre & Kyle, Margaret K, 2016. "The Effects of Pharmaceutical Innovation on Cancer Mortality," CEPR Discussion Papers 11487, C.E.P.R. Discussion Papers.
    2. Frank R. Lichtenberg, 2018. "The Impact of New Drug Launches on Life-Years Lost in 2015 from 19 Types of Cancer in 36 Countries," NBER Working Papers 24536, National Bureau of Economic Research, Inc.
    3. Dubois, Pierre & Kyle, Margaret, 2016. "The Effects of Pharmaceutical Innovation on Cancer Mortality Rates," TSE Working Papers 16-688, Toulouse School of Economics (TSE).
    4. repec:eee:respol:v:47:y:2018:i:2:p:440-461 is not listed on IDEAS
    5. repec:spr:laecrv:v:26:y:2017:i:1:d:10.1007_s40503-017-0045-6 is not listed on IDEAS

    More about this item

    Keywords

    Cancer; Neoplasm; Mortality; Longevity; Pharmaceutical; Chemotherapy; Innovation; Canada;

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • I10 - Health, Education, and Welfare - - Health - - - General
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J17 - Labor and Demographic Economics - - Demographic Economics - - - Value of Life; Foregone Income
    • L65 - Industrial Organization - - Industry Studies: Manufacturing - - - Chemicals; Rubber; Drugs; Biotechnology; Plastics
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes

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