University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104-6299, USA.
Soc Sci Med. 2010 Apr;70(7):961-8. doi: 10.1016/j.socscimed.2009.11.033. Epub 2010 Jan 25.
Although there is a good deal of speculation surrounding the role of pharmaceutical innovation in late 20th century mortality improvements in the United States, there is little empirical evidence on the topic and there remains a good deal of doubt regarding whether pharmaceuticals matter at all for mortality. Using a reliable indicator of pharmaceutical innovation-yearly approvals of new molecular entities (NMEs) by the Food and Drug Administration, along with information on priority status and disease-category indication-this study examines the relationship between pharmaceutical innovation and life expectancy between 1960 and 2000. The study demonstrates a significant relationship between pharmaceutical innovation and life expectancy at birth, which is robust to controls for gross domestic product, as well as controls for various forms of medical spending. The relationship with life expectancy is robust, in part, because pharmaceutical innovation has a stronger relationship with early-life mortality (between 20 and 50) than with later-life mortality (65 and over), even though older persons consume more pharmaceuticals and many recently approved drugs target conditions more common in later life. There is, to be sure, another side to the results. There is some evidence, for example, that the relationship between pharmaceutical innovation and mortality has declined over time, suggesting a change in the kind of innovations now entering the market. Nevertheless, there is more to contemporary pharmaceutical innovation than the development of mere "halfway" technologies. The overall relationship between innovation and mortality is sufficiently strong to warrant further consideration as a key determinant of trends in mortality.
虽然人们对制药创新在美国 20 世纪末的死亡率降低方面的作用有很多猜测，但在这个主题上几乎没有经验证据，而且对于制药是否对死亡率有影响仍存在很大的疑问。本研究使用了一种可靠的药物创新指标——美国食品和药物管理局（FDA）每年批准的新分子实体（NMEs），以及有关优先状态和疾病类别适应症的信息，来研究 1960 年至 2000 年间药物创新与预期寿命之间的关系。研究表明，药物创新与出生时的预期寿命之间存在显著的关系，这一关系在控制国内生产总值以及各种医疗支出形式后仍然稳健。与预期寿命的关系稳健，部分原因是药物创新与早逝（20 至 50 岁）的关系比与晚逝（65 岁及以上）的关系更强，尽管老年人消耗更多的药物，而且许多最近批准的药物针对的是晚年更常见的疾病。诚然，结果还有另一面。例如，有证据表明，药物创新与死亡率之间的关系随着时间的推移而下降，这表明现在进入市场的创新类型发生了变化。尽管如此，当代药物创新不仅仅是发展“中途”技术。创新与死亡率之间的总体关系足够强，有必要进一步将其视为死亡率趋势的关键决定因素。
