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1998-2015 年美国社区居民的生物制药创新对残疾、社会保障受益和医疗保健使用的影响。

The Impact of Biopharmaceutical Innovation on Disability, Social Security Recipiency, and Use of Medical Care of U.S. Community Residents, 1998-2015.

机构信息

Columbia University, New York, USA.

出版信息

Forum Health Econ Policy. 2022 Aug 30;24(1):35-74. doi: 10.1515/fhep-2021-0050. eCollection 2021 Jun 1.

Abstract

This study seeks to analyze the overall impact that biopharmaceutical innovation had on disability, Social Security recipiency, and the use of medical services of U.S. community residents during the period 1998-2015. We test the hypothesis that the probability of disability, Social Security recipiency, and medical care utilization associated with a medical condition is inversely related to the number of drug classes previously approved for that condition. We use data from the 1998-2015 waves of the Medical Expenditure Panel Survey and other sources to estimate probit models of an individual's probability of disability, Social Security recipiency, and medical care utilization. The effect of biopharmaceutical innovation is identified by differences across over 200 medical conditions in the growth in the lagged number of drug classes ever approved. 18 years of previous biopharmaceutical innovation is estimated to have reduced: the number of people who were completely unable to work at a job, do housework, or go to school in 2015 by 4.5%; the number of people with cognitive limitations by 3.2%; the number of people receiving SSI in 2015 by 247 thousand (3.1%); and the number of people receiving Social Security by 984 thousand (2.0%). Previous innovation is also estimated to have caused reductions in home health visits (9.2%), inpatient events (5.7%), missed school days (5.1%), and outpatient events (4.1%). The estimated value in 2015 of some of the reductions in disability, Social Security recipiency, and use of medical care attributable to previous biopharmaceutical innovation ($115 billion) is fairly close to 2015 expenditure on drug classes that were first approved by the FDA during 1989-2006 ($127 billion). However, for a number of reasons, the costs are likely to be lower, and the benefits are likely to be larger, than these figures.

摘要

本研究旨在分析 1998-2015 年期间,生物制药创新对美国社区居民的残疾、社会保障受益和医疗服务使用的总体影响。我们检验了以下假设:与某种疾病相关的残疾、社会保障受益和医疗服务使用的概率与先前为此种疾病批准的药物种类数量呈反比。我们使用 1998-2015 年医疗支出面板调查(MEPS)的各期数据和其他来源的数据,估计个体残疾、社会保障受益和医疗服务使用概率的概率模型。通过比较 200 多种医疗条件下滞后批准药物种类数量的增长,确定了生物制药创新的影响。18 年的前期生物制药创新预计减少了:2015 年完全无法工作、做家务或上学的人数 4.5%;认知障碍人数 3.2%;2015 年接受 SSI 的人数 24.7 万(3.1%);以及接受社会保障的人数 98.4 万(2.0%)。前期创新还估计导致家庭健康访视(9.2%)、住院事件(5.7%)、缺课天数(5.1%)和门诊事件(4.1%)减少。2015 年归因于前期生物制药创新的一些残疾、社会保障受益和医疗服务使用减少的估计价值(1150 亿美元)与 1989-2006 年期间 FDA 首次批准的药物种类的 2015 年支出(1270 亿美元)相当接近。然而,由于各种原因,成本可能低于这些数字,而收益可能大于这些数字。

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