Fewer Drugs, Shorter Lives, Less Prosperity: The Impact of Comparative Effectiveness Research on Health and Wealth

Title
Fewer Drugs, Shorter Lives, Less Prosperity: The Impact of Comparative Effectiveness Research on Health and Wealth

Abstract
1. Advocates of comparative effectiveness research (CER) claim it can be used to reduce health care spending because a large portion pays for medical technologies that add little health or social benefit. This assumption runs counter to evidence that medical innovation is associated with lower and greater longevity. 2. To the extent that CER is used to reduce the development and use of new drugs, devices, and diagnostics, it is important to estimate what impact the reduced rate of innovation would have on quality of life and life expectancy. 3. Using empirical models that establish a direct relationship between pharmaceutical returns on investment and clinical development costs, we developed an estimate of the cost of CER and its impact on rates of R&D. 4. We found that CER could conservatively increase R&D costs by an amount equal to 50 percent of the most complex and time-consuming part of drug development. The added cost would reduce R&D spending by $32 billion over 10 years. 5. Based on research that quantified the relationship between increased R&D and greater life expectancy and well-being, we conclude that CER would cost Americans 81 million life years and $4 trillion. 6. CER advocates ignore the impact of such requirements at the possible expense of longer life and economic growth.