Healthcare

We update and extend our previous study of the effect of drug age -- years since FDA approval -- on total medical expenditure, in several respects. The estimates indicate that, in the entire population, a reduction in the age of drugs utilized reduces non-drug expenditure 7.2 times as much as it increases drug expenditure. In the Medicare population, a reduction in the age of drugs utilized reduces non-drug expenditure by all payers 8.3 times as much as it increases drug expenditure; it reduces Medicare non-drug expenditure 6.0 times as much as it increases drug expenditure.

Between 1960 and 1997, life expectancy at birth of Americans increased approximately 10% - from 69.7 to 76.5 years - and it has been estimated that the value of life extension during this period nearly equaled the gains in tangible consumption. We investigate whether an aggregate health production function can help to explain the substantial fluctuations in the rate of increase in longevity since 1960. We view longevity as the output of the health production function, and output fluctuations as the consequence of fluctuations in medical inputs (expenditure) and technology.

Due to the importance of leisure time in general, and longevity in particular, to economic well-being, we propose replacing GDP in the production function by "full income," defined herein. We hypothesize that R&D-generated increases in the stock of knowledge capital may have a positive impact on both components of full income: leisure time (via longetivity) and consumption of goods and services.

We perform an econometric analysis of the effect of new drug launches on longevity, using data from the IMS Health Drug Launches database and the WHO Mortality Database. Our data cover virtually all of the diseases borne by people in 52 countries during the period 1982-2001 and enable us to control, to an unusually great extent, for the effects of other potential determinants of longevity, e.g., education, income, nutrition, the environment, and "lifestyle." We find that launches of new chemical entities (NCEs) have a strong positive impact on the probability of survival.

Only about one third of the approximately 80 drugs currently used to treat cancer had been approved when the war on cancer was declared in 1971. We assess the contribution of pharmaceutical innovation to the increase in cancer survival rates in a differences in differences' framework, by estimating models of cancer mortality rates using longitudinal, annual, cancer-site-level data based on records of 2.1 million people diagnosed with cancer during the period 1975-1995.

We perform an econometric analysis of the effect of new drug launches on longevity, using data from the IMS Health Drug Launches database and the WHO Mortality Database.

Study Objective: Significant variation in emergency department patient arrival rates necessitates the adjustment of staffing patterns to optimize the timely care of patients. This study evaluates the effectiveness of a queueing model in identifying provider staffing patterns to reduce the fraction of patients who leave without being seen.

Objective: To examine the relationship between ambulance diversions and the incidence of myocardial infarction deaths in New York City. Methods: We obtained data for 1999 and 2000 on all 9,743 deaths due to myocardial infarction in New York City, as well as periods of diversion status for 58 New York City area hospitals operating under a central ambulance dispatch by the New York City Fire Department. Negative binomial regressions were used to model the percentage increase in myocardial infarction deaths associated with diversion status.

Importation of drugs into the U.S. may soon become legal. Since prices of drugs are lower in most other countries than they are in the U.S., importation would result in a decline in U.S. drug prices. The purpose of this paper is to assess the consequences of importation for new drug development.