Papers on Pharmaceutical Innovation and Longevity Gains

Earlier this year, I noted a paper by Frank Lichtenberg that correlates life expectancy with the pace of introduction of new drugs - both of which are metrics that can be measured fairly well, and are fairly well recorded over the past few decades. So we see the expected result: one fairly general measure of the pace of progress in medicine is linked to longevity, most likely indicating that more rapid development of new medicine leads to longer lives, even when that medical progress is largely old-style drug discovery and commercial development. Here, I'll point out a few other papers along the same lines by the same author, one recent and the others from past years:

Pharmaceutical Innovation and Longevity Growth in 30 Developing and High-income Countries, 2000-2009

We examine the impact of pharmaceutical innovation, as measured by the vintage of prescription drugs used, on longevity, using longitudinal, country-level data on 30 developing and high-income countries during the period 2000-2009. We control for fixed country and year effects, real per capita income, the unemployment rate, mean years of schooling, the urbanization rate, real per capita health expenditure (public and private), the DPT immunization rate, HIV prevalence and tuberculosis incidence.

Life expectancy at all ages and survival rates above age 25 increased faster in countries with larger increases in drug vintage. The increase in drug vintage was the only variable that was significantly related to all of these measures of longevity growth. ... Pharmaceutical innovation is estimated to have accounted for almost three-fourths of the 1.74-year increase in life expectancy at birth in the 30 countries in our sample between 2000 and 2009, and for about one third of the 9.1-year difference in life expectancy at birth in 2009 between the top 5 countries (ranked by drug vintage in 2009) and the bottom 5 countries (ranked by the same criterion).

What to take away from this: even under the outright terrible systems of regulation that presently exist in most countries with advanced medical research communities, regulation that greatly slows progress and increases costs, the great utility of biotech research and development still filters through to this degree. Imagine how much better off we'd all be if there were no massive government agencies devoted to slowing down and blocking progress in medicine!

The older papers provide some more numbers to further flesh out the picture sketched by Lichtenberg and his colleagues. Medical progress is good - we should have more of it:

Pharmaceutical innovation and the longevity of Australians: a first look (2008)

We examine the impact of pharmaceutical innovation on the longevity of Australians during the period 1995-2003. Due to the government's Pharmaceutical Benefits Scheme, Australia has much better data on drug utilization than most other countries. We find that mean age at death increased more for diseases with larger increases in mean drug vintage. The estimates indicate that increasing the mean vintage of drugs by 5 years would increase mean age at death by almost 11 months. The estimates also indicate that using newer drugs reduced the number of years of potential life lost before the ages of 65 and 70 (but not before age 75). During the period 1995-2003, mean age at death increased by about 2.0 years, from 74.4 to 76.4. The estimates imply that, in the absence of any increase in drug vintage, mean age at death would have increased by only 0.7 years. The increase in drug vintage accounts for about 65% of the total increase in mean age at death.

Pharmaceutical Innovation, Mortality Reduction, and Economic Growth (1998)

We perform an econometric investigation of the contribution of pharmaceutical innovation to mortality reduction and growth in lifetime per capita income. In both of the periods studied (1970-80 and 1980-91), there is a highly significant positive relationship across diseases between the increase in mean age at death (which is closely related to life expectancy) and rates of introduction of new, priority (as defined by the FDA) drugs. The estimates imply that in the absence of pharmaceutical innovation, there would have been no increase and perhaps even a small decrease in mean age at death, and that new drugs have increased life expectancy, and lifetime income, by about 0.75-1.0% per annum.

The connection between wealth and longevity is strong. For a deeper historical perspective, you might look back at these posts:

Comments

I find the conclusion that drug use correlates with longevity to be intuitively repulsive. We know drugs and surgery kill over 110,000 Americans every year and the figure is rising. And that figure applies to correctly applied drugs and surgeries, not malpractice. We also know that otc and prescription drugs kill people as one of their side effects and many have been taken off the market because of this fact. Therefore, it would seem to me that any study that concludes drug use extends lifespan has several probable flaws:

1. Correlation is not causation. The correlation of longevity with drug use is not proof that drug use caused the unexpectedly longer lifespan.

2. The statement that drugs kill people, that is, shortens their lifespan, is not a matter of correlation; it is a matter of causation. The dead people were autopsied and the drugs that killed them were found in their bodies. Did the study that concluded drugs extend lifespan perform blood tests to actually find out if these people actually consumed their drugs? Or, did the study merely look at pharmacies' records of prescriptions and drug sales or some other remote record such as this? Without knowing if the subjects actually consumed the drugs they were prescribed and perhaps bought, there is no causation.

Posted by: David Dressler, BA, RMT at July 29th, 2012 10:38 PM

I find your conclusion that the study is flawed to be intuitively repulsive. This is compounded by the fact that you appear not to have read the study, and don't have any specific complaints that directly challenge the actual paper itself.

No-one is arguing that drugs don't have their problems. But to say that the current use of drugs makes things worse instead of better is to completely ignore and/or misinterpret the evidence.

Penicillin is a drug. Aspirin is a drug. Lipitor is a drug, chloroquine is a drug, and epinephrine is a drug. All of these have made profound improvements to human longevity and quality of life. To say otherwise is disingenuous at best, unethical fraud at worst.

Finally, your claim that "drugs and surgery kill over 110,000 Americans every year" seems trivially uninteresting when you consider that this is a mere 4% of the total yearly death count in the USA. If drugs have more than a 4% impact on that rate (which they do), they clearly come out as a net saver of lives.

Posted by: Dentin at July 30th, 2012 10:56 AM

Dentin, I am a little late in replying, it seems, but it appears while I was ruminating, 40,000 people died from taking aspirin. Is that a high enough figure for you to consider it more than "trivially uninteresting?"

Posted by: David Dressler, BA, RMT at February 24th, 2013 1:26 AM

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