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Fifty million life-years saved through medical innovation

Today’s debate over the costs of the new medicines, especially molecularly targeted therapies, basically gets down to this question: what is medical innovation really worth?  

From the standpoint of the Alliance for the Adoption of Innovations in Medicine (Aimed Alliance), the answer is unequivocal: the return on investment (ROI) has been substantial. Simply put, while the cost of developing novel therapies can run as high as $5 billion per medicine, according to a recent article in Forbes Magazine, medical innovation has saved more than 50 million life-years in the United States since 1990, dramatically reduced the burden to the healthcare system, and helped expand our economy. 

{mosads}Looking specifically at cancer — now the nation’s most costly disease and the second most common cause of death — medical innovation has had a major impact. Today, almost 70 percent of patients live at least five years after a cancer diagnosis, and there are approximately 14 million cancer survivors, up from 6 million in 1990.  In other disease areas, the benefits have been even more dramatic. The development of four human immunodeficiency virus (HIV) therapies led to a 90 percent reduction in HIV-related deaths. 

Examining the ROI of more lives saved on a macro level, every dollar spent extending people’s life span is magnified in the overall economy. With cancer, new therapies are associated with reduced spending on hospital and physician care, amounting to an economic gain of $1.2 million per person. This translates into $3.2 trillion per year in national wealth added to the economy between 1970 and 2000, a value equal to about half the annual Gross Domestic Product (GMP) over this 30 year period.  

On the micro level, the additional time added to life is priceless for patients and families. For example, in July 1999, the Centers for Disease Control and Prevention (CDC) announced the death at age 90 of the first American to be saved by penicillin– 57 years after she fell deathly ill and was cured by an experimental drug that enabled her to marry, raise a family, and thrive for many more decades.  

Also describing the real-life ROI of medical innovation, Siddhartha Mukherjee, MD, in his 2011 Pulitzer Prize winning nonfiction book, The Emperor of All Maladies, told this story of a cancer patient: “In 2005, a man diagnosed with multiple myeloma asked me if he would be alive to watch his daughter graduate from high school in a few months. In 2009, bound to a wheelchair, he watched his daughter graduate from college,” More importantly, Dr. Mukherjee added, “The wheelchair had nothing to do with his cancer. The man had fallen down while coaching his youngest son’s baseball team.”  

Thus, on both a macro and micro level, the ROI from medical innovation is well documented and quantified. Yet, what is not well quantified are the increasing regulatory requirements and delays in review decisions that add years and costs to scientific discovery and drug development. While a new HIV treatment only required two years from discovery to Food and Drug Administration (FDA) approval during the height of the AIDS epidemic, it now takes an average of 8.8 years to bring a new cancer therapy to patients. Moreover, drug development is an uncertain process in which an estimated 19 out of every 20 experimental compounds end up failing.  

Therefore, to realize the ROI that medical innovation makes possible, patients will be better served by policy solutions that reduce the time and costs of bringing new therapies to market instead of a lot of finger-pointing. To be clear, innovative medicines come with costs. However, the benefits of cutting-edge treatments – to patients, the healthcare system, and the economy – are many times greater than their price tag.

Worthy is  policy director for the Alliance for the Adoption of Innovations in Medicine.

 

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