The Expanding Pharmaceutical Arsenal in the War on Cancer

Oncology eJournal Pub Date : 2004-02-01 DOI:10.3386/W10328
F. Lichtenberg
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引用次数: 36

Abstract

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 control for fixed cancer site effects, fixed year effects, incidence, stage distribution of diagnosed patients, mean age at diagnosis, and surgery and radiation treatment rates. Cancers for which the stock of drugs increased more rapidly tended to have greater increases in survival rates. The increase in the stock of drugs accounted for about 50-60% of the increase in age-adjusted survival rates in the first 6 years after diagnosis. New cancer drugs increased the life expectancy of people diagnosed with cancer by about one year from 1975 to 1995. The estimated cost to achieve the additional year of life per person diagnosed with cancer below $3000 is well below recent estimates of the value of a statistical life-year. Since the lifetime risk of being diagnosed with cancer is about 40%, the estimates imply that new cancer drugs accounted for 10.7% of the overall increase in U.S. life expectancy at birth.
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抗癌战争中不断扩大的药物库
1971年向癌症宣战时,目前用于治疗癌症的大约80种药物中,只有大约三分之一获得批准。我们利用1975-1995年期间210万癌症确诊患者的记录,使用纵向、年度、癌症地点水平的数据估计癌症死亡率模型,在差异中的差异框架下,评估了药物创新对癌症存活率提高的贡献。我们控制了固定的癌症部位效应、固定的年份效应、发病率、确诊患者的分期分布、诊断时的平均年龄以及手术和放射治疗率。药物储备增加得更快的癌症,其存活率往往会有更大的提高。药物库存的增加约占诊断后前6年年龄调整生存率增加的50-60%。从1975年到1995年,新的抗癌药物使癌症患者的预期寿命增加了大约一年。要使每个被诊断为癌症的人多活一年的估计成本低于3000美元,这远远低于最近对统计生命年价值的估计。由于一生中被诊断为癌症的风险约为40%,估计意味着新的癌症药物占美国出生时预期寿命总体增长的10.7%。
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