糖尿病研究与公益:联邦政府对1型糖尿病研究的支持

R. Shapiro, Nam D. Pham
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引用次数: 1

摘要

糖尿病是当今美国最常见、增长最快的危及生命的疾病之一:2011年,近2600万美国人患有糖尿病,高于2007年的2400万;流行病学家估计,到2020年,将近12%的美国人或3920万人将患有糖尿病。糖尿病是每年超过7万美国人死亡的潜在原因,另外还有16万人死亡。糖尿病也给美国经济造成了巨大损失。本研究分析了这些经济影响,并评估了是否继续特殊糖尿病计划,该计划通过国家卫生研究院资助治疗和治愈1型糖尿病(T1D)的研究,可能有助于有意义地改善与糖尿病相关的不利经济影响。我们发现,2007年治疗糖尿病患者花费了美国人1280亿美元,约占GDP的0.9%;我们估计,到2020年,这些医疗费用将达到4100亿美元,占2020年预计GDP 23.4万亿美元的1.8%。我们进一步估计,2007年,因糖尿病及其并发症导致的误工、永久性残疾和过早死亡所造成的生产力损失总计达650亿美元,占当年美国GDP的0.5%。我们进一步估计,到2020年,这些非医疗经济成本将达到1960亿美元,占当年预计GDP的0.8%以上。美国国立卫生研究院目前每年提供1.5亿美元用于支持T1D的研究,以及通过其他拨款项目提供的额外资金,我们不知道这项研究最终是否会产生更好的治疗方法。然而,在美国国立卫生研究院支持T1D研究15年后,如果该项目继续下去,取得额外突破的可能性应该会增加。我们进一步预测,如果到2020年,这些进步将T1D的发病率和严重程度降低10%,每年节省的医疗费用将超过26亿美元,其中包括医疗保险和医疗补助节省的19亿美元,再加上每年22亿美元的非医疗经济节省,每年总计节省48亿美元。在这种情况下,这些预付款将产生163%的年回报率,年复一年。我们还估计,如果这些进步的溢出效应在2020年将2型糖尿病(T2D)的发病率和严重程度降低5%,那么每年将节省近174亿美元的医疗费用,其中包括每年超过123亿美元的医疗保险和医疗补助费用,以及每年近75亿美元的非医疗经济成本。基于这一分析,我们得出结论,联邦政府应该继续支持T1D的研究。
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Diabetes Research and the Public Good: Federal Support for Research on Type 1 Diabetes
Diabetes is one of the most common, rapidly-growing life-threatening medical conditions in the United States today: Nearly 26 million Americans had diabetes in 2011, up from 24 million in 2007; and epidemiologists estimate that by 2020, nearly 12 percent of Americans or 39.2 million people will have diabetes. Diabetes is the underlying cause of death of over 70,000 Americans a year and a contributor to an additional 160,000 deaths. Diabetes also exacts a large toll on the U.S. economy. This study analyzes these economic effects and assesses whether continuing the Special Diabetes Program, which funds research into treating and curing Type 1 Diabetes (T1D) through the National Institutes of Health, could contribute to meaningfully ameliorating the adverse economic effects associated with diabetes. We found that treating people with diabetes cost Americans $128 billion in 2007 or about 0.9 percent of GDP; and we estimate that by 2020, these medical costs will reach $410 billion or an estimated 1.8 percent of a projected GDP of $23.4 trillion in 2020. We further estimate that the productivity losses associated with missed work, permanent disabilities and premature deaths from diabetes and its complications totaled $65 billion in 2007 or 0.5 percent of U.S. GDP in that year. We further estimate that by 2020, these non-medical, economic costs will reach $196 billion or more than 0.8 percent of projected GDP in that year. The NIH currently provides $150 million per-year to support research into T1D, as well as additional funds through other grant programs, and we cannot know if this research will ultimately produce better treatments for the disease. However, after 15 years of NIH support for T1D research, the likelihood of additional breakthroughs should increase if the program is maintained. We further project that if such those advances reduce the incidence and severity of T1D by 10 percent by 2020, the savings in medical costs would exceed $2.6 billion per-year, including $1.9 billion in savings for Medicare and Medicaid, plus another $2.2 billion in annual non-medical economic savings, for a total savings of $4.8 billion a year. In this scenario, the advances would produce an annual rate of return of 163 percent year after year. We also estimate that if spillovers from these advances reduce the incidence and severity of Type 2 Diabetes (T2D) by 5 percent in 2020, that would save nearly $17.4 billion per-year in medical costs, including more than $12.3 billion per-year in Medicare and Medicaid costs, plus nearly $7.5 billion per-year in non-medical economic costs. Based on this analysis, we conclude that federal support for research in T1D should continue.
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