Can Medical Progress Be Sustained? Implications of the Link between Development and Output Markets

A. Malani, T. Philipson
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引用次数: 13

Abstract

There is considerable debate about the impact of health care reform on the growth in medical spending. Medical innovation is thought to be a central contributor to that growth. We argue that there is a unique linkage between reforms that affect output markets for medical care and medical R&D costs. This linkage is due to the fact that potential consumers of medical care are also potential participants in clinical trials that are required to develop new medical products. Therefore, reforms that increase the quality or reduce the price of already developed treatments reduce the incentive of patients to participate in trials of experimental treatments. This delays development and reduce the returns to in innovation. We provide evidence of this "subject market effect" by considering the impact of changes in the quality of conventional care on development. We document a dramatic drop in trial recruitment following introduction of break-through HIV/AIDS therapies in 1996. We conclude by discussing additional positive and normative implications of the subject market effect that link input and output markets for medical products.
医学进步能否持续?发展与产出市场之间联系的含义
关于医疗改革对医疗支出增长的影响存在相当大的争论。医疗创新被认为是这一增长的主要贡献者。我们认为,影响医疗产出市场的改革与医疗研发成本之间存在独特的联系。这种联系是由于医疗保健的潜在消费者也是开发新医疗产品所需的临床试验的潜在参与者。因此,提高已经开发的治疗方法的质量或降低价格的改革降低了患者参与实验性治疗试验的动机。这拖延了发展,降低了创新的回报。我们通过考虑传统护理质量变化对发展的影响,为这种“主体市场效应”提供证据。我们记录了1996年引入突破性的艾滋病毒/艾滋病疗法后,试验招募人数急剧下降。最后,我们讨论了连接医疗产品投入和产出市场的主体市场效应的其他积极和规范含义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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