Have Newer Cardiovascular Drugs Reduced Hospitalization? Evidence from Longitudinal Country-Level Data on 20 OECD Countries, 1995-2003
Have Newer Cardiovascular Drugs Reduced Hospitalization? Evidence from Longitudinal Country-Level Data on 20 OECD Countries, 1995-2003
复制标题
新型心血管药物是否减少了住院率？
DOI：
10.1002/hec.1382
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
F. Lichtenberg
中科院分区：
文献类型：
--
作者：
F. Lichtenberg
本研究使用纵向国家级数据探讨了心血管系统药物年份分布的变化对心血管疾病住院和死亡率的影响。药物的年份是指该药物在世界任何地方上市的第一年。我们使用 1995 年至 2003 年期间 20 个 OECD 国家使用 1100 多种心血管药物（活性成分）的年度数据。含有 1995 年后成分的心血管药物剂量比例增加较大的国家，在控制了每人消耗的心血管药物数量、其他医疗创新（计算机断层扫描仪和磁共振成像设备）的使用、潜在风险因素（卡路里、烟草和酒精的平均消耗量）和人口变量（人口）后，心血管疾病出院率增幅较小。 规模和年龄结构、收入和教育程度）。估计还表明，新型心血管药物的使用降低了平均住院时间和年龄调整后的心血管死亡率，但并未降低每 10 万人中 70 岁之前因心血管疾病导致的潜在寿命损失数。估计表明，如果 1995-2004 年期间药品使用量没有增加，2004 年的住院率和死亡率将会更高。我们估计，如果 1995-2004 年期间药品使用量没有增加，2004 年心血管住院的人均支出将增加 70%（89 美元）。如果 1995 年至 2004 年期间药物年数没有增加，2004 年心血管药物的人均支出将会较低。然而，我们对心血管住院支出增加的估计大约是我们对人均心血管药物支出减少（24 美元）估计的 3.7 倍。
This study examines the effect of changes in the vintage distribution of cardiovascular system drugs on hospitalization and mortality due to cardiovascular disease using longitudinal country-level data. The vintage of a drug is the first year in which it was marketed anywhere in the world. We use annual data on the utilization of over 1100 cardiovascular drugs (active ingredients) in 20 OECD countries during the period 1995-2003. Countries with larger increases in the share of cardiovascular drug doses that contained post-1995 ingredients had smaller increases in the cardiovascular disease hospital discharge rate, controlling for the quantity of cardiovascular medications consumed per person, the use of other medical innovations (computed tomography scanners and magnetic resonance imaging units), potential risk factors (average consumption of calories, tobacco, and alcohol), and demographic variables (population size and age structure, income, and educational attainment). The estimates also indicate that the use of newer cardiovascular drugs has reduced the average length of stay and the age-adjusted cardiovascular mortality rate, but not the number of potential years of life lost due to cardiovascular disease before age 70 per 100,000 population. The estimates indicate that if drug vintage had not increased during 1995-2004, hospitalization and mortality would have been higher in 2004. We estimate that per capita expenditure on cardiovascular hospital stays would have been 70% ($89) higher in 2004 had drug vintage not increased during 1995-2004. Per capita expenditure on cardiovascular drugs would have been lower in 2004 had drug vintage not increased during 1995-2004. However, our estimate of the increase in expenditure on cardiovascular hospital stays is about 3.7 times as large as our estimate of the reduction in per capita expenditure for cardiovascular drugs that would have occurred ($24).