8 - Medical Technologies: Aligning Private Rewards with Health Impacts

8 - 医疗技术：将私人奖励与健康影响结合起来

• 批准号: 10224055
• 负责人: HEIDI Lie WILLIAMS
• 金额: $ 13.16万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-02-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224055
• 关键词: Address; Affect; Automobile Driving; Censuses; Communities; Data; Data Set; Development; Diabetes Mellitus; Diagnostic tests; Drug Compounding; Evidence Based Medicine; Exercise; Expenditure; Funding; Goals; Health; Health Benefit; Heterogeneity; Incentives; Investments; Legal patent; Light; Link; Measures; Medical; Medical Research; Medical Technology; Medicine; Methodology; Outcome; Patients; Pharmaceutical Preparations; Policies; Policy Analysis; Privatization; Public Policy; Regulation; Research; Resources; Rewards; Role; Science; Scientist; Structure; Subgroup; System; Technology; Testing; Time; United States Food and Drug Administration; Work; aging population; base; cancer therapy; cost; design; improved; innovation; next generation; novel; off-patent; patient subsets; personalized medicine; programs; public health relevance; response

PROJECT SUMMARY/ABSTRACT Project 8 – Medical Technologies: Aligning Private Rewards with Health Impacts Over the past several decades, new medical technologies have generated dramatic improvements in health outcomes for many groups of patients. While a key ingredient in the development of any new medical technology is a scientific breakthrough, market incentives are often a critical determinant of which scientifically feasible medical technologies successfully make the transition from a scientist's lab to a patient's bedside. Hence, the design of public policies that affect market incentives —such as the patent system and regulations such as those of the US Food and Drug Administration (FDA) direction of medical innovation. —can have important effects on the rate and The goal of this project is to investigate whether our current system of patent and FDA policies fails to provide incentives for the development of some scientifically feasible medical technologies that would generate health benefits to patients. Our focus is the so-called “new uses” distortion, which may arise in cases where an off- patent drug has a new use discovered, such as the discovery that an off-patent diabetes drug may be an effective cancer treatment. There are few incentives for private research investments into such new uses of old drugs, and public research subsidies are not explicitly designed to encourage research into such new uses. We will develop a conceptual framework for policy analysis (Aim 1) and will develop newly-constructed data (Aim 2) to empirically test (Aim 3) whether this “new uses” distortion results in some scientifically feasible drugs never reaching patients. We will then attempt to quantify the health value to patients of these “missing” medical technologies (Aim 4), in order to estimate the potential health gains that could be realized under alternative policies. The results of this project aim to contribute more broadly to the ongoing debate about how best to deliver evidence-based medicine to patients, particularly in the emerging field of personalized medicine. Specifically, to the extent that the “new uses” problem exists, the magnitude of the invisible costs of the “missing” innovations it may cause are growing as personalized medicine becomes increasingly important. Personalized medicine is based on the idea of separating patients into subgroups, under the assumption that drugs that work for one subgroup of patients may not work well for another. As progress is made in science and medicine about how best to classify patients into such subgroups, opportunities will arise for new medically valuable matches between drugs and more targeted groups—and many or most of these new matches would likely come from the stock of existing drugs. Maximizing the health of an aging population will thus increasingly depend on policies that promote the most effective use of medications across patients and conditions.

项目概要/摘要 项目 8 – 医疗技术：使私人奖励与健康影响相一致 在过去的几十年里，新的医疗技术极大地改善了健康状况 许多患者群体的结果。虽然是开发任何新医学的关键因素 技术是一项科学突破，市场激励往往是科学突破的关键决定因素 可行的医疗技术成功地从科学家的实验室转移到患者的床边。 因此，影响市场激励的公共政策的设计——例如专利制度和法规 例如美国食品和药物管理局 (FDA) 的规定 医疗创新方向。 - 可以对速率和产生重要影响 该项目的目标是调查我们当前的专利制度和 FDA 政策是否未能提供 鼓励开发一些科学上可行的医疗技术，以促进健康 对患者的好处。我们的重点是所谓的“新用途”扭曲，这种扭曲可能在​​以下情况下出现： 专利药物发现了新用途，例如发现专利到期的糖尿病药物可能是 有效的癌症治疗。私人研究投资于旧有新用途的激励措施很少 药物和公共研究补贴并没有明确旨在鼓励对此类新用途的研究。 我们将开发政策分析的概念框架（目标 1），并将开发新构建的数据 （目标 2）凭经验检验（目标 3）这种“新用途”扭曲是否会导致一些科学上可行的药物 永远无法到达患者身边。然后，我们将尝试量化这些“缺失”的医疗设备对患者的健康价值 技术（目标 4），以估计替代方案下可实现的潜在健康收益 政策。 该项目的结果旨在为正在进行的关于如何最好地交付的辩论做出更广泛的贡献 为患者提供循证医学，特别是在新兴的个性化医疗领域。具体来说， 只要存在“新用途”问题，“缺失”的隐形成本就有多大 随着个性化医疗变得越来越重要，它可能带来的创新也在不断增长。个性化 医学基于将患者分为亚组的想法，假设药物 对一个亚组患者的工作可能不适用于另一亚组患者。随着科学和医学的进步 关于如何最好地将患者分为此类亚组，将会出现新的具有医学价值的机会 药物与更有针对性的群体之间的匹配——这些新匹配中的许多或大部分可能会 来自现有药品库存。因此，最大限度地提高老龄化人口的健康将越来越 取决于促进针对患者和病情最有效地使用药物的政策。