Economic Impacts of New Drugs

描述（由申请人提供）：处方药是心理健康治疗的核心组成部分。在过去的15年里，精神药物发生了巨大的创新。与此同时，近年来精神药物的支出以每年15%以上的速度增长。这些增加主要是由于精神药物使用量的增加和新药价格的上涨。新型精神药物的支出已成为公共和私人政策制定者关注的焦点。一些分析人士认为，为了判断新药对支出的净影响，必须考虑新药在整个系统中的影响。本申请提出了一个研究计划，通过检查新的精神药物是否通过抵消其他健康和精神卫生保健费用来“自付”，从而评估新的精神药物对健康和精神卫生保健支出的净影响。我们将重点关注三种具体情况：重度抑郁症、双相情感障碍和精神分裂症。将通过荟萃分析对临床试验的证据进行评估。该研究的主要内容将使用1991-2000年大量参保人口和1993-2002年佛罗里达医疗补助计划的数据。将使用工具变量方法指定和估计计量经济模型，以支持从观测数据得出的推论。最后，我们将研究这一命题，即补偿在不同种族和民族群体中发生的差异，对于高利用率和根据保险安排的组织。

DESCRIPTION (provided by applicant): Prescription drugs are central components to mental health treatments. Dramatic innovations in psychotropic drugs have occurred over the last 15 years. At the same time spending on psychotropic medications has increased at rates of over 15% per annum in recent years. These increases have been driven primarily by increases in the volume of psychotropic drugs used and by the prices of new drugs. Spending on new psychotropic medications has become a focus of both public and private policy makers. Some analysts have argued that one must look at the system wide effect of new drugs in order to judge their net impact on spending. This application proposes a program of research that will assess the net impact of new psychotropic drugs on health and mental health care spending by examining whether new psychotropic drugs "pay for themselves" by offsetting other health and mental health care costs. We will focus on three specific conditions: major depression, bipolar disorder and schizophrenia. Evidence will be assessed from clinical trials via the use of meta-analysis. The major thrust of the research will use data from a large insured population for the years 1991-2000 and from the Florida Medicaid program for the years 1993-2002. An econometric model will be specified and estimated using instrumental variables methods to bolster the inferences from the observational data. Finally, we will examine the proposition that offsets occur differentially across racial and ethnic groups, for high utilizers and according to the organization of insurance arrangements.