Frank Lichtenberg
Columbia University, Graduate School of Business, Faculty Member
- Frank R. Lichtenberg is Cain Brothers & Company Professor of Healthcare Management at the Columbia University Graduate School of Businessedit
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info:eu-repo/semantics/nonPublishe
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Objective: To investigate whether there were racial and gender disparities in the effect of new drug approvals on U.S. cancer mortality since 1990. Study design: We estimate two-way (by cancer site and year (1990–2019)) fixed-effects... more
Objective: To investigate whether there were racial and gender disparities in the effect of new drug approvals on U.S. cancer mortality
since 1990. Study design: We estimate two-way (by cancer site and year (1990–2019)) fixed-effects models of the age-adjusted
mortality rate for four race/sex groups: white males, white females, black males, and black females. The main explanatory variables of
the models are distributed lags of the number of drugs approved for a cancer site. We control for the current and lagged age-adjusted
incidence rate. Principal findings: For all four demographic groups, the age-adjusted mortality rate is significantly inversely related to
either the number of drugs approved 0–5 years earlier, the number of drugs approved 6–10 years earlier, or both. The approval of one
additional drug for a cancer site reduced the mortality rate of white males and black males by about 2% and 1%, respectively,
controlling for lagged incidence. The approval of one additional drug for a cancer site 6–10 years earlier reduced the black female
mortality rate by about 1.3–58% as much as it reduced the white female mortality rate (2.2%). Conclusions: Some demographic
groups may have had greater access to new cancer drugs than other groups. Some cancer drug innovations for certain sites have been
shown to be more effective for some groups than for others. Also, there may be racial differences in rates of usage of some drugs
for some cancers due to racial differences in levels of trust of biomedical/drug institutions.
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This study seeks to analyze the overall impact that biopharmaceutical innovation had on disability, Social Security recipiency, and the use of medical services of U.S. community residents during the period 1998–2015. We test the... more
This study seeks to analyze the overall impact that biopharmaceutical innovation had on disability, Social Security recipiency, and the use of medical services of U.S. community residents during the period 1998–2015. We test the hypothesis that the probability of disability, Social Security recipiency, and medical care utilization associated with a medical condition is inversely related to the number of drug classes previously approved for that condition. We use data from the 1998–2015 waves of the Medical Expenditure Panel Survey and other sources to estimate probit models of an individual’s probability of disability, Social Security recipiency, and medical care utilization. The effect of biopharmaceutical innovation is identified by differences across over 200 medical conditions in the growth in the lagged number of drug classes ever approved. 18 years of previous biopharmaceutical innovation is estimated to have reduced: the number of people who were completely unable to work at ...
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We analyze the association that pharmaceutical innovation had with premature mortality from all diseases in Switzerland during the period 1996–2018, and its association with hospital utilization for all diseases in Switzerland during the... more
We analyze the association that pharmaceutical innovation had with premature mortality from all diseases in Switzerland during the period 1996–2018, and its association with hospital utilization for all diseases in Switzerland during the period 2002–2019. The analysis is performed by investigating whether the diseases that experienced more pharmaceutical innovation had larger subsequent declines in premature mortality and hospitalization. Pharmaceutical innovation is measured by the growth in the number of drugs used to treat a disease ever registered in Switzerland. Utilization of a chemical substance reaches a peak 9–12 years after it was first launched, and then declines. Our estimates indicate that the number of years of potential life lost before ages 85, 75, and 65 is significantly inversely related to the number of chemical substances ever registered 6–9, 3–9, and 0–9 years earlier, respectively. The new chemical substances that were registered during the period 1990–2011 are...
Between 1960 and 1997, life expectancy at birth of Americans increased approximately 10 % from 69.7 to 76.5 years and it has been estimated that the value of life extension during this period nearly equaled the gains in tangible... more
Between 1960 and 1997, life expectancy at birth of Americans increased approximately 10 % from 69.7 to 76.5 years and it has been estimated that the value of life extension during this period nearly equaled the gains in tangible consumption. While life expectancy has tended to increase, there have been substantial fluctuations in the rate of increase. In this paper we investigate whether an aggregate health production function can help to explain the annual time-series behavior of U.S. longevity since 1960. We view longevity as the output of the health production function, and output fluctuations as the consequence of fluctuations in medical inputs (expenditure) and technology. We estimate longevity models using annual U.S. time-series data on life expectancy, health expenditure, and medical innovation. Reliable annual data are available for only one type of innovation new drugs but pharmaceutical R&D accounts for a significant fraction of total biomedical research. The empirical an...
Background We analyzed the role that the launch of new drugs has played in reducing the number of years of life lost (YLL) before three different ages (85, 70 and 55 y) due to 66 diseases in 27 countries. Methods We estimated two-way... more
Background We analyzed the role that the launch of new drugs has played in reducing the number of years of life lost (YLL) before three different ages (85, 70 and 55 y) due to 66 diseases in 27 countries. Methods We estimated two-way fixed-effects models of the rate of decline of the disease- and country-specific age-standardized YLL rate. The models control for the average decline in the YLL rate in each country and from each disease. Results One additional drug launch 0–11 y before year t is estimated to have reduced the pre-age-85 y YLL rate (YLL85) in year t by 3.0%, and one additional drug launch ≥12 y before year t is estimated to have reduced YLL85 by 5.5%. (A drug’s utilization peaks 8–10 y after it is launched.) Controlling for the number of drugs previously launched, YLL rates are unrelated to the number of drug classes previously launched. Conclusions The estimates imply that, if no new drugs had been launched after 1981, YLL85 in 2013 would have been 2.16 times as high a...
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This study provides econometric evidence about the impact that new chemical entity (NCE) launches had on premature mortality from 17 diseases in 9 Middle Eastern and African countries during the period 2007–2015. The greater the relative... more
This study provides econometric evidence about the impact that new chemical entity (NCE) launches had on premature mortality from 17 diseases in 9 Middle Eastern and African countries during the period 2007–2015. The greater the relative number of NCEs for a disease launched in a country, the greater the subsequent relative decline in premature mortality from that disease, controlling for the average rate of mortality decline in each country and from each disease. An 8-year increase in the number of post-1992 NCEs ever launched is estimated to have reduced the number of years of potential life lost before age 75 (YPLL75) in 2015 by 9.5 %. This is approximately half of the 18.9 % reduction in YPLL75, and about one-third of the 29.7 % reduction in the premature mortality rate. In the absence of 8 previous years of NCE launches, 2.80 million additional YPLL before age 75 would have been lost in 2015. Expenditure on new drugs per life-year below age 75 gained in 2015 from the drugs was ...
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The premature cancer mortality rate has been declining in Switzerland, but there has been considerable variation in the rate of decline across cancer sites (e.g., breast or digestive organs). I analyze the effect that pharmaceutical... more
The premature cancer mortality rate has been declining in Switzerland, but there has been considerable variation in the rate of decline across cancer sites (e.g., breast or digestive organs). I analyze the effect that pharmaceutical innovation had on premature cancer mortality in Switzerland during the period 1995-2012 by investigating whether the cancer sites that experienced more pharmaceutical innovation had larger declines in premature mortality, controlling for the number of people diagnosed and mean age at diagnosis. Premature cancer mortality before ages 75 and 65 is significantly inversely related to the cumulative number of drugs registered 5, 10, and 15 years earlier. The number of drugs registered during 1980-1997 explains 63 % of the variation across cancer sites in the 1995-2012 log change in the premature (before age 75) mortality rate. Controlling for the cumulative number of drugs, the cumulative number of chemical subgroups does not have a statistically significant ...
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I investigate the contribution of pharmaceutical innovation to recent longevity growth in Germany and France. First, I examine the effect of the vintage of prescription drugs (and other variables) on the life expectancy and age-adjusted... more
I investigate the contribution of pharmaceutical innovation to recent longevity growth in Germany and France. First, I examine the effect of the vintage of prescription drugs (and other variables) on the life expectancy and age-adjusted mortality rates of residents of Germany, using longitudinal, annual, state-level data during the period 2000-2007. The estimates imply that almost half of the 1.7-year increase in German life expectancy during the period 2000-2007 was due to the replacement of older drugs by newer drugs. Next, I examine the effect of the vintage of chemotherapy treatments on age-adjusted cancer mortality rates of residents of France, using longitudinal, annual, cancer-site-level data during the period 2002-2006. The estimates imply that chemotherapy innovation accounted for at least one-sixth of the decline in French cancer mortality rates, and may have accounted for as much as half of the decline.
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There are two types of prescription drug cost offsets. The first type of cost offset – from prescription drug use – is primarily about the effect of changes in drug quantity (e.g. due to changes in out-of-pocket drug costs) on other... more
There are two types of prescription drug cost offsets. The first type of cost offset – from prescription drug use – is primarily about the effect of changes in drug quantity (e.g. due to changes in out-of-pocket drug costs) on other medical costs. Previous studies indicate that the cost offsets from prescription drug use may slightly exceed the cost of the drugs themselves. The second type of cost offset – the cost offset from prescription drug innovation – is primarily about the effect of prescription drug quality on other medical costs. Two previous studies (of a single disease or a single country) found that pharmaceutical innovation reduced hospitalization, and that the reduction in hospital cost from the use of newer drugs was considerably greater than the innovation-induced increase in pharmaceutical expenditure. In this study, we reexamine the impact that pharmaceutical innovation has had on hospitalization, employing a different type of 2-way fixed effects research design. I...
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... Biographical notes: Frank R. Lichtenberg is the Courtney C. Brown Professor of Business ... Kyle, MK (2007) 'Pharmaceutical price controls and entry strategies', The Review of Economics ... from longitudinal disease-level... more
... Biographical notes: Frank R. Lichtenberg is the Courtney C. Brown Professor of Business ... Kyle, MK (2007) 'Pharmaceutical price controls and entry strategies', The Review of Economics ... from longitudinal disease-level data from 52 countries, 19822001', International Journal of ...
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The benefits of new drugs to society exceed their cost by a substantial margin. These benefits include net decrease in overall medical expenditures, reduced limitations on work and other activities contributing to quality of life, and... more
The benefits of new drugs to society exceed their cost by a substantial margin. These benefits include net decrease in overall medical expenditures, reduced limitations on work and other activities contributing to quality of life, and increased longevity. Further, new drugs contribute to health and economic growth in the United States. Formularies, to the extent that they restrict drug choices, restrict access to new drugs.
Research Interests: Accessibility, Mental Health, Economic Growth, Quality of life, Public Health, and 15 moreHealth Policy, Comparative Study, Longevity, Humans, Life Expectancy, Health Status, Health Expenditures, Cost Benefit Analysis, Drug Therapy, Drug Industry, Drug Utilization, New Product, Health Services Accessibility, Psychology and Cognitive Sciences, and Medical and Health Sciences
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