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Value Of Innovation |
PROLOGUE
The Value Of Innovation
PROLOGUE: By firmly establishing the link between microbes and infectious diseases, Louis Pasteur’s famous experiments captured the imagination of the forebears of today’s pharmaceutical giants, who were quick to recognize the therapeutic value of Pasteur’s work. But the marvels of yesterday have faded into the background to become today’s expectations, and public fascination with the miracles of modern medicine has given way to concern over pharmaceutical profits and, more generally, the effect of the march of technology on health care costs.
Attacks on the pharmaceutical industry in particular have become a staple of the daily news, with members of Congress, health plans, and citizens’ groups demanding laws to control profits and make prescription drugs more affordable. Industry representatives counter the charges of profiteering by pointing out that industry opponents often look exclusively at the costs of innovations, without taking full account of their benefits.
The papers that follow take up several issues surrounding just this issue of "value" in medical innovation. David Cutler and Mark McClellan analyze technological change in five medical conditions to determine whether or not the benefits of medical advances exceed the costs in those diseases. They base their study on an extensive literature—including their own work—on heart attack, low-birthweight infants, depression, cataracts, and breast cancer. For the first four of these, they find that the estimated benefit of technological change is much greater than the cost. Victor Fuchs and Harold Sox present the results of a recent survey of leading general internists, who were asked to provide their opinions of the relative importance to patients of thirty medical innovations. Fuchs is a well-known health economist who has devoted a large portion of his career to the question of balancing the benefits and costs of technology in the context of rationing care and extending access; Sox is a physician and equally distinguished researcher who now edits the Annals of Internal Medicine. J.D. Kleinke, a health technology entrepreneur, closes out the section with an essay that proclaims, among other things, that current proposals for price and utilization controls are simplistic and could possibly set off a round of unwelcome consequences.
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