During 1948-1958, pharmaceutical companies introduced 4,829 new products and 3,686 new compounds. According to a recent study, 150 of the 200 most frequently prescribed drugs in 1982 were developed since 1950. As a result of this pharmaceutical research, enormous progress has been made in conquering disease. The value of modern medicines has perhaps been most succinctly stated by Victor Fuchs in his examination of health-economic issues, Who Shall Live? (Basic Books, 1974): "Surgery, radiotherapy, and diagnostic tests are all important, but the ability of health care providers to alter health outcome...depends primarily on drugs....Our age has been given many names--atomic, electronic, space, and the like-but measured by impact on people's lives it might just as well be called the drug age." Anti-Infective Agents Many contagious diseases that once were leading causes of death in the United States have been controlled through the development of anti-infective drugs. The use of medicines, particularly antibiotics and other antibacterial agents, also has led to a reduction in surgery for such conditions as osteomyelitis, mastoid infection and brain and lung abcess. At the turn of the century, just three infectious diseases-tuberculosis, influenza and pneumonia-accounted for more than Since that time, the 25 percent of all deaths in the United States. death rate from tuberculosis has been dramatically reduced in this country partly as a result of the development of effective medicines. Some 10 pharmaceuticals-including several antibiotics-developed since the 1940s have helped to control the disease. In 1980, there were 27,749 tuberculosis cases and only 1,770 deaths caused by the disease in the United States compared to 84,304 cases and 19,707 deaths in 1953-8 91 percent reduction in deaths. Vaccines Similarly, anti-infective medicines and vaccines have helped to cut the death rates in this country from influenza, pneumonia and such other serious diseases as cholera, puerperal sepsis, scarlet fever, meningococcal meningitis, typhoid fever, dysentery and syphilis. Dramatic successes have been achieved against smallpox and polio. During the 1920s, there were more than 530,000 cases of smallpox reported in the United States. Because of widespread vaccination, not one confirmed case of smallpox has been reported in this country in more than 25 years not one throughout the world since 1977. As recently as 1952, 57,879 cases of polio were reported in the United States. The Salk vaccine was introduced in 1955, followed by the Sabin vaccine six years later. The result: only eight cases of polio reported in 1983. Vaccines also have provided immunity against infectious diseases such as measles, diphtheria, whooping cough, tetanus, rubella, mumps, pneumoccal pneumonia, hepatitis B and rabies. Analgesics Aspirin-introduced just after the turn of the century-was the first safe and effective non-narcotic analgesic, but its potency was limited. Although analgesics do not cure or appreciably alter the course of a disease, they can relieve pain and bring a sense of well-being in the presence of disease. The first non-opiate drug to match the opium alkaloids in analgesic potency was meperidine, synthesized in 1939. Some of the recently-discovered non-steroidal anti-inflammatory drugs also have excellent analgesic properties. Cardiovascular Drugs During the last 25 years, new medicines helped produce a substantial reduction in the death rate for what had become the leading killer in the United States and throughout the industrialized world-cardiovascular disease. In just the last 10 years, deaths from strokes declined by 43 percent, while deaths from heart attacks decreased by 25 percent. New medicines, including the thiazide class of diuretic hypotensives, beta blockers and calcium antagonists, were partly responsible for the improvement. Anti-Cancer Drugs Medicines also have become increasingly effective in treating the disease Americans fear the most-cancer. The first anti-cancer drugs, the nitrogen mustards, were introduced in 1942. Since that time, more than 50 other anti-cancer drugs have been developed. In late 1983, the National Cancer Institute reported that more than 50 percent of all cancer patients are surviving for at least five years--up from 33 percent in the mid 1950s--and that most of this group are cured of the disease. Medicines have helped treat a wide range of other diseases-including mental illnesses, epilepsy, diabetes, glaucoma and Parkinson's disease--and, in all, have helped prolong and greatly improve the quality of life for millions of people throughout the world. REVIEW OF LITERATURE ON COST-EFFECTIVENESS OF VACCINES (Reports 2 and 3) Reviews of the literature on vaccines and vaccination programs both in developed and developing countries result in the same conclusion: their benefits generally exceed their costs, despite differences in evaluative approaches and in the data used. Vaccines in Developed Countries In Report 2, Burton A. Weisbrod and John H. Huston of the University of Wisconsin reviewed cost-effectiveness studies of 10 vaccines and vaccination programs in developed countries. The results of their review follow. Measles: All seven studies of measles vaccine showed that its benefits far exceeded its costs. The unanimity of results was found even though the studies were conducted over many years-from 1963 to 1975-and in many regions of several countries-Austria, Finland and the United States. Of the two studies reporting results that can be expressed in benefit-cost ratios, one found that benefits were more than 10 times costs over a nine-year period (a benefit-cost ratio of 10.4:1), the other that benefits were almost five times costs over a six-year period (a benefit-cost ratio of 4.9:1). And in another study, benefits were shown to exceed costs by $1.3 billion from 1963 to 1972. 45-024 085 - 6 |