Manhattan Institute’s Longevity Report–Overstating the Benefits of Drugs

The Manhattan Institute, an organization with the goal “\to develop and disseminate new ideas that foster greater economic choice and individual responsibility.” has reported that thanks to new drugs we are living longer. The organization has the support of Vice President Cheney as a “place of tremendous creativity, of original thinking, and of intellectual rigor.” He continued: “The scholars of the Manhattan Institute have shown, time and again, the power of good ideas to shape public policy and to have an impact on the lives of people here in New York and across the nation.” It should be noted that Cheney is an expert at shaping public policy by misstating facts.

The Manhattan Institute, from a medicynical point of view, has a checkered history and has been associated with the tobacco industry and does receive funding from Big PHARMA.” A 1997 R.J. Reynolds memo reveals RJR’s intent to use the Manhattan Institute as a third party to help the company reduce the public’s perception of danger from exposure to secondhand smoke.” The Institute, FYI, receives hundreds of thousands of dollars in drug company funding. The author of the study, Frank Lichtenberg, has received unrestricted grants from (Merck) and has worked as a consultant to Pfizer–there may be other unreported associations.

In the current study he notes:

• From 1991 to 2004, nationwide, life expectancy at birth increased 2.33 years; life expectancy at age 65 increased by 1.29 years.

• The states with the largest increases in life expectancy were the District of Columbia (5.7 years), New York (4.3 years), California (3.4 years), New Jersey (3.3 years), and Illinois (3.0 years).

• The states with the smallest increases in life expectancy were Oklahoma (0.3 years), Tennessee (0.8 years), Utah (0.9 years), Alabama (1.0 years), and West Virginia (1.0 years).

• In the eight states with the smallest increases, life expectancy increased by 0.31-1.16 years. In the eight states with the largest increases, life expectancy increased by 2.60-4.33 years.

What’s remarkable about the study is that it attributes the improvement in longevity almost entirely to the availability of expensive, often copy-cat, “newer” drugs of limited efficacy–rather than changes in life style (smoking cessation and diet for example) or medical practice. The data cited shows wide variation in each state’s longevity some of which seems more likely to be due to sample error rather than medical intervention. Who can believe, for example, an improvement of 5.7 years in the District of Columbia over 14 years. It doesn’t seem reasonable that this was due mainly to access to “new drugs.” The cited example of Lipitor is noteworthy in that the drug will decrease cholesterol but there is precious little data to indicate at this time that the drug will have a major effect on longevity–studies are in progress.

Given the contributions of the pharmaceutical industry to the Institute and the author, it seems to a medicynic that the study provides accolades for a financial supporter rather than serious scientifically defensible information.

The facts are:

“Despite spending over $2 trillion a year on health care — 18% of the U.S. GDP and twice as much as any other nation — the United States ranks only 45th in life expectancy and 37th in a World Health Organization study on the performance of national health systems. The U.S. federal government currently spends more on health care than on Social Security and national defense combined, the next most expensive items, but Americans get the right treatment only 55% of the time. Expenditures on health care in the United States — already the highest per person in the world — are predicted to nearly double by 2016, to $4.1 trillion, or 20% of GDP. That means, if this trajectory is not altered, in less than a decade, 20 cents out of every dollar produced in America will be spent on health care. Currently, more than 75% of health care dollars are spent on patients with chronic diseases, yet an estimated 80% of all chronic diseases are caused by preventable factors, such as smoking, obesity, and physical inactivity.4,5 But despite these statistics, less than 5 cents of every health care dollar is spent on prevention and public health.” (medicynical emphasis)

It should be noted that these other countries with better health outcomes than the U.S. all have LESS access to the wonder drugs flogged in the Manhattan Institute’s so-called report.

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