Silver Book

Chronic Disease  /  Innovative Medical Research

While medical innovations and public health gains in the past century have been measurable in leaps and bounds, significant progress against acute disease has revealed an equally enormous challenge—chronic disease on an unprecedented scale. Close to half of Americans have chronic conditions and 1 in 4 have more than one. They cause 7 out of every 10 deaths and cost our country 75 cents of every health care dollar. With chronic disease prevalence growing at a faster rate than the population as a whole, the forecast is daunting.

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    • The percentage of noninstitutionalized adults 65 years of age and over with limitation of activity decreased from 39% to 36% between 1997 and 1999 and then remained at 34-35% between…  
    • Medicines in Development for Older Americans, 2008  
    • Eliminating hypertension in all elderly persons would result in 75 million additional disability-adjusted life years (DALYs) and reduce Medicare spending by around $890 billion.  
    • “In 1985, the age adjusted nursing home residence rate was 54 people per 1,000 age 65 and over. By 2004 this rate had declined to 35 people per 1,000. Among…  
    • The average length of stay for older Americans has decreased by 6 days since 1980.  
    • Avoidable Treatment Expenditures, 2023  
    • Percent Growth in Number of People Reporting Chronic Diseases, 2003-2023: Current Path versus Alternative Path  
    • Costs That Can Be Avoided, 2003-2023  
    • Avoidable Treatment Costs and Output Losses, 2023  
    • Avoidable Productivity Losses, 2023  
    • Changes in behavior, preventative measures and innovation could save $1.6 trillion in treatment costs.  
    • In an optimistic scenario, more effective prevention and management of disease could save $218 billion in treatment expenditures annually in 2023.  
    • Improvements in preventing and managing chronic disease could reduce future economic costs in the United States by 27% ($1.1 trillion) in 2023. $905 billion would come from gains in productivity;…  
    • Resonable disease prevention and management efforts could add $5.7 trillion to the nation’s economic output by 2050– a boost of 18%.  
    • If resonable improvements in preventing and managing chronic disease are made, 40.2 million cases of chronic disease will be avoided in 2023.  
    • Delaying the onset of Alzheimer’s disease, innovations that delay disability among the elderly through 2009, and a 25% increase in efficiency and effectiveness of cancer treatment would save $138 billion…  
    • Appropriate use of diagnostics prevents between $28-$46 million in prescription drug, outpatient and inpatient costs.  
    • Analysis of Medicare data on quality and costs of care for acute myocardial infarction (AMI), hip fracture, and colorectal cancer (with resection) reveals substantial variations in one-year, risk-adjusted mortality rates…  
    • The Cleveland Clinic lists these medical innovations in their top ten, because of the potential for short term clinical impact, high probability of success, the availability, and/or data to support…  
    • If the major risk factors for chronic disease were eliminated, at least 80% of heart disease, stroke and type 2 diabetes would be prevented; and 40% of cancer would be…  
    • Private health insurance benefit spending is predicted to slow from a peak of 9.5% in 2001 to 4.7% in 2006, partially because of Medicare Part D.  
    • National health spending growth is projected to slow from 6.9% in 2005 to 6.8% in 2006, which marks the 4th consecutive year of a slowing trend.  
    • From 1970-2000, increased longevity added approximately $3.2 trillion per year to national wealth, the equivalent of half of the average annual gross domestic product over the period. Half of these…  
    • Medicines in Development for Older Americans  
    • 2004 saw the sharpest drop in deaths in around 60 years – down almost 50,000 from 2003. The research team for “Death: Preliminary Data for 2004” from the National Center…  
    • Spending $11,000 on general medical care adds an average of 1 year of life. Spending only $1,345 on pharmaceutical research and development yields the same return.  
    • Every $1 invested in newer medications saves $7 in other costs.  
    • Increased longevity added about $3.2 trillion per year to national wealth between 1970 and 2000, an uncounted value equal to approximately 1/2 of the average annual GDP during that period.  
    • The share of elderly with impairments in their ability to live independently went down between 1% and 1.5% annually between 1984 and 2004, compared to the historical annual decline in…  
    • Analysis suggests that in the past 20 years, each additional dollar spent on health care services produced health gains valued at between $2.40 and $3.00.  
    • The United States would have spent $634 billion less on health care in 2000 without many of the improvements in health and the associated investments that were seen between 1980…  
    • Between 1980 and 2000, annual age adjusted per person health care costs increased by $2,254 (102%) but were accompanied by significant health gains including: a 16% decline in annual death…  
    • New Medicines Account for 40% of Increase in Life Expectancy  
    • Benefit of Increased Health Care Spending: Disability rates declining for seniors, 1982-1999  
    • Greater Adherence to Medicines Decreases Total Health Care Spending  
    • Increased Use of Medicines Reduces Overall Health Care Costs: Mental health/substance abuse (MH/SA) spending per patient fell as drug spending increased, 1992-1999  
    • Using Newer Medicines Results in Savings of $111 per Treated Condition  
    • In 2000, Americans saved 206 million days of hospital care because of health care investments.  
    • For every $1 spent on newer instead of older medicines, total health care spending is reduced by $6.17.  
    • For each $1 spent on newer pharmaceuticals. $6.17 is saved in total health care spending. $4.44 of this savings is in hospital spending alone.  
    • New medicines, or “new chemical entities” accounted for 40% (0.8 years) of the two-year gain in life expectancy seen in 52 countries from 1986-2000.  
    • Decline in Disability Rates for People Aged over 65 Years, 1982-2000  
    • Using newer drugs could lower overall health expenses by as much as $111 per person, per condition, for the general population, and $155 for Medicare beneficiaries.  
    • Medicare could save $26 billion per year if currently healthy older people were able to remain fully independent over the course of a single year.  
    • During the twentieth century, cumulative gains in life expectancy, for both men and women, were worth over $1.2 million per person.  
    • Each new drug approved between 1970 and 1991 saves an average of 11,200 life-years in 1991.