How much has growth of ‘reasonable and necessary’ medical treatments reduced US mortality?

ABSTRACT

Between 1994 and 2019, the number of treatments designated as ‘reasonable and necessary’ (R&N) for the treatment of an illness that had ever been developed increased from 1210 to 2845. We investigate the effect of R&N treatment growth on the mortality of Americans during the period 1999–2019. We employ a difference-in-differences (disease by year) research design: we measure attributes (the number and mean vintage) of the R&N treatments for a disease that had ever been developed by or before a year, and analyze their correlation with several measures of mortality from that disease in that year. The number of years of potential life lost from a disease is significantly inversely related to the mean vintage of R&N treatments associated with the disease that had ever been established 0–6 years earlier. Mean age at death from a disease is significantly positively related to the mean vintage of R&N treatments that had ever been established 2–8 years earlier. During the period 1999–2019, age-adjusted rates of premature (before ages 85, 75, and 65) mortality declined by about 20%. The data indicate that in the absence of R&N treatment growth, premature mortality rates would not have declined during the period 1999–2019.

Lichtenberg, F. R. (2026). How much has growth of ‘reasonable and necessary’ medical treatments reduced US mortality? Economics of Innovation and New Technology. Advance online publication. https://doi.org/10.1080/10438599.2026.2656320