PurposeThe objective of this study is to reevaluate the correlation among pharmaceutical consumption, per capita income, and life expectancy across different age groups (at birth, middle age, and advanced age) within the OECD countries between 1998 and 2018.Design/methodology/approachWe employ a two-step methodology, utilizing two independent approaches. Firstly, we con-duct the Dumitrescu-Hurlin pairwise panel causality test, followed by Machine Learning (ML) experiments employing the Causal Direction from Dependency (D2C) Prediction algorithm and a DeepNet process, thought to deliver robust inferences with respect to the nature, sign, direction, and significance of the causal relationships revealed in the econometric procedure.FindingsOur findings reveal a two-way positive bidirectional causal relationship between GDP and total pharmaceutical sales per capita. This contradicts the conventional notion that health expenditures decrease with economic development due to general health improvements. Furthermore, we observe that GDP per capita positively correlates with life expectancy at birth, 40, and 60, consistently generating positive and statistically significant predictive values. Nonetheless, the value generated by the input life expectancy at 60 on the target income per capita is negative (−61.89%), shedding light on the asymmetric and nonlinear nature of this nexus. Finally, pharmaceutical sales per capita improve life expectancy at birth, 40, and 60, with higher magnitudes compared to those generated by the income input.Practical implicationsThese results offer valuable insights into the intricate dynamics between economic development, pharmaceutical consumption, and life expectancy, providing important implications for health policy formulation.Originality/valueVery few studies shed light on the nature and the direction of the causal relationships that operate among these indicators. Exiting from the standard procedures of cross-country regressions and panel estimations, the present manuscript strives to promote the relevance of using causality tests and Machine Learning (ML) methods on this topic. Therefore, this paper seeks to contribute to the literature in three important ways. First, this is the first study analyzing the long-run interactions among pharmaceutical consumption, per capita income, and life expectancy for the Organization for Economic Co-operation and Development (OECD) area. Second, this research contrasts with previous ones as it employs a complete causality testing framework able to depict causality flows among multiple variables (Dumitrescu-Hurlin causality tests). Third, this study displays a last competitive edge as the panel data procedures are complemented with an advanced data testing method derived from AI. Indeed, using an ML experiment (i.e. Causal Direction from Dependency, D2C and algorithm) it is believed to deliver robust inferences regarding the nature and the direction of the causality. All in all, the present paper is believed to represent a fruitful methodological research orientation. Coupled with accurate data, this seeks to complement the literature with novel evidence and inclusive knowledge on this topic. Finally, to bring accurate results, data cover the most recent and available period for 22 OECD countries: from 1998 to 2018.