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2016 ; 10
(ä): 1-7
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Do new cancer drugs offer good value for money? The perspectives of oncologists,
health care policy makers, patients, and the general population
#MMPMID26719677
Dilla T
; Lizan L
; Paz S
; Garrido P
; Avendaño C
; Cruz-Hernández JJ
; Espinosa J
; Sacristán JA
Patient Prefer Adherence
2016[]; 10
(ä): 1-7
PMID26719677
show ga
BACKGROUND: In oncology, establishing the value of new cancer treatments is
challenging. A clear definition of the different perspectives regarding the
drivers of innovation in oncology is required to enable new cancer treatments to
be properly rewarded for the value they create. The aim of this study was to
analyze the views of oncologists, health care policy makers, patients, and the
general population regarding the value of new cancer treatments. METHODS: An
exploratory and qualitative study was conducted through structured interviews to
assess participants' attitudes toward cost and outcomes of cancer drugs. First,
the participants were asked to indicate the minimum survival benefit that a new
treatment should have to be funded by the Spanish National Health System (NHS).
Second, the participants were requested to state the highest cost that the NHS
could afford for a medication that increases a patient's quality of life (QoL) by
twofold with no changes in survival. The responses were used to calculate
incremental cost-effectiveness ratios (ICERs). RESULTS: The minimum improvement
in patient survival means that justified inclusions into the NHS were 5.7, 8.2,
9.1, and 10.4 months, which implied different ICERs for oncologists
(?106,000/quality-adjusted life year [QALY]), patients (?73,520/QALY), the
general population (?66,074/QALY), and health care policy makers (?57,471/QALY),
respectively. The costs stated in the QoL-enhancing scenario were ?33,167,
?30,200, ?26,000, and ?17,040, which resulted in ICERs of ?82,917/QALY for
patients, ?75,500/QALY for the general population, ?65,000/QALY for oncologists,
and ?42,600/QALY for health care policy makers, respectively. CONCLUSION: All
estimated ICER values were higher than the thresholds previously described in the
literature. Oncologists most valued gains in survival, whereas patients assigned
a higher monetary value to treatments that enhanced QoL. Health care policy
makers were less likely to pay more for therapeutic improvements compared to the
remaining participants.