Document Detail


Does adjusting for health-related quality of life matter in economic evaluations of cancer-related interventions?
MedLine Citation:
PMID:  21351863     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aims: We investigated the extent to which adjusting for health-related quality of life (HRQoL) alters incremental cost per life-year gained ratios, and the implications for reimbursement decisions. Methods: We identified all cancer-related interventions in the Tufts Medical Center Cost-Effectiveness Analysis Registry in which both a cost/quality-adjusted life-year (QALY) and a cost/life-year ratio were reported in the same study. We assessed the ordinal relationship between these ratios and analyzed the extent to which using a cost/QALY rather than a cost/life-year ratio would potentially yield different reimbursement decisions. Results: The rank-order correlation between cost/life-year and cost/QALY ratio pairs was 0.917 (p < 0.0001). In 78.8% of comparisons, both cost/QALY and cost/life-year ratios were below a prespecified threshold (e.g., US$50,000 per QALY or life-year). Adjusting for HRQoL resulted in a higher ratio such that it crossed a prespecified threshold in 18.6% of interventions. The data suggest that adjusting life-years for HRQoL does not substantively affect cost per life-year ratios for the vast majority of cancer-related interventions. Conclusion: Our analysis implies that the method used for HRQoL adjusting or even HRQoL adjusting at all does not matter for most reimbursement decisions on life-saving interventions. The results could differ for interventions that have large impacts on patients' HRQoL compared with the impact on survival.
Authors:
Dan Greenberg; Peter J Neumann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Expert review of pharmacoeconomics & outcomes research     Volume:  11     ISSN:  1744-8379     ISO Abbreviation:  Expert Rev Pharmacoecon Outcomes Res     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101132257     Medline TA:  Expert Rev Pharmacoecon Outcomes Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  113-9     Citation Subset:  IM    
Affiliation:
The Center for the Evaluation of Value and Risk in Health, The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
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