A recent survey of US and Canadian oncologists explored how they perceive cost-effectiveness of the new and costly cancer treatments, and whether providers are considering value questions of quality versus cost in their clinical decisions.
Ubel and colleagues asked oncologists to assess how much life expectancy would a new cancer drug have to deliver to justify its high cost and lead them to prescribe it for their patients. Overall, when asked what constituted “good value for money,” Canadian oncologists, on average, were looking for greater cost-effectiveness than US oncologists.
But the majority of both groups agreed that adding 1 year of life would be worth prescribing it if the drug cost up to $100,000. However, when assessing a hypothetical example of an individual patient, the providers conceded that they might consider prescribing a drug that cost up to $250,000 for an additional 1 year of life.
Overall, oncologists expected longer survival for a drug that cost $150,000 a year, but this demand did not increase in proportion to the incremental cost of the drug. This suggests a cost-effectiveness ratio that is dependent on the cost of the drug overall.
The survey results show that oncologists do not agree on how to assign value to a drug when considering its cost versus the potential survival it can deliver. The investigators suggest that providers should be educated on how to incorporate cost-effectiveness information into their clinical decision-making. Ubel and colleagues suggest that clinical guidelines that consider costs within the clinical decision-making process are now needed. Ubel PA, et al. Health Aff (Millwood). 2012;31:709-715.
