Abstract
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.
Original language | English |
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Pages (from-to) | 113-119 |
Number of pages | 7 |
Journal | Expert Review of Pharmacoeconomics and Outcomes Research |
Volume | 11 |
Issue number | 1 |
DOIs | |
State | Published - 1 Feb 2011 |
Keywords
- QALY
- cancer
- costeffectiveness analysis
- health-related quality of life
- life-year gained
- reimbursement
ASJC Scopus subject areas
- Health Policy
- Pharmacology (medical)