Does adjusting for health-related quality of life matter in economic evaluations of cancer-related interventions?

Dan Greenberg, Peter J. Neumann

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


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 languageEnglish
Pages (from-to)113-119
Number of pages7
JournalExpert Review of Pharmacoeconomics and Outcomes Research
Issue number1
StatePublished - 1 Feb 2011


  • QALY
  • cancer
  • costeffectiveness analysis
  • health-related quality of life
  • life-year gained
  • reimbursement

ASJC Scopus subject areas

  • Health Policy
  • Pharmacology (medical)


Dive into the research topics of 'Does adjusting for health-related quality of life matter in economic evaluations of cancer-related interventions?'. Together they form a unique fingerprint.

Cite this