Skip to main content
Erschienen in: Clinical and Translational Oncology 10/2014

01.10.2014 | Research Article

Social value of a quality-adjusted life year (QALY) in Spain: the point of view of oncologists

verfasst von: C. Camps-Herrero, L. Paz-Ares, M. Codes, R. López-López, A. Antón-Torres, P. Gascón-Vilaplana, V. Guillem-Porta, A. Carrato, J. J. Cruz-Hernández, C. Caballero-Díaz, A. Blasco-Cordellat, J. A. Moreno-Nogueira, E. Díaz-Rubio

Erschienen in: Clinical and Translational Oncology | Ausgabe 10/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The economic situation showed that the resources devoted to health spending are limited, making rationalisation of their consumption necessary. The relevance of pharmacoeconomic analyses is becoming crucial. The ECO Foundation, promoting the quality of oncology care, set out to analyse the consensus on the new therapeutic targets inclusion and the integration of pharmacoeconomics when evaluating their effectiveness.

Methods

Study about pharmacoeconomic estimations was performed during the first ECO-Seminar (2010). It was developed using a modified Delphi method, in four stages: (1) committee coordinator establishment, (2) expert-panel selection, (3) preparation and submission of survey (1 question) by email, and (4) analysis of the degree of consensus reached.

Results

Results were obtained from surveys completed by 35 experts. Regarding the tolerable annual cost for the approval of new drugs, 68.8 % of the respondents considered a cost per quality-adjusted life year (QALY) gained between €30,000 and 100,000 acceptable (34.4 % €30,000–60,000; 34.4 % €60,000–100,000), 21.9 % of the respondents found costs between €100,000–150,000/QALY and 9.3 % of the respondents found costs above €150,000/QALY acceptable.

Conclusions

The costs of new drugs are higher than traditional treatments, making it a priority to identify subgroups of patients with specific molecular profiles as candidates for higher-efficiency-targeted therapies. The allocation of the available resources to the most effective interventions, to achieve the best clinical outcomes with lower costs and best subjective profile possible, allows expenditure to be rationalised. Pharmacoeconomic studies are a basic tool for obtaining better health outcomes according to the available resources, while also considering the other needs of the population.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Darba J. Pharmaceutical expenditure and therapeutic value of new medicines in Spain. Pharmacoeconomics. 2003;21(16):1211–2.PubMedCrossRef Darba J. Pharmaceutical expenditure and therapeutic value of new medicines in Spain. Pharmacoeconomics. 2003;21(16):1211–2.PubMedCrossRef
2.
Zurück zum Zitat Pazdur R. Endpoints for assessing drug activity in clinical trials. Oncologist. 2008;13:19–21.PubMedCrossRef Pazdur R. Endpoints for assessing drug activity in clinical trials. Oncologist. 2008;13:19–21.PubMedCrossRef
3.
Zurück zum Zitat Sargent D. What constitutes reasonable evidence of efficacy and effectiveness to guide oncology treatment decisions? Oncologist. 2009;15:19–23.CrossRef Sargent D. What constitutes reasonable evidence of efficacy and effectiveness to guide oncology treatment decisions? Oncologist. 2009;15:19–23.CrossRef
4.
Zurück zum Zitat Ocaña A, Tannock IF. When are “positive” clinical trials in oncology truly positive? J Natl Cancer Inst. 2011;103:16–20.PubMedCrossRef Ocaña A, Tannock IF. When are “positive” clinical trials in oncology truly positive? J Natl Cancer Inst. 2011;103:16–20.PubMedCrossRef
5.
Zurück zum Zitat Sobrero A, Bruzzi P. Incremental advance or seismic shift? The need to raise the bar of efficacy for drug approval. J Clin Oncol. 2009;27:5868–73.PubMedCrossRef Sobrero A, Bruzzi P. Incremental advance or seismic shift? The need to raise the bar of efficacy for drug approval. J Clin Oncol. 2009;27:5868–73.PubMedCrossRef
7.
Zurück zum Zitat Fojo T, Grady C. How much is life worth: cetuximab, non-small-cell lung cancer, and the $440 billion question. J Natl Cancer Inst. 2009;101:1044–8.PubMedCrossRefPubMedCentral Fojo T, Grady C. How much is life worth: cetuximab, non-small-cell lung cancer, and the $440 billion question. J Natl Cancer Inst. 2009;101:1044–8.PubMedCrossRefPubMedCentral
8.
Zurück zum Zitat Fojo T, Parkinson DR. Biologically targeted cancer therapy and marginal benefits: are we making too much of too little or are we achieving too little by giving too much? Clin Cancer Res. 2010;16:5972–80.PubMedCrossRef Fojo T, Parkinson DR. Biologically targeted cancer therapy and marginal benefits: are we making too much of too little or are we achieving too little by giving too much? Clin Cancer Res. 2010;16:5972–80.PubMedCrossRef
9.
Zurück zum Zitat Ministerio de Sanidad y Consumo. Estrategia en Cáncer del SNS. 2005. Ministerio de Sanidad y Consumo. Estrategia en Cáncer del SNS. 2005.
10.
Zurück zum Zitat López Bastida J, Oliva J, Antoñanzas F, García-Altés A, Gisbert R, Mar J, et al. Propuesta de guía para la evaluación económica aplicada las tecnologías sanitarias. Gac Sanit. 2010; 24(02):154–70. López Bastida J, Oliva J, Antoñanzas F, García-Altés A, Gisbert R, Mar J, et al. Propuesta de guía para la evaluación económica aplicada las tecnologías sanitarias. Gac Sanit. 2010; 24(02):154–70.
11.
Zurück zum Zitat Groose SD. Assessing cost-effectiveness in healthcare: history of the $50,000 per QALY threshold. Expert Rev Pharmacoecon Outcomes Res. 2008;8:165–78.CrossRef Groose SD. Assessing cost-effectiveness in healthcare: history of the $50,000 per QALY threshold. Expert Rev Pharmacoecon Outcomes Res. 2008;8:165–78.CrossRef
12.
Zurück zum Zitat Devlin N, Parkin D. Does NICE have a cost-effectiveness threshold an what other factors influence its decision? A binary choice analysis. Health Econ. 2004;13:437–52.PubMedCrossRef Devlin N, Parkin D. Does NICE have a cost-effectiveness threshold an what other factors influence its decision? A binary choice analysis. Health Econ. 2004;13:437–52.PubMedCrossRef
13.
Zurück zum Zitat Bobinac A, Van Exel NJ, Rutten FF, Brouwer WB. Willingness to pay for a quality-adjusted life-year: the individual perspective. Val Health. 2010;13:1046–55.CrossRef Bobinac A, Van Exel NJ, Rutten FF, Brouwer WB. Willingness to pay for a quality-adjusted life-year: the individual perspective. Val Health. 2010;13:1046–55.CrossRef
14.
Zurück zum Zitat Shiroiwa T, Sung YK, Fukuda T, Lang HC, Bae SC, Tsutani K. International survey on willingness-to-pay (WTP) for one additional QALY gained. What is the threshold of cost-effectiveness? Health Econ. 2010;19:422–37.PubMedCrossRef Shiroiwa T, Sung YK, Fukuda T, Lang HC, Bae SC, Tsutani K. International survey on willingness-to-pay (WTP) for one additional QALY gained. What is the threshold of cost-effectiveness? Health Econ. 2010;19:422–37.PubMedCrossRef
15.
Zurück zum Zitat Cleemput I, Neyt M, Thiry N, De Laet C, Leys M. Using threshold values for cost per quality-adjusted life-year gained in healthcare decisions. Int J Health Technol Assess Health Care. 2011;27:71–6.CrossRef Cleemput I, Neyt M, Thiry N, De Laet C, Leys M. Using threshold values for cost per quality-adjusted life-year gained in healthcare decisions. Int J Health Technol Assess Health Care. 2011;27:71–6.CrossRef
16.
Zurück zum Zitat Bobinac A, van Exel NJ, Rutten FF, Brouwer WB. Inquiry into the relationship between equity weights and the value of the QALY. Val Health. 2012; 1119–26. Bobinac A, van Exel NJ, Rutten FF, Brouwer WB. Inquiry into the relationship between equity weights and the value of the QALY. Val Health. 2012; 1119–26.
17.
Zurück zum Zitat Donaldson C, Baker R, Mason H, Jones-Lee M, Lancsar E, Wildman J, et al. The social value of a QALY: raising the bar or barring the raise? BMC Health Serv Res. 2011;11:8.PubMedCrossRefPubMedCentral Donaldson C, Baker R, Mason H, Jones-Lee M, Lancsar E, Wildman J, et al. The social value of a QALY: raising the bar or barring the raise? BMC Health Serv Res. 2011;11:8.PubMedCrossRefPubMedCentral
18.
Zurück zum Zitat Pinto-Prades JL, Loomes G, Brey R. Trying to estimate a monetary value for the QALY. J Health Econ. 2009;28:553–62.PubMedCrossRef Pinto-Prades JL, Loomes G, Brey R. Trying to estimate a monetary value for the QALY. J Health Econ. 2009;28:553–62.PubMedCrossRef
19.
Zurück zum Zitat Zhao FL, Yue M, Yang H, Wang T, Wu JH, Li SC. Willingness to pay per quality-adjusted life year: is one threshold enough for decision-making? Med Care. 2011;49:267–72.PubMedCrossRef Zhao FL, Yue M, Yang H, Wang T, Wu JH, Li SC. Willingness to pay per quality-adjusted life year: is one threshold enough for decision-making? Med Care. 2011;49:267–72.PubMedCrossRef
20.
Zurück zum Zitat Sacristán JA, Oliva J, Del Llano J, Prieto L, Pinto JL. ¿Qué es una tecnología sanitaria eficiente en España? Gac Sanit. 2002;16:334–43.PubMedCrossRef Sacristán JA, Oliva J, Del Llano J, Prieto L, Pinto JL. ¿Qué es una tecnología sanitaria eficiente en España? Gac Sanit. 2002;16:334–43.PubMedCrossRef
21.
Zurück zum Zitat Prieto L, Sacristán JA, Antoñanzas F, Rubio-Terrés C, Pinto JL, Rovira J. Análisis coste-efectividad en la evaluación económica de intervenciones sanitarias. Med Clin (Barc). 2004;122(13):505–10.CrossRef Prieto L, Sacristán JA, Antoñanzas F, Rubio-Terrés C, Pinto JL, Rovira J. Análisis coste-efectividad en la evaluación económica de intervenciones sanitarias. Med Clin (Barc). 2004;122(13):505–10.CrossRef
22.
Zurück zum Zitat Camps C, Caballero C, Sirera R, Blasco A, Cayuela D, Gil M, et al. Can the Spanish care system assume the new costs of medications against cancer? Clin Transl Oncol. 2008;10(2):96–101.PubMedCrossRef Camps C, Caballero C, Sirera R, Blasco A, Cayuela D, Gil M, et al. Can the Spanish care system assume the new costs of medications against cancer? Clin Transl Oncol. 2008;10(2):96–101.PubMedCrossRef
23.
Zurück zum Zitat Isla D, González-Rojas N, Nieves D, Brosa M, Finnern HW. Treatment patterns, use of resources, and costs of advanced non-small-cell lung cancer patients in Spain: results from a Delphi panel. Clin Transl Oncol. 2011;13:460–71.PubMedCrossRef Isla D, González-Rojas N, Nieves D, Brosa M, Finnern HW. Treatment patterns, use of resources, and costs of advanced non-small-cell lung cancer patients in Spain: results from a Delphi panel. Clin Transl Oncol. 2011;13:460–71.PubMedCrossRef
24.
Zurück zum Zitat Oyagüez I, Frías C, Seguí MA, Gómez-Barrera M, Casado MA, Queralt Gorgas M. Eficiencia de tratamientos oncológicos para tumores sólidos en España. Farm Hosp. 2013;37:240–59.PubMed Oyagüez I, Frías C, Seguí MA, Gómez-Barrera M, Casado MA, Queralt Gorgas M. Eficiencia de tratamientos oncológicos para tumores sólidos en España. Farm Hosp. 2013;37:240–59.PubMed
25.
Zurück zum Zitat Kantarjian HM, Fojo T, Mathisen M, Zwelling LA. Cancer drugs in the United States: Justum Pretium—the just price. J Clin Oncol. 2013;28:3600–4.CrossRef Kantarjian HM, Fojo T, Mathisen M, Zwelling LA. Cancer drugs in the United States: Justum Pretium—the just price. J Clin Oncol. 2013;28:3600–4.CrossRef
26.
Zurück zum Zitat Tsimberidou AM, Ringborg U, Schilsky RL. Strategies to overcome clinical, regulatory, and financial challenges in the implementation of personalized medicine. Am Soc Clin Oncol Educ Book. 2013:118–25. doi:10.1200/EdBook_AM.2013.33.118. Tsimberidou AM, Ringborg U, Schilsky RL. Strategies to overcome clinical, regulatory, and financial challenges in the implementation of personalized medicine. Am Soc Clin Oncol Educ Book. 2013:118–25. doi:10.​1200/​EdBook_​AM.​2013.​33.​118.
27.
Zurück zum Zitat Pfister DG. The just price of cancer drugs and the growing cost of cancer care: oncologists need to be part of the solution. J Clin Oncol. 2013;28:3487–9.CrossRef Pfister DG. The just price of cancer drugs and the growing cost of cancer care: oncologists need to be part of the solution. J Clin Oncol. 2013;28:3487–9.CrossRef
28.
Zurück zum Zitat Piccart MJ. Why your preferred targeted drugs may become unaffordable. Cancer Res. 2013;73:5849–51.PubMedCrossRef Piccart MJ. Why your preferred targeted drugs may become unaffordable. Cancer Res. 2013;73:5849–51.PubMedCrossRef
Metadaten
Titel
Social value of a quality-adjusted life year (QALY) in Spain: the point of view of oncologists
verfasst von
C. Camps-Herrero
L. Paz-Ares
M. Codes
R. López-López
A. Antón-Torres
P. Gascón-Vilaplana
V. Guillem-Porta
A. Carrato
J. J. Cruz-Hernández
C. Caballero-Díaz
A. Blasco-Cordellat
J. A. Moreno-Nogueira
E. Díaz-Rubio
Publikationsdatum
01.10.2014
Verlag
Springer Milan
Erschienen in
Clinical and Translational Oncology / Ausgabe 10/2014
Print ISSN: 1699-048X
Elektronische ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-014-1170-1

Weitere Artikel der Ausgabe 10/2014

Clinical and Translational Oncology 10/2014 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.