Decision Making in the Context of Funding Cancer Therapy

Many new cancer treatments come at a high cost. In numerous countries, governments subsidise these treatments so patients can access them at no cost, or at a fraction of the market price. Whilst this is an excellent outcome for patients, this chapter considers the health economic aspects of decisions to fund such treatments. Governments, like us, do not have bottomless buckets of money. Therefore, decisions must be made that aim to provide the best health outcomes for the population, given the available resources (e.g., money). Health economic evaluations provide important information that is used to in this decision-making process. This chapter provides an introduction to health economic evaluations, and how measures of quality of life are incorporated. The concept of health state utility values - a measure of quality of life - will be introduced, along with different approaches to measuring these values. The chapter will then demonstrate how these health state utility values are incorporated into a measure of both quantity and quality of life: The Quality Adjusted Life Year (QALY). Finally, we will discuss an overall measure of the cost-effectiveness of treatments, and society’s willingness to pay for these.