Cost-effectiveness impacts cancer care funding decisions in British Columbia, Canada, evidence from 1998 to 2008

Zahra Ismail, Stuart J. Peacock, Laurel Kovacic, Jeffrey S Hoch

Research output: Contribution to journalArticle

Abstract

Objectives: The Priorities and Evaluation Committee (PEC) funding recommendations for new cancer drugs in British Columbia, Canada have been based on both clinical and economic evidence. The British Columbia Ministry of Health makes funding decisions. We assessed the association between cost-effectiveness of cancer drugs considered from 1998 to 2008 and the subsequent funding decisions. Methods: All proposals submitted to the PEC between 1998 and 2008 were reviewed, and the association between cost-effectiveness and funding decisions was examined by (i) using logistic regression to test the hypothesis that interventions with higher incremental cost-effectiveness ratios (ICERs) have a lower probability of receiving a positive funding decision and (ii) using parametric and nonparametric tests to determine if a statistically significant difference exists between the mean cost-effectiveness of funded versus not funded proposals. A sub-Analysis was conducted to determine if the findings varied across different outcome measures. Results: Of the 149 proposals reviewed, 78 reported cost-effectiveness using various outcome measures. In the proposals that used life-years gained as the outcome (n = 22), a statistically significant difference of nearly $115,000 was observed between the mean ICERs for funded proposals ($42,006) and for unfunded proposals ($156,967). An odds ratio indicating higher ICERs have a lower probability of being funded was also found to be statistically significant (p <.05). Conclusions: Economic evidence appears to play a role in British Columbia cancer funding decisions from 1998 to 2008; other decision-making criteria may also have an important role in recommendations and subsequent funding decisions.

Original languageEnglish (US)
Pages (from-to)481-486
Number of pages6
JournalInternational Journal of Technology Assessment in Health Care
Volume33
Issue number4
DOIs
StatePublished - Jan 1 2017

Fingerprint

British Columbia
Cost-Benefit Analysis
Canada
Neoplasms
Economics
Outcome Assessment (Health Care)
Pharmaceutical Preparations
Decision Making
Logistic Models
Odds Ratio
Health

Keywords

  • Cancer
  • Cost-effectiveness
  • Drug funding decisions

ASJC Scopus subject areas

  • Health Policy

Cite this

Cost-effectiveness impacts cancer care funding decisions in British Columbia, Canada, evidence from 1998 to 2008. / Ismail, Zahra; Peacock, Stuart J.; Kovacic, Laurel; Hoch, Jeffrey S.

In: International Journal of Technology Assessment in Health Care, Vol. 33, No. 4, 01.01.2017, p. 481-486.

Research output: Contribution to journalArticle

@article{7144096501e24346af228ac31e0b12d6,
title = "Cost-effectiveness impacts cancer care funding decisions in British Columbia, Canada, evidence from 1998 to 2008",
abstract = "Objectives: The Priorities and Evaluation Committee (PEC) funding recommendations for new cancer drugs in British Columbia, Canada have been based on both clinical and economic evidence. The British Columbia Ministry of Health makes funding decisions. We assessed the association between cost-effectiveness of cancer drugs considered from 1998 to 2008 and the subsequent funding decisions. Methods: All proposals submitted to the PEC between 1998 and 2008 were reviewed, and the association between cost-effectiveness and funding decisions was examined by (i) using logistic regression to test the hypothesis that interventions with higher incremental cost-effectiveness ratios (ICERs) have a lower probability of receiving a positive funding decision and (ii) using parametric and nonparametric tests to determine if a statistically significant difference exists between the mean cost-effectiveness of funded versus not funded proposals. A sub-Analysis was conducted to determine if the findings varied across different outcome measures. Results: Of the 149 proposals reviewed, 78 reported cost-effectiveness using various outcome measures. In the proposals that used life-years gained as the outcome (n = 22), a statistically significant difference of nearly $115,000 was observed between the mean ICERs for funded proposals ($42,006) and for unfunded proposals ($156,967). An odds ratio indicating higher ICERs have a lower probability of being funded was also found to be statistically significant (p <.05). Conclusions: Economic evidence appears to play a role in British Columbia cancer funding decisions from 1998 to 2008; other decision-making criteria may also have an important role in recommendations and subsequent funding decisions.",
keywords = "Cancer, Cost-effectiveness, Drug funding decisions",
author = "Zahra Ismail and Peacock, {Stuart J.} and Laurel Kovacic and Hoch, {Jeffrey S}",
year = "2017",
month = "1",
day = "1",
doi = "10.1017/S0266462317000642",
language = "English (US)",
volume = "33",
pages = "481--486",
journal = "International Journal of Technology Assessment in Health Care",
issn = "0266-4623",
publisher = "Cambridge University Press",
number = "4",

}

TY - JOUR

T1 - Cost-effectiveness impacts cancer care funding decisions in British Columbia, Canada, evidence from 1998 to 2008

AU - Ismail, Zahra

AU - Peacock, Stuart J.

AU - Kovacic, Laurel

AU - Hoch, Jeffrey S

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objectives: The Priorities and Evaluation Committee (PEC) funding recommendations for new cancer drugs in British Columbia, Canada have been based on both clinical and economic evidence. The British Columbia Ministry of Health makes funding decisions. We assessed the association between cost-effectiveness of cancer drugs considered from 1998 to 2008 and the subsequent funding decisions. Methods: All proposals submitted to the PEC between 1998 and 2008 were reviewed, and the association between cost-effectiveness and funding decisions was examined by (i) using logistic regression to test the hypothesis that interventions with higher incremental cost-effectiveness ratios (ICERs) have a lower probability of receiving a positive funding decision and (ii) using parametric and nonparametric tests to determine if a statistically significant difference exists between the mean cost-effectiveness of funded versus not funded proposals. A sub-Analysis was conducted to determine if the findings varied across different outcome measures. Results: Of the 149 proposals reviewed, 78 reported cost-effectiveness using various outcome measures. In the proposals that used life-years gained as the outcome (n = 22), a statistically significant difference of nearly $115,000 was observed between the mean ICERs for funded proposals ($42,006) and for unfunded proposals ($156,967). An odds ratio indicating higher ICERs have a lower probability of being funded was also found to be statistically significant (p <.05). Conclusions: Economic evidence appears to play a role in British Columbia cancer funding decisions from 1998 to 2008; other decision-making criteria may also have an important role in recommendations and subsequent funding decisions.

AB - Objectives: The Priorities and Evaluation Committee (PEC) funding recommendations for new cancer drugs in British Columbia, Canada have been based on both clinical and economic evidence. The British Columbia Ministry of Health makes funding decisions. We assessed the association between cost-effectiveness of cancer drugs considered from 1998 to 2008 and the subsequent funding decisions. Methods: All proposals submitted to the PEC between 1998 and 2008 were reviewed, and the association between cost-effectiveness and funding decisions was examined by (i) using logistic regression to test the hypothesis that interventions with higher incremental cost-effectiveness ratios (ICERs) have a lower probability of receiving a positive funding decision and (ii) using parametric and nonparametric tests to determine if a statistically significant difference exists between the mean cost-effectiveness of funded versus not funded proposals. A sub-Analysis was conducted to determine if the findings varied across different outcome measures. Results: Of the 149 proposals reviewed, 78 reported cost-effectiveness using various outcome measures. In the proposals that used life-years gained as the outcome (n = 22), a statistically significant difference of nearly $115,000 was observed between the mean ICERs for funded proposals ($42,006) and for unfunded proposals ($156,967). An odds ratio indicating higher ICERs have a lower probability of being funded was also found to be statistically significant (p <.05). Conclusions: Economic evidence appears to play a role in British Columbia cancer funding decisions from 1998 to 2008; other decision-making criteria may also have an important role in recommendations and subsequent funding decisions.

KW - Cancer

KW - Cost-effectiveness

KW - Drug funding decisions

UR - http://www.scopus.com/inward/record.url?scp=85039962927&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85039962927&partnerID=8YFLogxK

U2 - 10.1017/S0266462317000642

DO - 10.1017/S0266462317000642

M3 - Article

C2 - 28871898

AN - SCOPUS:85039962927

VL - 33

SP - 481

EP - 486

JO - International Journal of Technology Assessment in Health Care

JF - International Journal of Technology Assessment in Health Care

SN - 0266-4623

IS - 4

ER -