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COST-EFFECTIVENESS IMPACTS CANCER CARE FUNDING DECISIONS IN BRITISH COLUMBIA, CANADA, EVIDENCE FROM 1998 TO 2008

Published online by Cambridge University Press:  05 September 2017

Zahra Ismail ,
Stuart J. Peacock ,
Laurel Kovacic  and
Jeffrey S. Hoch Open the ORCID record for Jeffrey S. Hoch [Opens in a new window]
Zahra Ismail
Affiliation:
Canadian Centre for Applied Research in Cancer Control Cancer Care Ontario
Stuart J. Peacock
Affiliation:
Canadian Centre for Applied Research in Cancer Control British Columbia Cancer Agency Simon Fraser University
Laurel Kovacic
Affiliation:
British Columbia Cancer Agency
Jeffrey S. Hoch
Affiliation:
University of California at Davis St. Michael's Hospital University of Torontojshoch@ucdavis.edu
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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

CancerCost-effectivenessDrug funding decisions
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 4: Mini-Theme: Stories of HTA Impact , 2017 , pp. 481 - 486
Copyright
Copyright © Cambridge University Press 2017 

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