Economic evaluation of anti-cancer therapies — specific approach and challenges of clinical outcomes assessment in oncology

Abstract

The use of QALY (quality adjusted life years) metric to quantify clinical benefit in oncological settings is limited and
does not correspond with role and importance of QALY introduced with legal changes implemented in Poland
in 2012 by Reimbursement Act.
The authors compare different approaches to economic evaluation of anti-cancer therapy in Poland, UK, Canada,
Australia and Germany. The country were considered based on health technology assessment orientated reimbursement
system, specific approach applied for anti-cancer or end-of-life therapies and benchmarking in
recommendations issued by Agency of Health Technology Assessment in Poland. Following literature review the
key problems concerning QALY in the evaluation of antineoplastic treatments were defined, i.e. EQ-5D is relatively insensitive to changes in health status of cancer patients, limitations of health utility measurement in cancer, fixed
threshold of cost-effectiveness for all medical technologies regardless of disease specificity.