Grant: CIHR Fellowship

While the demand for new cancer treatments is rising dramatically, so are their costs. As there is a limited amount of money available for health treatments, decision-makers have to select which treatments to fund. Currently, this decision is based on comparing the benefit provided by the treatment with its cost; this is known as cost-utility analysis. The most common way to measure the treatment's benefit is how much it increases a patient's quantity and quality of life. These two measures are combined into a single number, the quality-adjusted life years (QALYs) gained. Measuring quality of life is very difficult and is highly individual. How the public values the quality of life for a health outcome is vital to maximize the benefits from the health funds available. To do this, decision-makers set upper limits on the cost per QALY for a treatment to be funded. This should be separate from the disease; however, there is evidence that cancer treatments are often approved at higher costs per QALY than for other health conditions. This project will examine whether the QALY is a good tool to guide decision-makers' assessment of different treatments. Specifically, the project will assess whether QALYs for different diseases are equal and will determine how much it is reasonable to spend to achieve improvements in survival and quality of life in cancer. The project also investigates if other factors (i.e., patient age or disease severity) should be included in healthcare funding decisions. The proposed project has significant implications for health policy. By determining what the public are willing to pay to gain one QALY in cancer, more informed decisions can be made in terms of what treatments should receive financial support. This will ensure that society is getting the most out of the money allocated to healthcare. Also this will provide information on whether the use of QALYs in decision-making will help to guarantee sustainability in the health system.