Reducing uncertainty in health-care resource allocation

• Published in: British journal of cancer Vol. 96; no. 12; pp. 1834 - 1838
• Main Authors: SIMONSSON, T, SJÖLUND, K, BÜMMING, P, AHLMAN, H, NILSSON, B, ODEN, A
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 18-06-2007
• Subjects: Biological and medical sciences; Cancer research; Cancer therapies; Cell growth; Clinical Study; Delivery of Health Care; Disease; Drugs; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Stromal Tumors - economics; Gastrointestinal Stromal Tumors - mortality; Gastrointestinal Stromal Tumors - surgery; Gastrointestinal Stromal Tumors - therapy; Gastrointestinal Stromal Tumors/economics/mortality/surgery/therapy; Genes; Health care policy; Humans; Kinases; Life expectancy; MEDICAL AND HEALTH SCIENCES; Medical prognosis; Medical research; Medical sciences; MEDICIN OCH HÄLSOVETENSKAP; Patients; Pharmaceutical industry; Proportional Hazards Models; Proteins; Quality of life; Quality-Adjusted Life Years; Resource Allocation - methods; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Survival Analysis; Sweden; Tumors; Sweden; Antineoplastic agent; Imatinib; GIST; Enzyme; Health; gastrointestinal stromal tumour; Transferases; Resource allocation; Enzyme inhibitor; imatinib mesylate; Survival; Care; Quality of life; Gastrointestinal stromal tumor; Cancerology; Treatment; Digestive diseases; Protein-tyrosine kinase
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/sj.bjc.6603795

A key task for health policymakers is to optimise the outcome of health care interventions. The pricing of a new generation of cancer drugs, in combination with limited health care resources, has highlighted the need for improved methodology to estimate outcomes of different treatment options. Here we introduce new general methodology, which for the first time employs continuous hazard functions for analysis of survival data. Access to continuous hazard functions allows more precise estimations of survival outcomes for different treatment options. We illustrate the methodology by calculating outcomes for adjuvant treatment of gastrointestinal stromal tumours with imatinib mesylate, which selectively inhibits the activity of a cancer-causing enzyme and is a hallmark representative for the new generation of cancer drugs. The calculations reveal that optimal drug pricing can generate all win situations that improve drug availability to patients, make the most of public expenditure on drugs and increase pharmaceutical company gross profits. The use of continuous hazard functions for analysis of survival data may reduce uncertainty in health care resource allocation, and the methodology can be used for drug price negotiations and to investigate health care intervention thresholds. Health policy makers, pharmaceutical industry, reimbursement authorities and insurance companies, as well as clinicians and patient organisations, should find the methodology useful.