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How Long and How Well

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  • Michael A. Kozminski
  • Peter J. Neumann
  • Eric S. Nadler
  • Aleksandra Jankovic
  • Peter A. Ubel

Abstract

Objective . To determine how oncologists value quality-enhancing v. life-prolonging outcomes attributable to chemotherapy. Methods . The authors surveyed a random sample of 1379 US medical oncologists (members of the American Society of Clinical Oncology), presenting them with 2 scenarios involving a hypothetical new chemotherapy drug. Given their responses, the authors derived the implicit cost-effectiveness ratios each physician attributed to quality-enhancing and life-prolonging chemotherapies. Results . The authors received responses from 58% of the oncologists surveyed. On average, the responses implied that oncologists were willing to prescribe treatments that cost $245,972 per quality-adjusted life-year (QALY; SD $243,663 per QALY) in life-prolonging situations v. only $119,082 per QALY (SD $197,048 per QALY) for treatments that improve quality of life but do not prolong survival (P 0.05 for all specifications). Differences across these situations persisted even among those who considered themselves to be “well-prepared†to make cost-effectiveness decisions. Conclusion . Cost-effectiveness thresholds for oncologists vary widely for life-prolonging chemotherapy compared to treatments that only enhance quality of life. This difference suggests that oncologists value length of survival more highly than quality of life when making chemotherapy decisions.

Suggested Citation

  • Michael A. Kozminski & Peter J. Neumann & Eric S. Nadler & Aleksandra Jankovic & Peter A. Ubel, 2011. "How Long and How Well," Medical Decision Making, , vol. 31(3), pages 380-385, May.
    • Handle: RePEc:sae:medema:v:31:y:2011:i:3:p:380-385
    DOI: 10.1177/0272989X10385847
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    References listed on IDEAS

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    1. Cairns, John, 2006. "Providing guidance to the NHS: The Scottish Medicines Consortium and the National Institute for Clinical Excellence compared," Health Policy, Elsevier, vol. 76(2), pages 134-143, April.
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    Cited by:

    1. Mark Pennington & Rachel Baker & Werner Brouwer & Helen Mason & Dorte Gyrd Hansen & Angela Robinson & Cam Donaldson & the EuroVaQ Team, 2015. "Comparing WTP Values of Different Types of QALY Gain Elicited from the General Public," Health Economics, John Wiley & Sons, Ltd., vol. 24(3), pages 280-293, March.

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