Social value of a quality-adjusted life year (QALY) in Spain: the point of view of oncologists

C. Camps-Herrero, L. Paz-Ares,M. Codes, R. López-López,A. Antón-Torres, P. Gascón-Vilaplana,V. Guillem-Porta, A. Carrato, J. J. Cruz-Hernández, C. Caballero-Díaz, A. Blasco-Cordellat, J. A. Moreno-Nogueira,E. Díaz-Rubio

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico(2014)

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Abstract
Purpose The economic situation showed that the resources devoted to health spending are limited, making rationalisation of their consumption necessary. The relevance of pharmacoeconomic analyses is becoming crucial. The ECO Foundation, promoting the quality of oncology care, set out to analyse the consensus on the new therapeutic targets inclusion and the integration of pharmacoeconomics when evaluating their effectiveness. Methods Study about pharmacoeconomic estimations was performed during the first ECO-Seminar (2010). It was developed using a modified Delphi method, in four stages: (1) committee coordinator establishment, (2) expert-panel selection, (3) preparation and submission of survey (1 question) by email, and (4) analysis of the degree of consensus reached. Results Results were obtained from surveys completed by 35 experts. Regarding the tolerable annual cost for the approval of new drugs, 68.8 % of the respondents considered a cost per quality-adjusted life year (QALY) gained between €30,000 and 100,000 acceptable (34.4 % €30,000–60,000; 34.4 % €60,000–100,000), 21.9 % of the respondents found costs between €100,000–150,000/QALY and 9.3 % of the respondents found costs above €150,000/QALY acceptable. Conclusions The costs of new drugs are higher than traditional treatments, making it a priority to identify subgroups of patients with specific molecular profiles as candidates for higher-efficiency-targeted therapies. The allocation of the available resources to the most effective interventions, to achieve the best clinical outcomes with lower costs and best subjective profile possible, allows expenditure to be rationalised. Pharmacoeconomic studies are a basic tool for obtaining better health outcomes according to the available resources, while also considering the other needs of the population.
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Key words
Pharmacoeconomic study, Oncology, New drugs, Cost
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