Economic evaluation is a tool used to decide which medical services and pharmaceuticals should be publicly funded. Professor Madeline King, Director of the University of Sydney’s Quality of Life Office, has developed ways to measure quality of life for use in economic evaluation of cancer interventions in Australia and across the world.
“Economic evaluation is crucial in this age of soaring health care costs and limited health budgets. When we compare two treatments, we need to know which provides better survival, which provides better quality of life and which is the most cost effective.
Cancer medicines cost the Australian Government around $2 billion in 2016–17 — around one in every six dollars of expenditure in the Pharmaceutical Benefits Scheme.
Department of Health. “Cancer fact sheets” Australian Government. 8 January 2018. Accessed 25 August 2020. https://www1.health.gov.au/ internet/main/publishing.nsf/Content/cancer-factsheets-1
“We all aspire to a good quality of life. When health is threatened, patients, families and health care providers all hope to preserve both life and quality of life.”
Professor King brought together researchers from diverse fields such as economics, oncology and psychology to understand the impact of medical services and pharmaceuticals on the quality of life of cancer patients.
Through this grant, The Multi-Attribute Utility in Cancer (MAUCa) Consortium was established, with the common goal of including quality of life data in economic evaluation of new cancer treatments. Demonstrating the importance of the consumer voice in research, patients self-reported the impacts of trial treatments on their quality of life, which has informed the study’s outcomes. Professor King and her team have successfully demonstrated this model and illustrated its valuable application in Australia.
“MAUCa has developed mathematical formulae to apply the preferences of a particular country’s general population so that these quality of life data can be included in economic evaluation. This helps inform decisions about which treatments will be funded by a country, and at what price.
The variety and differences in the way researchers from different disciplines think and talk about quality of life was a challenge
for this multi-disciplinary research.
“Through its success, other MAUCa members have secured funding to fulfil its objectives in China, Japan and Singapore, as well as several countries across Europe and North America.”
“Economists use the term ‘utility’ when talking about patient benefits, and while psychologists and oncologists also use this term, they sometimes use it differently, and they also think and talk about quality of life in other ways. While challenging, it was important to have these different areas of research working together.”
Now that the consortium has made these tools available to the broader cancer research community, the next steps are to see if they are useful in capturing cancer-specific quality of life in economic evaluation — due not only to the effect of the disease itself, but also to side-effects associated with many common treatments. Professor King and her team’s focus now is to develop user manuals and resources for the tools with the aim of expanding their use to more parts of the world.