10 Years of End-of-Life Criteria in the United Kingdom

Bovenberg, Josien; Penton, Hannah; Büyükkaramikli, Nasuh

doi:10.1016/j.jval.2020.11.015

Cited by 14 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The median 99,906 RMB (14,479USD, 1.39 times the GDP per capita) of the overall sample in our study was smaller than the National Institute for Health and Care Excellence (NICE) threshold for end-of-life interventions of £50,000 (64,103USD, 1.56 times the GDP per capita in 2020) [ 27 ], and the ratio of the GDP per capita was close. In comparison to the WTP/QALY for patients with malignant tumors in other Asian countries, the median 99,906 RMB (14,479USD, 1.39 times the GDP per capita) of the overall sample in this paper was between the 11,031USD among patients with lung cancer in Vietnam in 2018 [ 28 ] and the 19,200–32,000USD among patients with solid tumors and the general population in the Kingdom of Saudi Arabia [ 29 ].…”

Section: Discussionmentioning

confidence: 71%

Estimation of the value of curative therapies in oncology: a willingness-to-pay study in China

Huang

Peng

Li-hua

et al. 2023

Cost Eff Resour Alloc

View full text Add to dashboard Cite

The objective of this study was to estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) among people with malignancies in China. The WTP for a QALY was estimated using a contingent valuation survey. Health utility was measured in EuroQol-5 dimensions (EQ-5D). The questionnaires were completed in face-to-face interviews. Respondents consisted of patients with malignant tumors and their family members and came from three tertiary hospitals in different cities with high, medium, and low gross domestic product (GDP) levels. In this study, we offered lump-sum payments and 10 year installment plans to respondents. Finally, we conducted sensitivity analysis and stepwise regression analyses to identify factors that affected the WTP/QALY ratios. A total of 1264 people participated in this survey, and 1013 people gave WTP responses for further analysis. The mean and median WTP/QALY values based on the lump-sum payments were 366,879 RMB (53,171USD, 5.1 times the GDP per capita) and 99,906 RMB (14,479USD, 1.39 times the GDP per capita) for the overall sample; 339,330 RMB (49,178USD, 4.71 times the GDP per capita) and 83,875 RMB (12,156USD, 1.16 times the GDP per capita) for the patient group; and 407,396 RMB (59,043USD, 5.66 times the GDP per capita) and 149,436 RMB (21,657USD, 2.08 times the GDP per capita) for the family group. Considering the skewedness of the data distribution, we suggest setting the cost-utility threshold with reference to the median. When the payment plan changed to 10-year installments, the median increased to 134,734RMB (19,527USD), 112,390 RMB (16,288USD) and 173,838 RMB (25,194USD) for the above groups, respectively. EQ-5D-5L health utility, annual household income per capita, patients with other chronic diseases, occupation, regular physical examinations (patients) and age (family members) were significantly related to WTP/QALY. This study provides empirical evidence of the monetary value of a QALY from a sample of the Chinese population with malignancies. In addition, the ratio of the WTP/QALY to GDP per capita was related to the disease and hypothetical scenario, and a higher ratio of GDP per capita for malignant tumor therapies should be considered.

show abstract

Section: Discussionmentioning

confidence: 71%

Estimation of the value of curative therapies in oncology: a willingness-to-pay study in China

Huang

Peng

Li-hua

et al. 2023

Cost Eff Resour Alloc

View full text Add to dashboard Cite

show abstract

“…The large discrepancy between the quality-of-life improvement and life extension scenarios leads to the question of whether we should adopt a higher threshold for end-of-life treatment. For example, the National Institute for Health and Care Excellence (NICE) standard threshold is £20,000 to £30,000, but for end-of-life interventions the threshold is £50,000 [ 31 ]. Whether and how this heterogeneity should be reflected in health care decision making in low- and middle-income countries is a question beyond the scope of this paper, but clearly a subject for future research.…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, a positive effect of income on WTP/Q would argue for the theoretical validity of WTP research [8,9,13]. Moreover, it was assumed that worse health state scenario [26][27][28] and smaller QALY gain [4,26,30,31] should lead to a higher WTP/Q. Our regressions confirmed previous results and proved the theoretical validity of our estimates: WTP/Q was higher when respondents had higher incomes, when analyzing both the whole sample and subgroups; the mean WTP/Q value for life extension is almost 2.25 times that for quality-of-life improvement; negative effect of QALY gain on WTP/Q was observed.…”

Section: Tablementioning

confidence: 99%

Willingness to Pay for One Additional Quality Adjusted Life Year: A Population Based Survey from China

Abduhilil

Huang

et al. 2022

Appl Health Econ Health Policy

View full text Add to dashboard Cite

Objective The aim of this study was to estimate the population’s willingness to pay (WTP) for an additional quality-adjusted life-year (QALY) in China. Methods The WTP for an additional QALY (WTP/Q) was estimated using a contingent valuation survey with quota sampling and snowball sampling, using a pre-designed questionnaire with 18 hypothetical scenarios. The change in health state was depicted by the EQ-5D-5L. The questionnaires were completed by telephone and face-to-face interviews. Two-part regression models were used to test validity and how different factors affect WTP/Q. Results A total of 2008 people participated in this survey and provided 3265 WTP responses for further analysis. The average WTP/Q for the entire sample is 113,120 Renminbi (RMB) (USD 16,884), which is 1.75 times the gross domestic product (GDP) per capita. For the quality-of-life improvement scenarios, the mean WTP/Q is RMB 78,907 (USD 11,777, 1.22 times GDP per capita), which is significantly lower than the life extension scenarios (RMB 177,761, USD 26,531, 2.76 times GDP per capita). Age was found to be negatively related to positive WTP. Educational level was positively related to the probability of reporting positive WTP and the level of WTP/Q. Although the EQ-5D-5L utility scores of respondents did not prove to be statistically significant determinants of WTP/Q, the two dimensions of EQ-5D-5L, pain/discomfort and anxiety/depression, had an impact on WTP/Q. In addition, WTP/Q was higher when the health outcome had a 50% probability of occurring than when the health outcome was 100% certain. WTP/Q was higher when a lower health gain was presented to the respondent. Conclusion This study provides empirical evidence of the monetary value of an additional QALY from a sample of the Chinese population. In addition, a higher threshold for end-of-life therapies should be considered. Supplementary Information The online version contains supplementary material available at 10.1007/s40258-022-00750-z.

show abstract

“…The most cost-effective treatment was inferred through a sequential analysis based on the cost-effectiveness frontier. As all treatments in this study were end-of-life anti-cancer drugs, lower and higher boundaries of willingness-to-pay (WTP) threshold in the UK were set to £20000 and £50000 per QALY respectively based on NICE’s recommendation ( 23 , 24 ). Approximately 1 time (£8000) and 3 times (£24000) the annual gross domestic product (GDP) per capita was used as the lower and higher boundaries of the threshold in China ( 22 ).…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of 12 First-Line Treatments for Patients With Advanced EGFR Mutated NSCLC in the United Kingdom and China

Guan

Wang²,

Chen³

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundLung cancer is imposing significant pressure on the national health insurance system worldwide, especially under the COVID-19 pandemic. However, the cost-effectiveness of all available first-line treatments for patients with advanced epidermal growth factor receptor (EGFR) mutated non-small cell lung cancer (NSCLC) is still uncertain. The aim of this study was to evaluate the cost-effectiveness of 12 first-line treatments for patients with advanced EGFR mutated NSCLC from the perspective of the United Kingdom (UK) National Health Service and Chinese health care system.MethodsWe used a Markov model to estimate the cost-effectiveness of 12 treatments, including 6 EGFR tyrosine kinase inhibitors, 4 combination treatments and 2 chemotherapies. The key clinical efficacy and safety data were from a network meta-analysis. The cost and health preference were mainly collected from the literature. The most cost-effective treatment was inferred through a sequential analysis. Uncertainty was tested with one-way sensitivity analyses, scenario analyses, and probabilistic sensitivity analyses. Quality-adjusted life years (QALYs), direct medical costs, and incremental cost-effectiveness ratio (ICER) were estimated, at willingness-to-pay thresholds of £20000 to £50000 and £8000 to £24000 per QALY in the UK and China respectively.ResultsFor clinical effectiveness, osimertinib and gefitinib plus pemetrexed based chemotherapy (PbCT) yielded the highest QALYs, while two chemotherapy treatments gained the lowest QALYs. For costs, gefitinib treatment was the cheapest option in both countries (£24529 in the UK and £12961 in China). For cost-effectiveness, 4 treatments including gefitinib, gefitinib plus pemetrexed, gefitinib plus PbCT, and osimertinib formed the cost-effectiveness frontier in both countries. Gefitinib alone (70.7% and 80.0% under the threshold of £20000 and £8000 per QALY in the UK and China, respectively) and gefitinib plus PbCT (62.3% and 71.2% under the threshold of £50000 and £24000 per QALY in the UK and China, respectively) were most likely to be cost-effective compared with other first-line treatments.ConclusionsGefitinib and gefitinib plus PbCT were likely to be cost-effective for patients with advanced EGFR mutated NSCLC in both countries.

show abstract

10 Years of End-of-Life Criteria in the United Kingdom

Cited by 14 publications

References 18 publications

Estimation of the value of curative therapies in oncology: a willingness-to-pay study in China

Estimation of the value of curative therapies in oncology: a willingness-to-pay study in China

Willingness to Pay for One Additional Quality Adjusted Life Year: A Population Based Survey from China

Cost-Effectiveness of 12 First-Line Treatments for Patients With Advanced EGFR Mutated NSCLC in the United Kingdom and China

Contact Info

Product

Resources

About