Cisplatin-Based Combination Chemotherapy in the Treatment of Advanced-Stage Testicular Cancer: Cost-Benefit Analysis

Abstract

A cost-benefit analysis of the impact of cisplatin-based combination chemotherapy for treatment of disseminated testicular cancer showed that the annual estimated economic value of this treatment innovation in the United States is approximately $150 million. The estimate was based on the human capital approach, which conservatively values a human life in terms of economic productivity. Because testicular cancer predominantly strikes young adult males, the savings reported were due to the future earning potential of the survivors. A comparison of relevant National Cancer Institute (NCI) costs for drug development and clinical trials versus annual savings realized indicated that the total costs over a 17-year period are recovered in less than 1 year. This report is an example of health care cost savings resulting from NCI support of biomedical research.

Gains in Life Expectancy from Medical Interventions — Standardizing Data on Outcomes

“…For example, the gain in life expectancy from chemotherapy for testicular cancer is about nine years for those receiving the intervention (Table 3). 32 However, because this disease is so rare, the gain from making this treatment available to the man at average risk is about one hour. This gain is very small in comparison with the population-wide gains of months from the preventive interventions for coronary heart disease 9 shown in Table 1.…”

Pharmacoeconomy in cancer therapy

“…Shibley et al [11] applied this principle for the estimation of the economic value of cisplatin-based chemotherapy for the treatment of testicular cancer, revealing thereby an overwhelming net benefi t. May be that the so-called willingness-to-pay (WTP) approach will popularize again the CBA which is actually used less. In a WTP analysis, subjects are confronted with the standard and a hypothetical intervention and are asked to indicate the maximum amount they would be willing to pay for the latter.…”

Economic Evaluations of Medical Care Interventions for Cancer Patients: How, Why, and What Does it Mean?

“…Shibley et al used this approach to perform a CBA to estimate the economic value of cisplatin‐based combination chemotherapy in the treatment of patients with advanced‐stage testicular cancer. The CBA showed a net benefit of $150 million 28 . Many researchers have challenged the use of wages to measure the value of human lives and have also raised concerns about the monetary values that are used to represent the productivity of persons not in the labor force, such as children, stay‐at‐home parents, or retirees 10…”

“…The CBA showed a net benefit of $150 million. 28 Many researchers have challenged the use of wages to measure the value of human lives and have also raised concerns about the monetary values that are used to represent the productivity of persons not in the labor force, such as children, stay-at-home parents, or retirees. 10 The willingness-to-pay (WTP) approach is an alternative method to define the economic value for an intervention or a year of life.…”