KMID : 1146320140020010068
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Journal of Health Technology Assessment 2014 Volume.2 No. 1 p.68 ~ p.73
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Decision Making Based on Incremental Cost-Effectiveness Ratio for Anticancer Drugs
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Kim Hoe-Sang
Kang Young-Ju Ko Su-Kyoung Kang Hye-Young
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Abstract
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Objectives: To discuss potential problems of reimbursement decision making for anti-cancer drugs based on incremental cost-effectiveness ratio (ICER), and to examine alternative approaches that can replace ICER.
Methods: Literature review was conducted for peer-review journals published from 2006 and 2010 using a structured search strategy. Web-site search was carried out for documentation provided by health technology assessment institutes for selected countries including England, Canada, and Australia.
Results: To improve access to anti-cancer drugs, two alternative approaches for ICER criteria were discussed: variable ICER threshold and multi-criteria decision analysis (MCDA). Variable ICER threshold indicates to use different ICER threshold for different types of disease or population to reflect distinct characteristics, expectation, and value associated with specific disease or population. MCDA suggests to use multiple criteria such as rare condition, equity, equality, needs, as well as efficiency, in order to fully reflect social value of medicine. Pros and cons of these alternative approaches were discussed.
Conclusion: To employ these alternative approaches in reimbursement and/or pricing decision making for anti-cancer drugs, specific methods to operationalize and measure each criterion of MCDA and disease-specific ICER value should be developed. Further, the developed methods requires consensus by members of society.
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KEYWORD
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Cancer, Incremental cost-effectiveness ratio, Social value, Threshold
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