Drivers of Change: How HTA, Evidence and Policy Affect Perceptions of Value and Health Care Practice. Canadian Association for Population Therapeutics 2014

Main Article Content

The Canadian Association for Population

Keywords

pancreatic cancer, cost - effectiveness, EQ - 5D

Abstract

Objectives:


Previous Canadian EQ - 5D based cost - effectiveness studies commonly use UK or US valuations, as Canadian tariffs were o nly recently made available. The implications of using non - Canadian tariffs to inform decision - making are unclear. We aim to re - evaluate a previous cost - effectiveness study of therapies for metastatic pancreatic cancer, originally performed using US utilit ies, with weights from Canada and various countries to determine the impact of using non - country specific tariffs.


Methods:


EQ - 5D utilities were derived using tariffs from Canada, US, UK, Denmark, France, Germany, Japan, the Netherlands and Spain for the 10 health states in the pancreatic cancer model. Incremental cost - effectiveness ratios (ICERs) were generated, and probabilistic sensitivity analyses (PSA) were performed.


Results:


Canadian utilities are generally lower than the corresponding US values an d higher than those of UK. Compared to the Canadian - valued scenarios, US and UK estimates were statistically different for 5 and 10 scenarios, respectively. Overall, 60% (54 of 90) of the non - Canadian utilities were significantly different, clinically, fro m the Canadian values. Canadian ICERs were about 5% greater than those of the US and 9% lower than those of the UK. The minimum willingness - to - pay threshold at which the chemotherapy regimen GEM - CAP is the most cost - effective based on PSA was $5,239 less f or the US and $11,986 more for the UK compared to the Canadian threshold value.


Conclusions:


Using non - country specific tariffs, there are significant differences among the derived utilities, ICERs and PSA results. Past Canadian EQ - 5D based cost - effective ness studies and related funding decisions may need to be re - visited using Canadian tariffs.

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References

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