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Valuing the benefits of new anticancer drugs

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Improvements in survival and cancer-related symptoms must be weighed up against treatment-related adverse effects and financial burden

Annual expenditure on anticancer drugs by the Pharmaceutical Benefits Scheme (PBS) has risen from $65 million in 1999–00 to $466 million in 2011–12 — an average annual increase of 19%.1 This is more than double Australia’s average annual increase in health expenditure of 8% over the same period.2 New techniques in radiation oncology and surgical oncology have also increased expenditure on cancer. It has never been more important to assess the value of new cancer treatments, weighing up the balance between benefits, harms and costs. In oncology, clinical benefit is defined by improvements in survival and cancer-related symptoms, and must be traded off against treatment-related adverse effects and financial burden. In Australia, evaluation of the trade-offs for new anticancer drugs has been predominantly a matter of health care policy, and determined by the Pharmaceutical Benefits Advisory Committee (PBAC).

People affected by cancer also face decisions about paying for unfunded treatments and need to understand the degree of benefit a treatment may offer. This is not straightforward, as illustrated by an American study published in 2012, which reported that 69% of patients with metastatic lung cancer and 81%…