Scenario
You are a member of an area prescribing committee (APC) which is reviewing the treatment options for a cancer which is universally rapidly fatal (usually within months) if not treated. For the purposes of this cases study, please assume the following:
There is good evidence supporting the effectiveness of three medicines (A, B and C) in improving health outcomes.
The treatments are mutually exclusive: there is no evidence that patients are better off switching from one to another.
Effectiveness does not depend on patient or disease characteristics.
All costs fall within the first year of treatment.
Costs vary only according to the drug selected, since staff time, etc. are fixed and are the same requirements for each treatment.
The annual budget available for commissioning treatment is US$150,000.
The incidence of this cancer in the area covered by your APC is 500 new cases each year.
The health economic data are summarized below:
Treatment (current practice) A B C
Life-Year Gained 0.3 0.4 0.5
Health Utility Index (in each year) 0.8 0.7 0.5
Cost (per patient) $300 $1,500 $5
Question : From a society perspective, which treatment generates the greatest health gains given the funds available? Please show your calculation and explain briefly.
Question : Which treatment would you recommend to the area prescribing committee (APC): A, B or C?