Devita, Hellman, and Rosenberg's Cancer

LWBK1006-10 LWW-Govindan-Review November 24, 2011 11:21

118 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

Question 10.12. Which of the following is NOT true regarding methods of assessing the

economic impact of medical treatments?

A. Cost-minimization analysis takes into account the indirect costs that

patients experience (e.g., changes in quality of life) and seeks to min-

imize these.

B. Cost-effectiveness analysis compares cost with a relevant clinical vari-

able, such as cost per year of life.

C. Cost-utility analysis compares cost with quality-adjusted-life-years

(QALYs) such that the toxicities of therapies and the quality of life in

the setting of a chronic illness can be weighed along with the benefit.

D. Cost-benefit analysis assigns a dollar amount to a QALY, so that two

costs may be compared directly. This requires assigning a monetary

value to a quality-adjusted year of life.

Question 10.13. Assume a new drug for metastatic breast cancer is expensive, but claims

to be “cost-effective.” What might this mean?

A. The new treatment is less expensive than the old treatment because

it has a shorter infusion time resulting in lower administration costs.

B. The new treatment is less toxic than the old treatment, increasing the

number of QALYs compared to an older treatment.

C. The new treatment makes patients live longer with an incremental

cost of less than $50,000 for each additional year of life.

D. All of the above.

Question 10.14. Cost-benefit is frequently modeled as dollars per QALY. Which is NOT

true regarding this method of modeling?

A. The cost of hemodialysis ($50,000 per QALY) is frequently used as

a standard for what society in the United States is willing to fund.

B. In less affluent countries, the threshold of society support is often

correlated with per capita gross domestic product.

C. The legislation that established Medicare prohibits the consideration

of cost in determining coverage.

D. Insurers frequently incorporate these types of modeling in determin-

ing coverage.