Priority Setting Methods in Cancer: Evidence-Based Marginal Analysis

The challenge of priority setting in cancer has never been so great. Over the past 20 years, over 2.3 million Canadians developed cancer, of which 1.1 million died prematurely. Over the next 20 years, these levels will rise by approximately 56% and 48% respectively. Cancer control and care in BC faces many other challenges: the rising costs of innovation and technology, allocating resources across the spectrum of interventions, a lack of incremental funding growth despite growth in incidence and prevalence, growth in all cancer control programs, need for new programs required with no defined funding, and rising community expectations and demand. A systematic organization of the limited resources in cancer control and care is urgently needed to respond to the potential impacts of cancer.

Research Summary

The challenge of priority setting in cancer has never been so great. Over the past 20 years, over 2.3 million Canadians developed cancer, of which 1.1 million died prematurely. Over the next 20 years, these levels will rise by approximately 56% and 48% respectively. Cancer control and care in BC faces many other challenges: the rising costs of innovation and technology, allocating resources across the spectrum of interventions, a lack of incremental funding growth despite growth in incidence and prevalence, growth in all cancer control programs, need for new programs required with no defined funding, and rising community expectations and demand. A systematic organization of the limited resources in cancer control and care is urgently needed to respond to the potential impacts of cancer.

The objectives of the study are to pilot two significant innovations in the methods used in the program budgeting and marginal analysis (PBMA) priority setting framework, the only framework specifically designed to address these problems.

• Evidence-Based Marginal Analysis – using Quality Adjusted Life Years as the measure of health gain and an evidence-based approach employing systematic reviews and analysis to estimate effectiveness.
• Utilization and Outcomes Evaluation – evaluating the effectiveness of PBMA in terms of changes in utilization, and improvements in patient outcomes using mortality and quality of life data.

The outcomes of this study will result in an evidence-based framework for decision-making that will translate high quality research into knowledge for improving clinical practice, patient outcomes, and population health and well-being.