Glover Matthew, Buxton Martin, Guthrie Susan, Hanney Stephen, Pollitt Alexandra, Grant Jonathan
RAND Europe, Westbrook Centre, Milton Road, Cambridge CB4 1YG, UK.
BMC Med. 2014 Jun 16;12:99. doi: 10.1186/1741-7015-12-99.
Building on an approach developed to assess the economic returns to cardiovascular research, we estimated the economic returns from UK public and charitable funded cancer-related research that arise from the net value of the improved health outcomes.
To assess these economic returns from cancer-related research in the UK we estimated: 1) public and charitable expenditure on cancer-related research in the UK from 1970 to 2009; 2) net monetary benefit (NMB), that is, the health benefit measured in quality adjusted life years (QALYs) valued in monetary terms (using a base-case value of a QALY of GB£25,000) minus the cost of delivering that benefit, for a prioritised list of interventions from 1991 to 2010; 3) the proportion of NMB attributable to UK research; 4) the elapsed time between research funding and health gain; and 5) the internal rate of return (IRR) from cancer-related research investments on health benefits. We analysed the uncertainties in the IRR estimate using sensitivity analyses to illustrate the effect of some key parameters.
In 2011/12 prices, total expenditure on cancer-related research from 1970 to 2009 was £15 billion. The NMB of the 5.9 million QALYs gained from the prioritised interventions from 1991 to 2010 was £124 billion. Calculation of the IRR incorporated an estimated elapsed time of 15 years. We related 17% of the annual NMB estimated to be attributable to UK research (for each of the 20 years 1991 to 2010) to 20 years of research investment 15 years earlier (that is, for 1976 to 1995). This produced a best-estimate IRR of 10%, compared with 9% previously estimated for cardiovascular disease research. The sensitivity analysis demonstrated the importance of smoking reduction as a major source of improved cancer-related health outcomes.
We have demonstrated a substantive IRR from net health gain to public and charitable funding of cancer-related research in the UK, and further validated the approach that we originally used in assessing the returns from cardiovascular research. In doing so, we have highlighted a number of weaknesses and key assumptions that need strengthening in further investigations. Nevertheless, these cautious estimates demonstrate that the returns from past cancer research have been substantial, and justify the investments made during the period 1976 to 1995.
基于一种用于评估心血管研究经济回报的方法,我们估算了英国公共和慈善机构资助的癌症相关研究因健康改善成果的净值而产生的经济回报。
为评估英国癌症相关研究的这些经济回报,我们估算了:1)1970年至2009年英国癌症相关研究的公共和慈善支出;2)净货币效益(NMB),即从1991年至2010年优先干预措施清单中,以货币形式衡量的质量调整生命年(QALY)所带来的健康效益(使用一个QALY为25,000英镑的基础案例值)减去实现该效益的成本;3)可归因于英国研究的NMB比例;4)研究资金投入与健康改善之间的时间间隔;以及5)癌症相关研究投资对健康效益的内部收益率(IRR)。我们使用敏感性分析来分析IRR估计中的不确定性,以说明一些关键参数的影响。
以2011/12年的价格计算,1970年至2009年癌症相关研究的总支出为150亿英镑。1991年至2010年优先干预措施所带来的590万个QALY的NMB为1240亿英镑。IRR的计算纳入了估计为15年的时间间隔。我们将估计可归因于英国研究的年度NMB的17%(1991年至2010年的每一年)与15年前的20年研究投资(即1976年至1995年)相关联。这得出的最佳估计IRR为10%,而之前对心血管疾病研究估计的IRR为9%。敏感性分析表明,减少吸烟作为癌症相关健康改善的主要来源的重要性。
我们已经证明了英国癌症相关研究的公共和慈善资金投入从健康净收益中获得了可观的内部收益率,并进一步验证了我们最初用于评估心血管研究回报的方法。在此过程中,我们强调了一些在进一步调查中需要加强的弱点和关键假设。尽管如此,这些谨慎的估计表明,过去癌症研究的回报是巨大的,并且证明了1976年至1995年期间所做投资的合理性。