Box 2.

Hypothetical example of different novel cancer therapies (drug names are fictitious). Which should be provided in a Publicly-funded Healthcare System? For the purposes of this example, it is not necessary to specify the standard care. The new anti-cancer drugs will be prescribed in addition to standard care (not replacing standard care)

A public healthcare system is evaluating whether to fund new life extending cancer treatments. Various supplementary treatments have been assessed in comparison with the current standard of care

Axemab costs an additional £10,000 per treatment, and on average extends life by an additional 1 quality-adjusted life-year (QALY)

Boximab costs the same amount, but extends life by only 0.5QALY on average

Cliximab is more expensive, but also more effective than treatment A. It costs £20,000 per treatment, but extends life for 1.5 QALYs*

Daxamab costs £10,000 per treatment, but extends life for only one week

* Cliximab is the most effective treatment, and falls within the incremental cost-effectiveness threshold for the UK. Axemab, Boximab and Daxamab may be cost-equivalent (depending on the version of cost-equivalence used). See Table 3