Estimating the returns to UK publicly funded cancer-related research in terms of the net value of improved health outcomes
Cette étude analyse le retour sur investissement des fonds publics et privés investis dans la recherche publique sur le cancer, sur la période 1976-1995, en prenant en compte l'amélioration de la santé et de la survie des patients au Royaume-Uni
BACKGROUND: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. METHODS: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 GBGBP25,000) 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. RESULTS:In 2011/12 prices, total expenditure on cancer-related research from 1970 to 2009 was GBP15 billion. The NMB of the 5.9 million QALYs gained from the prioritised interventions from 1991 to 2010 was GBP124 billion. Calculation of the IRR incorporated an estimated elapsed time of 15years. We related 17% of the annual NMB estimated to be attributable to UK research (for each of the 20years 1991 to 2010) to 20years of research investment 15years 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. CONCLUSIONS: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.