Willingness to pay for cancer prevention

Abstract

Cancer inflicts great pain, burden and cost upon American society, and preventing cancer is important but not costless. The aim of this review was to explore the upper limits that American society is paying and appears willing to pay to prevent cancer, by enforced environmental regulations and implemented clinical practice guidelines.Cost-effectiveness studies of clinical and environmental cancer-prevention policies and programmes were identified through a comprehensive literature review and confirmed to be officially sanctioned and implemented, enforced or funded. Data were collected in 20056 and analysed in 2007.The incremental cost-effectiveness ratios (ICERs) for clinical prevention policies ranged from under $US2000 to over $US6000000 per life-year saved (LYS), exceeding $US100000 per LYS for only 11 of 101 guidelines. Median ICERs for tobacco-related ($US3978LYS), colorectal ($US22 694LYS) and breast ($US25687LYS) cancer prevention were within generally accepted ranges and tended not to vary greatly, whereas those for prostate ($US73603LYS) and cervical ($US125157LYS) cancer-prevention policies were considerably higher and varied substantially more. In contrast, both the median and range of the environmental policies were enormous, with 90 exceeding $US100000 per LYS, and ICERs ranging from $US61004 to over $US24 billion per LYS.Notwithstanding a relatively large and accessible literature evaluating the cost effectiveness of clinical and environmental cancer-prevention policies as well as the availability of ICERs for the policies identified in this study, the apparent willingness to pay to prevent cancer in the US still varies greatly and can be extremely high, particularly for many of the environmental cancer-prevention policies. © 2009 Adis Data Information BV. All rights reserved.