Publications [#301819] of Peter A Ubel

Journal Articles

1. Kozminski, MA; Neumann, PJ; Nadler, ES; Jankovic, A; Ubel, PA, How long and how well: oncologists' attitudes toward the relative value of life-prolonging v. quality of life-enhancing treatments., Medical decision making : an international journal of the Society for Medical Decision Making, vol. 31 no. 3 (May, 2011), pp. 380-385 [21088130], [doi]
   (last updated on 2026/01/17)

   Abstract:
   

   Objective

   To determine how oncologists value quality-enhancing v. life-prolonging outcomes attributable to chemotherapy.

   Methods

   The authors surveyed a random sample of 1379 US medical oncologists (members of the American Society of Clinical Oncology), presenting them with 2 scenarios involving a hypothetical new chemotherapy drug. Given their responses, the authors derived the implicit cost-effectiveness ratios each physician attributed to quality-enhancing and life-prolonging chemotherapies.

   Results

   The authors received responses from 58% of the oncologists surveyed. On average, the responses implied that oncologists were willing to prescribe treatments that cost $245,972 per quality-adjusted life-year (QALY; SD $243,663 per QALY) in life-prolonging situations v. only $119,082 per QALY (SD $197,048 per QALY) for treatments that improve quality of life but do not prolong survival (P < 0.001). This difference did not depend on age, gender, percentage of time in clinical work, or self-reported preparedness to use and interpret cost-effectiveness information (P > 0.05 for all specifications). Differences across these situations persisted even among those who considered themselves to be "well-prepared" to make cost-effectiveness decisions.

   Conclusion

   Cost-effectiveness thresholds for oncologists vary widely for life-prolonging chemotherapy compared to treatments that only enhance quality of life. This difference suggests that oncologists value length of survival more highly than quality of life when making chemotherapy decisions.