Cost effectiveness in the treatment of advanced solid tumours

When the treatment of advanced cancer is palliative in intent, evaluation of quality of life is of paramount importance in judging the effectiveness of treatment. The balance between adverse effects (costs) and benefits has been particularly difficult to determine with cytotoxic drugs. An approach to this problem using medical audit is described. It has been found to be a reliable method which has demonstrated a highly significant correlation between achievement of objective regression and acquisition of benefit. The method is now undergoing corroboration by a prospective study.