ESTABLISHING THE VALUE OF WHAT WE DO
AND HOW WE DO IT

THERE ARE THREE WAYS TO LOOK AT IT:

I.  Investigating interventions to find the ones that are truly effective

II. Choosing Interventions that are valuable -- that make a difference

III. Applying efficiency in our organization Within an Organization that is efficient

The International Breast Cancer Research Foundation (IBCRF) provides medical interventional research in women with breast cancer, always with an evaluative component.

How can we judge whether the interventions we are testing are worth the effort and importantly the cost, financially?

A well designed and conducted research project should usually generate some new knowledge, whose value at the time may be difficult to assess.

Methodologically, IBCRF researchers often use randomized clinical trials as their tool for investigation. This is the recognized gold standard in determining efficacy and effectiveness of a new intervention compared to the usual, state-of-the-art approach. IBCRF investigators are university faculty researchers, with records of important accomplishments best demonstrated by their scientific publications.

Specific judgments of our projects then, by independent experts provide additional assurances that our projects meet high standards. At present, IBCRF projects are funded by grants from the United States National Institutes of Health, The Breast Cancer Research Foundation, and Ohio State University.

What are the values of the interventions IBCRF is studying, that is how much “health” does investment in these interventions, buy?

It is fair to ask, beyond knowledge gained, if our studied interventions proved effective, how much will they cost to save a year of life?

First some benchmarks to help understand the dollar figures we can provide:

A committee for The World Health Organization has suggested that a reasonable investment in health in a country occurs when good information shows that one year of life saved can be achieved with expenditure of an amount of money equivalent to the GDP annual per capita in the country.

Thus at present in the U.S. , with an annual GDP of about $40,000, a good health investment is one that “buys” a year of life for this amount of money or less. The annual GDP in Bangladesh is <$1000; in the Philippines~ $1500; in Vietnam $2000.

In a study of 500 effective health interventions, the middle intervention was estimated to cost $42,000 per year of life saved.

Breast cancer treatments commonly used in the United States cost from $10,000 to upwards of $250,000 per year of life saved.

Against these figures then, our estimates are that surgical oophorectomy as an adjuvant intervention costs $350 per year of life saved. If our studies prove that timing this surgery improves outcomes, then this will improve this figure to perhaps $150 per year of life saved.

Our studies to improve the selection of patients for tamoxifen treatment can lead to improving the cost efficacy of that treatment for treated women by four fold.

For our implementation research in Bangladesh, we estimate that for investments in three efforts, the following “breast health” can be achieved:

Primary Care Case-finding Project cost = $150,000 Cost per year of life saved= $200

Community cultural education: Project cost= $75,000 Cost per year of life saved= $100

Multidisciplinary Breast Specialty Care Center:

Project cost = $100,000 Cost per year of life saved= $100

In doing our research work how efficient are we in our use of donated financial support?

HOW WE DO IT -- AN EFFICIENT ORGANIZATION IN ACTION

In 2009 our administrative and fundraising expenditures were 9% of income during the first six months.