QALYs: The Math Doesn’t Work

The quality-adjusted life-year (QALY) is a metric widely used when assessing the cost-effectiveness of drugs and other health interventions. The assessments are used in the development of recommendations for pricing, formulary placement decisions, and health policy decisions. A new bill, H.R. 485, t...

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Main Authors: Tia G. Sawhney, Angela Dobes, Sirimon O'Charoen
Format: Article
Language:English
Published: Columbia Data Analytics, LLC 2023-07-01
Series:Journal of Health Economics and Outcomes Research
Online Access:https://doi.org/10.36469/001c.83387
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author Tia G. Sawhney
Angela Dobes
Sirimon O'Charoen
author_facet Tia G. Sawhney
Angela Dobes
Sirimon O'Charoen
author_sort Tia G. Sawhney
collection DOAJ
description The quality-adjusted life-year (QALY) is a metric widely used when assessing the cost-effectiveness of drugs and other health interventions. The assessments are used in the development of recommendations for pricing, formulary placement decisions, and health policy decisions. A new bill, H.R. 485, the Protecting Health Care for All Patients Act of 2023, was approved by the US House Energy and Commerce Health Subcommittee that will, if passed, end the practice of using QALYs in all federal programs.^1,2^ Proponents of the ban say that QALYs undervalue the positive effects of therapeutics on people with disabilities.^3^ We share their concerns. Furthermore, our review of the mathematical properties of QALYs, including an analysis of quality-of-life utility (QOL utility) data recently collected from patients with inflammatory bowel disease (IBD), has led us to conclude that QALYs are an inappropriate metric of drug and treatment cost-effectiveness for all people, both disabled and nondisabled, and should not be the basis for US healthcare policy decisions.
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spelling doaj-art-001d8e8f5fd04bc09c2bf28ed5ff00fa2025-02-10T16:12:47ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362023-07-01102QALYs: The Math Doesn’t WorkTia G. SawhneyAngela DobesSirimon O'CharoenThe quality-adjusted life-year (QALY) is a metric widely used when assessing the cost-effectiveness of drugs and other health interventions. The assessments are used in the development of recommendations for pricing, formulary placement decisions, and health policy decisions. A new bill, H.R. 485, the Protecting Health Care for All Patients Act of 2023, was approved by the US House Energy and Commerce Health Subcommittee that will, if passed, end the practice of using QALYs in all federal programs.^1,2^ Proponents of the ban say that QALYs undervalue the positive effects of therapeutics on people with disabilities.^3^ We share their concerns. Furthermore, our review of the mathematical properties of QALYs, including an analysis of quality-of-life utility (QOL utility) data recently collected from patients with inflammatory bowel disease (IBD), has led us to conclude that QALYs are an inappropriate metric of drug and treatment cost-effectiveness for all people, both disabled and nondisabled, and should not be the basis for US healthcare policy decisions.https://doi.org/10.36469/001c.83387
spellingShingle Tia G. Sawhney
Angela Dobes
Sirimon O'Charoen
QALYs: The Math Doesn’t Work
Journal of Health Economics and Outcomes Research
title QALYs: The Math Doesn’t Work
title_full QALYs: The Math Doesn’t Work
title_fullStr QALYs: The Math Doesn’t Work
title_full_unstemmed QALYs: The Math Doesn’t Work
title_short QALYs: The Math Doesn’t Work
title_sort qalys the math doesn t work
url https://doi.org/10.36469/001c.83387
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AT angeladobes qalysthemathdoesntwork
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