QALYs: The Math Doesn't Work.

IF 2.3 Q2 ECONOMICS Journal of Health Economics and Outcomes Research Pub Date : 2023-07-27 eCollection Date: 2023-01-01 DOI:10.36469/001c.83387

Tia G Sawhney, Angela Dobes, Sirimon O'Charoen

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Abstract

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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QALYs：数学不起作用。

质量调整生命年（QALY）是评估药物和其他健康干预措施成本效益时广泛使用的指标。评估用于制定定价建议、公式化安置决策和卫生政策决策。美国众议院能源和商业健康小组委员会批准了一项新法案H.R.485，即《2023年保护所有患者的医疗保健法》，如果该法案获得通过，将终止在所有联邦项目中使用QALYs的做法。1,2该禁令的支持者表示，QALYs低估了治疗对残疾人的积极影响。3我们与他们一样担心。此外，我们对QALYs的数学性质的审查，包括对最近从炎症性肠病（IBD）患者那里收集的生活质量效用（QOL效用）数据的分析，使我们得出结论，QALYs是衡量所有人（包括残疾人和非残疾人）药物和治疗成本效益的不适当指标，不应成为美国医疗政策决策的基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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