QALYs:数学不起作用

Tia Sawhney, Angela Dobes, Sirimon O'Charoen
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引用次数: 0

摘要

质量调整生命年(QALY)是在评估药物和其他卫生干预措施的成本效益时广泛使用的度量标准。评估结果用于制定定价建议、决定处方位置和制定卫生政策。美国众议院能源和商业卫生小组委员会通过了一项名为H.R. 485的新法案,即《2023年保护所有患者医疗保健法案》,如果该法案获得通过,将结束在所有联邦项目中使用质量评估指标的做法。这项禁令的支持者说,QALYs低估了治疗方法对残疾人的积极作用我们和他们一样感到关切。此外,我们回顾了QALYs的数学特性,包括对最近从炎症性肠病(IBD)患者收集的生活质量效用(QOL效用)数据的分析,得出结论:QALYs对所有人(包括残疾人和非残疾人)来说都不是一个不合适的药物和治疗成本效益指标,不应该成为美国医疗保健政策决策的基础。
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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, 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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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
55
审稿时长
10 weeks
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