What are QALYs and why do we use them?

QALY stands for Quality Adjusted Life Year. The QALY is commonly used in health economic evaluations as a means of quantifying the health effect of a medical intervention or a prevention program and ultimately to help payers allocate healthcare resources.

What is wrong with QALY?

The greatest flaw by far in the QALY methodology is the subjective threshold value attached to a year of perfect health. In the United States, the Institute for Clinical and Economic Review, which conducts drug cost-effectiveness analyses, values one QALY at $50,000 to $150,000.

How are QALYs determined?

QALYs are calculated simply by multiplying the duration of time spent in a health state by the HRQoL weight (i.e. utility score) associated with that health state. Therefore, the two key elements—HRQoL and survival—are incorporated.

How would you explain the concept of a QALY?

The quality-adjusted life-year (QALY) is a measure of the value of health outcomes. Since health is a function of length of life and quality of life, the QALY was developed as an attempt to combine the value of these attributes into a single index number.

Are QALYs fair?

The QALY assumes that health improvement is equally valued between individuals. Some can perceive as equitable, that is fair, the assumption that health improvement is equally valued between individuals in the QALY.

What is a QALY and how can this metric be used in cost utility analysis?

Cost utility analysis ( CUA ) is one type of economic evaluation that can help you compare the costs and effects of alternative interventions. CUA measures health effects in terms of both quantity (life years) and quality of life. These are combined into a single measure of health: quality-adjusted life years (QALYs).

Is the QALY fit for purpose?

It fails to treat diverse sets of people who can benefit from health care equitably. This is not to say that the overall purpose of the QALY framework—utility maximization—is always wrong, but that when it is activated without consideration and context, it can become a dangerously flawed tool.

Are all QALYs equal?

All QALYs are not created equal, if you will. Therefore, using the QALY and cost-per-QALY threshold to compare qualitatively different kinds of interventions and disease or condition categories – life-saving or life-threatening versus life-improving – may be problematic.

Is a QALY a good measure?

The use of QALYs has been criticized by disability advocates because otherwise healthy individuals cannot return to full health or achieve a high QALY score. Treatments for quadriplegics, patients with multiple sclerosis, or other disabilities are valued less under a QALY-based system.

What is QALY Maximisation?

In cost-utility analysis, the numbers of quality-adjusted life years (QALYs) gained are aggregated according to the sum-ranking (or QALY maximisation) rule. This requires that the social value from health improvements is a simple product of gains in quality of life, length of life and the number of persons treated.

What is QALY cost-effectiveness?

What Is a QALY? Cost-effectiveness studies usually provide the final result in the form of an incremental cost-effectiveness ratio. A simplified version demonstrates how much it costs to extend life by 1 year—for example, $100,000 per life year (LY).

What is the main application of quality-adjusted life years?

The quality-adjusted life year or quality-adjusted life-year (QALY) is a generic measure of disease burden, including both the quality and the quantity of life lived. It is used in economic evaluation to assess the value of medical interventions. One QALY equates to one year in perfect health.