QALYs and Value Assessment

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QALYs and Value Assessment

Mayvis Rebeira PhD, Canadian Health Policy Institute

ABSTRACT

This literature review highlights the limitations of using Quality-Adjusted Life-Years or QALYs, in assessing the value of therapies through its use in cost-effectiveness analysis. Objective: To highlight key issues and limitations with the use of QALYs and present alternative methods to assess value-for-money for evaluating innovative therapies: Methods and Results: Key considerations highlighted include ethical considerations, use of QALYs for resource allocation, underestimating impact of therapy, ageist bias and double jeopardy with respect to people with disabilities or permanent ill-health. Methodological and other limitations covered include lack of established threshold in cost-effectiveness analysis and QALY derivation. Recommendations: Several recommendations are proposed that can either be used in conjunction with QALYs or replace the current QALY metric in value assessment. Conclusion: QALYs are deeply embedded in health technology assessments. For a long period, it represented the only measure that attempts to quantify the impact of a therapy on an individual’s health and wellbeing. Given the limitations highlighted here, use of QALYs in value assessments can lead to sub-optimal decisions and impact health outcomes of patients. The gradual inclusion of alternate measures can lead to better evaluation of value-for money of new interventions whilst enabling a more just and fair system for all patients.

ACKNOWLEDGMENTS: N/A

CITATION: Rebeira, Mayvis (2022). QALYs and Value Assessment. Canadian Health Policy, NOV 2022. Toronto: Canadian Health Policy Institute. ISSN 2562-9492, https://doi.org/10.54194/DFUL2957, www.canadianhealthpolicy.com.

CORRESPONDENCE:  mayvis.rebeira@utoronto.ca

DISCLAIMER: N/A

DISCLOSURE: No conflicts were declared.

OPEN ACCESS: N/A Not sponsored.

REVIEW: This article was subject to peer review.

SUBMITTED: 2 NOV 2022 | PUBLISHED: 24 NOV 2022

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