QALY Ban Could Harm People with Disabilities and Chronic Illness
The U.S. House passed a bill that would ban the use of a metric known as quality-adjusted life-years (QALYs) in coverage and payment determinations for federal health-care programs. SHP's Joshua Salomon writes in this Health Affairs commentary the bill would compromise the evaluation of medical treatments.
In this Health Affairs commentary, Robert Kaplan, Peter Neumann, Joshua Salomon and Marthe Gold argue the metric known as quality-adjusted life-years (QALYs) is an important measure in health-care analyses that should not be phased out. They write:
"On February 7, 2024, the House of Representatives passed the Protecting Health Care for All Patients Act (HR 485). We believe the bill would compromise the evaluation of medical treatments. Here is why.
"HR 485 would ban the use of a metric known as quality-adjusted life-years (QALYs) in coverage and payment determinations under federal health care programs. Over the past 50 years, QALYs have gained worldwide acceptance as a preferred measure to enable wise use of limited health care resources, permitting health systems and policy makers to compare the costs and effectiveness of treatments that cross traditional disease categories. However, supporters of HR 485 argue that QALYs systematically discriminate against people with disabilities and chronic illnesses. These arguments have been raised before and have been roundly refuted by consensus panels of leading physicians, scientists, and policy makers. QALYs or related methods are the best way to assure fair treatment of people with disabilities, chronic illnesses, or other health conditions.
"QALYs, originally introduced in the 1970s, were developed in response to inequities in health care spending. Policy analysis using QALYs estimates how much health is gained or lost from illness and its prevention or treatment. QALYs capture dimensions of health that people identify as important for quality of life. These include how long people live in addition to everyday physical and cognitive functioning, emotional health, and pain.
