New Report: Quality Adjusted Life Years (QALY) Methodology Discriminates Against Older Americans, Threatens to Deny Seniors Access to Life-Saving Care

Share on Facebook
Share on Twitter
Share on
LinkedIn
+

Pioneer Institute Asserts that with Older Americans More Vulnerable during the COVID-19 Pandemic, All Health Plans Should Avoid Using the QALY Methodology When Assessing the Value of Care for Older Patients

Boston, MA (April 2, 2020) – Today, Pioneer Institute released a new report, Quality Adjusted Life Years (QALY): The Threat to Older Americans, which examines how the QALY methodology to determine drug treatment value threatens to discriminate against older adults by placing a lower value on treatments that would extend the life of or improve quality of life for older patients.  This clear bias against providing access to therapies to seniors comes at a critical and especially vulnerable time for older Americans given the coronavirus disease (COVID-19).  Authored by Pioneer Institute Visiting Fellow in Life Sciences, Dr. William Smith, the report concludes that the QALY methodology, utilized most notably by the Institute for Clinical and Economic Review (ICER), has the potential to deny seniors’ access to high-quality, life-saving treatments.

QALYs rate medical treatments according to their ability to extend life and to improve the quality of life. Pioneer Institute’s report explains how the QALY method of assessing the value of medicines is inherently discriminatory and ageist, as it will consistently rate treatments for older Americans as less cost-effective than for younger people. The report explains:

“Treatments that provide more ‘life years’ will be rated as ‘more effective’ under QALY, which superficially sounds commonsensical unless you realize that this standard will, by definition, be used to argue that drugs for senior citizens with shorter life expectancies will be rated lower than drugs for younger people.” (Pg. 1)

Pioneer Institute’s report explores how the use of the QALY methodology would specifically affect those receiving palliative care. While palliative care treatments may significantly improve the quality of life for patients with a serious or life-limiting condition, they often do not extend it. The report illustrates how the QALY methodology contains inherent bias when applied to palliative care:

“Palliative care highlights the problem of using the QALY methodology generally: not every decision made in healthcare should be justified solely based on cost-effectiveness. Human beings make value judgments about how to care for their fellow human beings…These formulas themselves are based upon certain value judgments that human life is less valuable than many Americans think.” (Pg. 3)

Pioneer Institute’s report warns that federal policy proposals that consider the use of QALYs to make treatment access decisions, such as “Medicare for All,” could have disastrous consequences for American seniors. The report concludes:

“Senior citizens who become enrolled in a Medicare for All plan and are then denied valuable treatments based upon a QALY cost-effectiveness review might not share ICER’s view on the value of QALYs. Not only is ICER’s modeling of the value of longevity flawed, they also de-value treatments such as palliative care that are extremely important to older Americans and their families but may not increase longevity.” (Pg. 3)

Read a one-page fact sheet on the report.

###

About the Author

William S. Smith is Visiting Fellow in Life Sciences at Pioneer Institute.  He has 25 years of experience in government and in corporate roles, including as vice president of public affairs and policy at Pfizer, and as a consultant to major pharmaceutical, biotechnology and medical device companies. He held senior staff positions for the Republican House leadership on Capitol Hill, the White House, and in the Massachusetts Governor’s office. He is affiliated as research fellow and managing director with the Center for the Study of Statesmanship at The Catholic University of America (CUA), where he earned his PhD.

About Pioneer Institute

Pioneer Institute is an independent, non-partisan, privately funded research organization that seeks to improve the quality of life in Massachusetts through civic discourse and intellectually rigorous, data-driven public policy solutions based on free market principles, individual liberty and responsibility, and the ideal of effective, limited and accountable government.

Get Updates On Our Work to Protect Patients and Innovation!

Related Posts:

Which industry’s workforce has been hurt the most from the COVID-19 outbreak?

/
Unemployment claims have reached all-time highs in the U.S. recently…

New Study Calls for Re-thinking Massachusetts’ COVID-19 Care Standards

Pioneer's new study raises concerns about the Massachusetts Department of Public Health’s (DPH’s) Crises Standards of Care (CSC) issued earlier this month, which bear the earmarks of a state bureaucratic effort and should be rethought under a process that includes a thorough vetting by Massachusetts citizens.

Pioneer Institute Launches Its New Policy Podcast, “HubWonk”

Pioneer Institute is pleased to announce the launch today of a new, weekly podcast called “HubWonk,” covering timely topics, with insights and in-depth interviews on the issues that affect our quality of life, ability to prosper, and liberties. 

Will the COVID-19-related economic recession cause a spike in crime?

/
Intuitively, it makes sense that people replace legitimate business…

New Report Offers Case Study for Transition to Online Learning

Virtual Schooling Pioneer Julie Young provides tips on how states should move forward with the transition to online education during COVID-19.

The Institute for Justice’s Tim Keller on Espinoza v. Montana DOR & ongoing school choice litigation

/
This week on “The Learning Curve,” Cara and Gerard continue coverage of COVID-19’s impact on K-12 education, joined by Tim Keller, Senior Attorney with the Institute for Justice, which is representing the plaintiffs in the high-profile Espinoza v. Montana Department of Revenue case currently before the U.S. Supreme Court,.

State Ranking: Michigan, Hawaii, Rhode Island, Pennsylvania, and Nevada have been hardest-hit by COVID-19 jobless claims so far. Massachusetts ranks as 9th hardest-hit.

/
The U.S. Department of Labor reported today that in the week ended April 4, the advance number of seasonally-adjusted initial jobless claims was 6,606,000. This follows 6,867,000 initial claims filed in the week ended March 28 and 3,307,000 in the week ended March 21.

COVID-19 Roundup from Pioneer: Tracking drug discovery efforts; Secrets to Germany’s success; Unemployment tsunami; Voc-techs answering the call; COVID prevalence by town & more!

/
Pioneer staff share their top picks for COVID-19 stories highlighting useful resources, best practices, and questions we should be asking our public and private sector leaders.