Editorial Staff

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

/in , , , , , , /by Editorial Staff
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 Life Sciences Work!

Related Posts:

Yale’s Pulitzer-Winning Prof. David Blight on Frederick Douglass, Slavery, & Emancipation

This week on “The Learning Curve," Cara Candal and guest co-host Derrell Bradford talk with David Blight, Sterling Professor of American History and director of the Gilder Lehrman Center for the Study of Slavery, Resistance, and Abolition at Yale University. He is the author of the Pulitzer Prize-winning biography, Frederick Douglass: Prophet of Freedom.

UVA Prof. E.D. Hirsch, Jr. on Core Knowledge, Equity, & Educating Citizens

This week on “The Learning Curve," co-hosts Cara Candal and Gerard Robinson talk with Professor E.D. Hirsch, Jr., founder and chairman of the Core Knowledge Foundation, professor emeritus at the University of Virginia, and acclaimed author of the books, Cultural Literacy: What Every American Needs to Know and How to Educate a Citizen: The Power of Shared Knowledge to Unify a Nation.

“Key of the Gulf” – Exploring Cuba – 35 Resources for Parents & Students

Castro’s despotism, the Cold War, the Cuban Missile Crisis, and the Embargo, remains the Cuban people – vibrant, creative, pious, and poor, who have continued to inspire and awe with their smiles, culture, music, dance, food, tobacco, resilience, and hopes. With the desire of passing along some of this magic to American families, students, teachers, and schools, we’re providing a variety of resources to educate our people about their neighbors, who live a mere 100 miles from our shores, in Cuba.

Human Rights Advocate Kristina Arriaga on Cuba, Religious Liberty, & Cancel Culture

This week on “The Learning Curve," co-hosts Cara Candal and Gerard Robinson talk with Kristina Arriaga, president of Intrinsic, a strategic communications firm, and former vice chair of the U.S. Commission on International Religious Freedom. Kristina shares her family’s experiences fleeing Castro’s communist regime in Cuba and other hardships, and how her background has shaped her commitment to religious liberty.

Pandemic Pension Payout: Essential COVID-19 Public Workers Rewarded Whether Essential or Working

Hubwonk host Joe Selvaggi talks with Pioneer Institute’s Director of Research and former Massachusetts Inspector General and State Representative Greg Sullivan about HB 2808, COVID-19 Essential Employee Retirement Credit Bonus, discussing the merits of the recently proposed joint bill, its cost, and our current public debt burden in the Commonwealth.

MBTA Ridership Trends Compared to Public Transportation Agencies Nationwide

0 Comments
/
The COVID-19 pandemic had a devastating effect on our economy,…

Public Statement on Implementation of the Charitable Giving Deduction

Despite being awash in cash, the state Legislature just overrode Gov. Charlie Baker’s veto of a provision to delay by yet another year a tax deduction for charitable donations. Rep. Mark Cusack, House chair of the Joint Committee on Revenue, said “it doesn’t mean no, just not now.” If not now, when?

The Globe’s Ornaments – Celebrating the Great Cities of the Ages – 35 Resources for Parents & Students

Celebrating the Great Cities of the Ages - This is part of Pioneer’s ongoing series of blogs on curricular resources for parents, teachers, and students during COVID-19.