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 Life Sciences Work!

Related Posts:

Hoover Institution’s Dr. Eric Hanushek on COVID-19, K-12 Learning Loss, & Economic Impact

/
This week on “The Learning Curve," Gerard and Cara talk with Dr. Eric Hanushek, the Paul and Jean Hanna Senior Fellow at Stanford University’s Hoover Institution. They discuss his research, cited by The Wall Street Journal, on learning loss due to the pandemic, especially among poor, minority, and rural students, and its impact on skills and earnings.

UK Classics Scholar Kathryn Tempest on Cicero, Brutus, & the Death of Caesar

This week on “The Learning Curve," Gerard and Cara talk with Dr. Kathryn Tempest, a Reader in Classics and Ancient History at the University of Roehampton in London, UK, and author of Cicero: Politics and Persuasion in Ancient Rome and Brutus: The Noble Conspirator. They discuss the historical, civic, and moral lessons political leaders, educators, and schoolchildren today can learn by studying the Roman Republic and the lives of key figures from that era such as Cicero and Brutus.

Pioneer Institute’s 2021 Government Transparency Resolutions: Sunshine Week Edition

As it does each year, Pioneer shares the resolutions it hopes state leaders will adopt to bring government actions into better focus and invigorate our democracy with heightened public engagement. As the late Supreme Court Justice Louis Brandeis noted, “sunlight is said to be the best of disinfectants; electric light the most efficient policeman.”

Traffic Strikes Back: New Transportation Strategies for Post-Pandemic Prosperity

Host Joe Selvaggi talks with Chris Dempsey, Director of Transportation for Massachusetts, about road and mass transit innovations that could address traffic challenges in a high-growth, post-pandemic economy.

Report Contrasts State Government and Private Sector Employment Changes During Pandemic

Massachusetts state government employment has been virtually flat during COVID-19 even as employment in the state’s private sector workforce remains nearly 10 percent below pre-pandemic levels, according to a new study published by Pioneer Institute. The study, “Public vs. Private Employment in Massachusetts: A Tale of Two Pandemics,” questions whether it makes sense to shield public agencies from last year’s recession at the expense of taxpayers.

Best-Selling, Netflix Author Loung Ung On Surviving Pol Pot’s Killing Fields

/
This week on “The Learning Curve," Gerard and Cara talk with Loung Ung, a human-rights activist; the author of the bestselling books First They Killed My Father: A Daughter of Cambodia Remembers, Lucky Child, and Lulu in the Sky; and a co-screenwriter of the 2017 Netflix Original Movie, First They Killed My Father. Ms. Ung shares her experiences living through genocide under Pol Pot and the Khmer Rouge from 1975 to 1979, which resulted in the deaths of nearly a quarter of Cambodia's population. 

Post-Pandemic Prospects: Tech Leaders’ Prescription for Preserving a Healthy Economy

/
Host Joe Selvaggi talks with Chris Anderson, President of the Massachusetts High Technology Council, about the reasons why Massachusetts has a thriving tech sector, what challenges his members have faced in the pandemic, and what he sees as the most prudent path toward future prosperity in the commonwealth.

American Federation for Children’s Tommy Schultz on School Choice & Edu Federalism

/
This week on “The Learning Curve," Gerard and Cara talk with Tommy Schultz, CEO-elect of the American Federation for Children (AFC). They discuss how COVID-19 school closures have increased the interest in alternatives to public schools, and what AFC's polling shows on shifts in attitudes toward school choice options in both urban and rural communities.