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:

MA Commissioner Jeff Riley on Remote Learning, Voc-Techs, & Reforming Boston’s Schools

0 Comments
/
This week on “The Learning Curve,” Cara and Gerard open with commentary on the George Floyd tragedy and K-12 education’s role in addressing racial injustice. Then, they are joined by Jeffrey Riley, the Massachusetts Commissioner of Elementary and Secondary Education, to talk about the unprecedented challenges of COVID-19.

Easthampton High Scores A National Educational Victory During The COVID-19 Pandemic

0 Comments
/
This spring, Massachusetts’ Easthampton High School was crowned national champion in the “We the People: The Citizen and the Constitution” contest. The competition brings together about 1,200 students from across the country to answer civics questions based on America’s Founding Documents including the U.S. Constitution; The Federalist Papers; and U.S. Supreme Court decisions.

Experts Find K-12 Online Education Can Be Appropriate for Most Special Needs Students

School closures due to COVID-19 have separated more than seven million K-12 special needs students from support they receive in the classroom, but online learning can be appropriate for most of those students if teachers and parents work as a team to provide each one with what he or she needs, according to a new report published by Pioneer Institute and ASU Prep Digital.

Pioneer Institute Looks Ahead to the Protection of Civil Liberties

Challenges to Americans’ civil liberties have increased in recent years.  History teaches us that during national emergencies governments are even more likely to overstep and violate constitutionally guaranteed freedoms. To address this concern, Pioneer Institute has created “Respect My Rights,” a web-based hotline to which citizens can submit complaints and descriptions of violations they have experienced.

COVID-19 Roundup from Pioneer: Antibodies & immunity; Talking about WHO; Telecommuting Survey Results; Mapping COVID – Update; & more!

0 Comments
/
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.

Even for the most remote part of Massachusetts (Franklin County), it’s far from business as usual

0 Comments
/
The Connecticut River valley is home to some of the most productive…

Hubwonk Ep. 8: Who is WHO? COVID-19, Massachusetts, and the unhealthy World Health Organization

0 Comments
/
Hubwonk host Joe Selvaggi and Pioneer Healthcare Senior Fellow Josh Archambault are joined by Hoover Institution’s Dr. Lanhee Chen to discuss the role that the World Health Organization (WHO) plays, what dysfunction may have contributed to the scale of the COVID-19 pandemic, and what steps can be taken to bring back transparency and trust.

Study: Safely Reopening Office Buildings Will Require Planning, Innovation

0 Comments
/
Safely bringing employees back into workplaces presents a significant challenge for employers located in office buildings, particularly when it comes to elevator operations and building entry and exit.  To address the challenge, managers must develop plans to control the flow of workers, according to a new study published by Pioneer Institute.