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:

New York Times Best Seller Paul Reid on Winston Churchill, WWII, & the Cold War

This week on “The Learning Curve," Cara and guest co-host Kerry McDonald talk with Paul Reid, co-author, with William Manchester, of the New York Times best-selling biography of Winston Churchill, The Last Lion: Defender of the Realm, 1940-1965. Reid shares how he was enlisted to complete William Manchester’s biographical trilogy on the greatest political figure of the 20th century, which became a best-seller.

Comparing Covid-19 Vaccination and New Infection Rates in Suffolk County: Is Vaccination Working?

/
Massachusetts ranks fourth nationally for the highest percent…

The People’s House The U.S. House Representatives – 40 Resources for High School Students

American schoolchildren need to know more about the basic civics and history of our key democratic institutions. To remedy this, we’re offering a variety of resources to help parents, teachers, and high schoolers:

Dr. Babak Movassaghi on Winning in Football & Healthcare Innovation

/
This week on JobMakers, Host Denzil Mohammed talks with Dr. Babak Movassaghi, founder of InfiniteMD (acquired last summer by ConsumerMedical), which connects patients with top U.S. medical professionals through second-opinion video consultations, guiding patients to better care. When the world shut down due to COVID-19, Dr. Movassaghi's company was already prepared to serve patients via telehealth. In this episode, they discuss his fascinating pivot from physics and professional football in Germany, to healthcare and innovation here in the U.S., an extension of his ability to navigate multiple identities as an Iranian-German living the American Dream.

COVID-19 and Unemployment Rates in the Cape and Islands 

/
  The COVID-19 pandemic has had a large impact on unemployment…

Nina Rees on the 30th Anniversary of Charter Public Schools in America

This week on “The Learning Curve," Gerard and Cara celebrate the 30th anniversary of charter schools with Nina Rees, President and Chief Executive Officer of the National Alliance for Public Charter Schools.

This Is No Time for a Tax Increase

This is no time to threaten Massachusetts’ prospects for an immediate economic recovery and the long-term competitiveness of the Commonwealth’s businesses. As Massachusetts lawmakers prepare to vote on whether to send a proposed constitutional amendment that would impose a 4 percent surtax on residents who earn $1 million or more in a year to the statewide ballot in 2022, Pioneer Institute urges them to recognize that tax policy sizably impacts business and job location decisions and that jobs are more mobile than ever.

The Spirit Enlightened Celebrating Classical Music – 50 Resources for High School Students

In Pioneer’s ongoing series of blogs on curricular resources for parents, families, and teachers during COVID-19, this one focuses on: Celebrating Classical Music.