By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Defending the Quality Adjusted Life Year (QALY)
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Defending the Quality Adjusted Life Year (QALY)
BusinessPolicy & Law

Defending the Quality Adjusted Life Year (QALY)

DavidEWilliams
DavidEWilliams
Share
4 Min Read
SHARE

Pity the QALY. The health economist’s admittedly imperfect measure has become a whipping boy of those who pretend the US can sustain policies that ignore aggregate spending levels in health care. Peter J. Neumann, ScD defends the QALY in the latest issue of JAMA. (Note: I serve on the Executive Advisory Board of Neumann’s Center for the Evaluation of Value & Risk in Health.)

Pity the QALY. The health economist’s admittedly imperfect measure has become a whipping boy of those who pretend the US can sustain policies that ignore aggregate spending levels in health care. Peter J. Neumann, ScD defends the QALY in the latest issue of JAMA. (Note: I serve on the Executive Advisory Board of Neumann’s Center for the Evaluation of Value & Risk in Health.)

The Quality Adjusted Life Year (QALY) is a way to measure health status over time, where perfect health (as measured by patient preferences) is defined as 1.0 and death 0.0. All else being equal a higher QALY is better than a lower one. The QALY is an improvement over simply measuring life expectancy. For example, it seems obvious that a person would prefer to live 5 years in perfect health than 5 years in a coma. QALYs reflect that preference. A nice feature of QALYs is they can be used across disease areas and types of treatment.

QALYs are imperfect methodologically. But the limitations are fairly modest (e.g., preference ratings are difficult to ascertain, the order in which health states are experienced is not reflected) and don’t explain the antipathy toward the very notion of measuring and publishing QALYs. There are many other kinds of imperfect measurements we rely on routinely, such as the consumer price index or even blood pressure, however you don’t hear a lot of attacks on those tools because few oppose measuring inflation or hypertension.

More Read

Universe.jpg
Is the Healthcare Industry Prepared for Human Immortality?
InVivo Therapeutics Treats the Spinal Cord Itself, A Novel Technology
Clinical Trial Recruitment Considerations for 2015
Small Airplane Crashes Into Community Hospital In Northern California
Strengthening Global Healthcare Systems Through Public-Private Partnerships

But the long knives are out for the QALY because of the widespread aversion to considering value and resource allocation in health care financing. QALYs themselves don’t incorporate any cost information. However cost per QALY calculations are used to influence coverage decisions, especially in other countries such as the UK. Sometimes a specific cost per QALY threshold is set for whether a treatment will be covered at all, and this is an understandable source of controversy.

The QALY is under attack due to its association with resource allocation decisions and rationing, but is likely to survive, even if explicit cost per QALY coverage decisions go by the wayside. As Neumman writes:

Shunning the QALY would not alter the unsustainability of the health spending trajectory or the need to confront the cross-disease and cross-sector tradeoffs inherent in health choices, but would merely mask them… Unavoidably, ways are needed to measure the value of health care delivered, especially to inform market-based approaches. And the QALY, perhaps a bit bruised by recent events, will be waiting in the wings.

 


TAGGED:health care business. health care policy
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

dental care
Importance of Good Dental Care for Health and Confidence
Dental health Specialties
October 2, 2025
AI in Healthcare
AI in Healthcare: Technology is Transforming the Global Landscape
Global Healthcare Policy & Law Technology
October 1, 2025
Choosing the Right Swimwear for Health and Safety
News
September 30, 2025
sports concussions
Concussion In Sports: How Common They Are And What You Need To Know
Infographics
September 28, 2025

You Might also Like

Why Projects Go From Best to Worst Case

March 4, 2011

Hospitals and Providers Using NHIN (Nationwide Health Information Network)

March 11, 2012

Tobacco Settlement as Addictive as Tobacco Itself?

December 8, 2012

Misinformation About IPAB

June 9, 2011
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?