Consortium: QALY is 'flawed reasoning'

A European consortium said that the U.K.'s approach to funding medical treatments is based on "flawed reasoning" and should be abandoned. The European Consortium in Healthcare Outcomes and Cost-Benefit research (ECHOUTCOME) said that based on a three-year study, quality-adjusted life year (QALY) -- a measure used by NICE to assess whether drugs are a cost effective use of NHS resources -- is an "invalid way to make medical decisions" and should be replaced by a more flexible, case-by-case approach using "adequate validated tools." The group said that rheumatoid arthritis drugs could be evaluated using a cost-per-remission approach, for example, while a cost-benefit approach could be used to evaluate wide-spread vaccination.

The group said four assumptions underlying QALY are invalid: that time and quality of life can be measured in consistent intervals; life years and quality of life are linked; people are neutral about risk; and that willingness to sacrifice life years is constant over time. The group's conclusion was based on a survey of 1,300 Europeans. ...