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ngd- QALY is a “kinder, gentler” way of saying that people with disabilities are less than human…
The quality-adjusted life-year (QALY) seeks to determine the value of health care treatments. Some patients are wary.
By all accounts, the drugs have been transformative, McNary said. But, she added, her boys “aren’t going to be cured,” and extending and improving their life for an unknown period of time comes at a high price. Emflaza came onto the market in 2017 at an annual cost of $65,000. Exondys 51 appeared in 2016 at $748,500. Neither of the drugs will help the young men walk again and, in the eyes of some U.S. health economists, the drugs are not worth the price.
That’s why McNary hates the quality-adjusted life year (QALY, pronounced “qua-lee”), an economic calculation that attempts to quantify the value of a medical intervention, based in part on the quality of life it bestows on recipients.
First developed by U.S. economists in the late 1960s and early 1970s, variations of the QALY have been used for years by governments around the world to help determine what treatments citizens can obtain under public health care. In America’s free-market health care system, however, QALY calculations have largely been avoided. As McNary and others like her are finding out, that’s starting to change.
As policymakers and insurance companies scramble to get a handle on skyrocketing health care costs, they are promoting the idea of paying for value. In this view, drugs designated as higher-value should be prioritized over lower-value treatments. But this raises a thorny question: Who gets to define “value”? Health economists and insurance companies who seek to use limited health care dollars judiciously? Or patients, parents, and doctors who want to receive the best health care for their situation?
Because the quality-adjusted life year threatens her sons’ ability to get the medicine they need, McNary is clear about her answer. “To me, the QALY is a measurement that says that keeping my sons alive by providing incremental benefit but not totally curing them is never going to be valuable,” McNary said. “Just mull that around in your head — if you are less than perfect, you are worth less money.”