The aim of this article is to review the concept of the quality-adjusted life-year (QALY), a widely used measure of healthimprovement that is used to guide health-care resource allocation decisions.

What is a QALY?

The Quality-Adjusted Life Year (QALY) is the gold standard for measuring how well a medical intervention improves and lengthens patients’ lives. It's been around for over 30 years. The method can compare different drugs, devices and other technologies in health for different conditions.

In Europe, the QALY is an important consideration in how the UK's NHS allocates healthcare resources. In the United States, the approach is gaining traction with the establishment of ICER.

In 2018, American pharmacy giant CVS Health initiated a program allowing its clients to exclude any drug launched at a price of greater than $100,000 per QALY. The New York State Drug Utilization Review Board has also used the cost-effectiveness threshold to justify its mandate for the Medicaid program to receive a steep discount on the price of a cystic fibrosis treatment.

Interestingly enough, the QALY was not initially developed to aid in clinical decision-making.

This 2009 article via @thewileynetwork and @ISPORJournals is an essential piece of reading from three seminal researchers in the field.

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