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The quality-adjusted life year (QALY) is a generic measure of disease burden, including both the quality and the quantity of life lived. [1] [2] It is used in economic evaluation to assess the value of medical interventions. [1] One QALY equates to one year in perfect health. [2] QALY scores range from 1 (perfect health) to 0 (dead). [3]
This answer can be used to calculate the individual's quality of life in that health state. For example, an individual with severe asthma could be offered 10 years in their current condition, or a shorter length of time in full health. If this individual is willing to trade off two of the ten offered years in order to regain full health, this ...
The exposure-based approach, which measures exposure via pollutant levels, is used to calculate the environmental burden of disease. [20] This approach requires knowledge of the outcomes associated with the relevant risk factor, exposure levels and distribution in the study population , and dose-response relationships of the pollutants.
This approach has to some extent been adopted in relation to QALYs; for example, the National Institute for Health and Care Excellence (NICE) adopts a nominal cost-per-QALY threshold of £20,000 to £30,000. [2] As such, the ICER facilitates comparison of interventions across various disease states and treatments.
The Health Utilities Index (HUI) is a rating scale used to measure general health status and health-related quality of life (HRQoL). HUI questionnaires are designed to map onto two classification systems, HUI-2 and HUI-3, capable of measuring 24,000 and 972,000 unique health states, respectively.
Patients on the new treatment on average live an extra 3 months, so 1.25 years in total. The quality of life gained is the product of life span and quality rating with the new treatment less the same calculation for the old treatment, i.e. (1.25 x 0.6) less (1.0 x 0.4) = 0.35 QALY. The marginal cost of the new treatment to deliver this extra ...
So, an example in which the costs and gains, respectively, are $140,000 and 3.5 QALYs, would yield a value of $40,000 per QALY. These values are often used by policy makers and hospital administrators to determine relative priorities when determining treatments for disease conditions.
However, HALYs, including DALYs and QALYs, are especially useful in guiding the allocation of health resources as they provide a common numerator, allowing for the expression of utility in terms of dollar/DALY, or dollar/QALY. [14] For example, in Gambia, provision of the pneumococcal conjugate vaccine costs $670 per DALY saved. [19]