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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]
As such, the ICER facilitates comparison of interventions across various disease states and treatments. In 2009, NICE set the nominal cost-per-QALY threshold at £50,000 for end-of-life care because dying patients typically benefit from any treatment for a matter of months, making the treatment's QALYs small. [3]
In HTAs it is usually expressed in quality-adjusted life years (QALYs). If, for example, intervention A allows a patient to live for three additional years than if no intervention had taken place, but only with a quality of life weight of 0.6, then the intervention confers 3 * 0.6 = 1.8 QALYs to the patient.
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.
QALY: quality-adjusted life year: q.AM: every day before noon (from Latin quaque die ante meridiem) q.d. every day (from Latin quaque die) q.d.s. four times each day (from Latin quater die sumendus) q.h. each hour (from Latin quaque hora) q.h.s. every bedtime (from Latin quaque hora somni) q.i.d. four times each day (from Latin quater in die)
Cost-effectiveness studies using QALYs, for example, do not discount time at different ages differently. [14] This age-weighting function applies only to the calculation of DALYs lost due to disability. Years lost to premature death are determined from the age at death and life expectancy.
For example, two treatments may provide the same extension of life, but one treatment might reduce the burden on the healthcare system while the other does not. These two treatments would be seen as providing the same value under the evLYG metric, despite the additional benefits provided by the latter.
Cost–benefit analysis (CBA), sometimes also called benefit–cost analysis, is a systematic approach to estimating the strengths and weaknesses of alternatives.It is used to determine options which provide the best approach to achieving benefits while preserving savings in, for example, transactions, activities, and functional business requirements. [1]