Academic Literature

Who Is Sowing Seeds of Confusion About The QALY?

Industry sponsorship of patient advocacy groups opposing the QALY threatens to undermine not just the QALY but also an objective analysis of policy decisions.
Originally published on 07/24/2020 in Health Affairs Blog

Since the 1970s, health economists and policymakers have relied on the QALY, or quality-adjusted life year, as a metric for measuring the tradeoff between fiscal realities and public health needs.

However, its wide acceptance is notwithstanding, as there is a minority view that it undervalues what a drug does for patients and threatens the future development of drugs to treat rare and debilitating conditions. This has been the recent position of many advocacy groups, which not only share incendiary language in their attacks but also substantial funding by pharmaceutical companies. 

In 2015 alone, the pharmaceutical industry spent more than $160 million on advocacy groups. The same also regularly use QALY to make the case for their products and prices. So why fund their opposition? The answer may lie in independent value assessments, which often find that drugs' prices exceed their value.

Read the full article here. 

Share

Research & Insights

We conduct non-partisan, independent research, and make our work accessible and informative to policymakers and the general audience alike. Browse our featured research or explore our work by article type.

The Conflict Between QALYs and Well-Funded Patient Advocacy Groups
The goal of a QALY is to figure out how much any given drug is worth to a society so that we, as a society, have a benchmark to evaluate the price of pharmaceutical products.
Relentless Health Value 12/10/2020
Cardiovascular Drugs Not Price Aligned with Value in US
U.S. prices of common cardiovascular drugs are not consistent with the cost-effectiveness evidence.
Health Affairs 08/01/2018
Medicare Must Study Unproven, Expensive Alzheimer’s Drug
Medicare cannot indiscriminately cover the cost of Aduhelm for the treatment of Alzheimer's disease without first evaluating whether it truly works.
Bloomberg Opinion 06/15/2021
Value-Based Management of Specialty Drugs: Practical Considerations and Implications for…
Not all approaches are suited to meeting policy makers and health plans’ goals of managing specialty drugs based on their value. Researchers conducted a qualitative study with Blue Cross Blue Shield plans interested in implementing value-based specialty pharmacy management to observe the plans’ objectives, strategies, and factors influencing their ability to execute on these strategies.
AJMC 05/13/2021
The Drugs at the Heart of Our Pricing Crisis
The US drug pricing system is broken, but not irreparable. For large-molecule biologic drugs, enter: Production Plus Profit Pricing (P-quad, pronounced like Ahab's seagoing vessel).
NYTimes 03/15/2021
Biosimilars: Market Changes do not equal policy success
Numerous articles and reports have trumpeted biosimilar market growth, but it's critical we do not lose sight of the sole objective for creating the biosimilar market: to reduce the cost of older biologic drugs for society and taxpayers.
Drug Pricing Lab 03/15/2021
Bottom-Up Pricing Estimate for P-quad
How much would biologic drugs cost under P-quad pricing? Two approaches to estimating fully loaded costs plus a profit (10% and 20% examined) suggest net discounts from current prices would be at least 65% to 75%
Drug Pricing Lab 03/12/2021
Modeling P-quad
The Drug Pricing Lab engaged Milliman to conduct an independent analysis of the Production Plus Profit Pricing (P-quad) policy proposal. The Milliman analysis estimates the projected spending on U.S. biologic and biosimilar drugs under a referent scenario where there is no biosimilar entry or competition, the existing ‘status quo’ scenario under the current biosimilar environment, and the Drug Pricing Lab’s P-quad policy proposal. 

This report was commissioned by Drug Pricing Lab.
Milliman 03/12/2021
Ethics of Clinical Trials to Evaluate Biosimilars
Biosimilars require extensive, expensive, and time-consuming human testing prior to market entry, a process vastly different than generics. So why are we still doing them?
MedRx IV 03/09/2021
COVID-19 Reduced Average Life Expectancy of Americans by Five Days,…
The CDC made a mistake.
STAT 02/25/2021
Priceless Knowledge: Attitudes and Awareness Around Drug Pricing Among US…
Medical students' education covers topics spanning health, disease, and treatment, but what about drug pricing and their role as prescribers?
Medical Science Educator 01/13/2021
Instead of debating 'first-shot' vs 'set-aside' vaccine approaches, hospitals' study…
Hospitals could start studies of their own employees to answer important questions, including whether the first-shot approach has downsides when compared to the set-aside strategy.
STAT 01/04/2021
Newsletter

Stay up to date on our work and news