STAT+: Could a fight over cost-effectiveness upend Medicare drug price negotiation before it’s begun?
Republicans are scrambling to ban a controversial cost-effectiveness metric, QALYs — a push Democrats argue could hobble Medicare negotiation.
WASHINGTON — As Medicare drug price negotiation looms, congressional Republicans are scrambling to push through a limit that Democrats argue could hobble the agency’s efforts before they have even begun.
A House committee last week advanced a bill that would bar federal health agencies from using a controversial value metric known as quality-adjusted life years, or QALYs. The metric places value not just on extension of life but also on various quality of life factors, which critics argue assigns a lower value to the life of someone who could be living with a debilitating disease. For instance, a QALY measurement would heavily favor a heart medicine that helps extend the life of an otherwise healthy person. In a disease like MS, in contrast, while QALYs would note that a medicine helps a patient stall or alleviate serious ailments, that MS patient would score lower on the metric than others because they’d have less mobility and more daily pain.
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