Patients 'should not expect NHS to save their life if it costs too ... Aug 15, 2008
" Nice defended its ruling last night saying that the Citizens Council provided useful input to its decisions but that the organisation's role was to determine how best to allocate the health service's limited resources. Nice is facing increasing accusations that it is giving undue weight to financial considerations - rather than medical benefits - when making decisions on whether to allow drugs or other treatments on the NHS. Doctors and patients have alleged that they are treated with contempt... (Telegraph.co.uk)
Nice should be abolished, expert claims Aug 14, 2008
Generally, Nice approves drugs that cost less than 20,000 for every extra year of improved quality of life they provide, known as a Qaly or Quality Adjusted Life Year ... He said there was no public debate about setting the Qaly threshold at 30,000 and it ought to be reviewed ... A spokesman for Nice said: Nice has adopted the threshold of between 20,000 and 30,000 per Qaly as it is the measure which economists have arrived at, as it is thought there would be sufficient benefit to justify... (Telegraph.co.uk)
Pfizer, Roche Cancer Drugs Rejected by U.K. Agency on Cost-Effectiveness Aug 7, 2008
NICE uses a measurement known as the cost per quality adjusted life year, or QALY, to determine how a medicine helps patients live longer or improve quality of life. The figure places an informal upper limit on what the National Health Service can spend to extend a person's life for a year. (Bloomberg -- UK)
Call for quicker drug decisions Jun 29, 2008
New treatments are generally only used if they cost under 30,000 for each year of good health they provide, a measurement known as a Quality Adjusted Life Year (QALY). They said there was no scientific basis to the threshold, which had not changed since NICE was set up. (BBC News -- UK)
HIV Screening Found Cost-effective In Older Adults Jun 19, 2008
5 percent of the study population were HIV-positive, the researchers found that HIV screening for patients aged 65 who were not sexually active would cost 55,440 per QALY gained, while screening for sexually-active 65 year olds would cost 30,020 per QALY. Sanders says such figures are within the range of other accepted cost-effective ratios, and in the United States, these would generally be considered "a good use of our healthcare dollars.". Based on case studies, they also found that screening... (Science Daily)
Half Of Heart Patients Significantly Underuse Effective Heart Medications, Many Because Of Cost Feb 23, 2008
In the study, Medicare beneficiaries who received prescription drug coverage under Part D lived an average eight years and two months of Quality Adjusted Life Years (QALYs) after their initial heart attack ... Those who received prescription drug coverage without deductibles or co-payments lived an average eight years and five months (QALY) with related medical costs of 111,600. (Science Daily)
Not All Women Need Digital Mammograms Jan 8, 2008
The study authors compared the screening methods using a measure known as quality-adjusted life year gained, or QALY -- a measurement devised to capture both quality and length of life. All-digital mammography screening cost $331,000 per QALY relative to film mammography, but it cost more and was less effective than targeted screening ... Targeted screening resulted in more detected cancers and fewer deaths than either all-film or all-digital mammography, and the cost-effectiveness ranged from... (MEDLINEplus)
Total Knee Replacement Safe for Most Patients Nov 14, 2007
Lifetime costs for patients who didn't have total knee replacement averaged $29,000, compared with $41,500 for those who had TKR, resulting in a cost-effectiveness ratio of $5,300 per quality-adjusted life year (QALY). The cost effectiveness ratio for high-risk patients who had a knee replaced was $7,000/QALY.. (MEDLINEplus)
Drug Eluting Stents Not Value For Money, Swiss Study Nov 3, 2007
To assess the benefits, researchers asked patients to fill in quality of life (EQ-5D) questionnaires from which they were able to work out patients' quality-adjusted life years (QALYS), a combination of quality and length of life ... The ICER cost of preventing a major adverse cardiac event for drug-eluting stents was 64,732 Euros (about 94,000 dollars) and the ICER cost per QALY gained was 40,467 Euros (about 58,000 dollars) ... ICER cost was most affected by stent costs, number of events, and... (Medical News Today)
Drug watchdog 'must get tougher' Aug 25, 2007
The effectiveness of the drug, and its side-effects, are balanced with its cost to give a price per extra year of good health - called a Quality Adjusted Life Year (QALY). In approximate terms, if the new treatment can deliver one QALY for 20,000 or less, then it is deemed cost-effective and heading for NHS approval. (BBC News -- UK)
NICE may be too generous Aug 25, 2007
NICE bases its assessments on "quality-adjusted life years", or QALYs, which measure a person's state of health. One QALY equals one year of perfect health, two years of half-perfect health or four years of one-quarter perfect health ... As a rule of thumb, NICE reckons medicines costing more than 30,000 pounds per QALY are too expensive, though it does make exceptions. (Reuters.uk)
Watchdog too generous in recommending new drugs Aug 25, 2007
NICE rates a drug as cost effective if there is evidence that it costs less than about 30,000 for every so-called quality-adjusted life year (QALY) saved ... The average primary care trust can gain an extra QALY in treating circulatory disease for 12,000, and in cancer for 19,000, they claim ... So if it is obliged to pay for treatments that cost 30,000 per QALY, the trust is forced to economise on those that cost less. (Times Online)
Is NICE's cost effectiveness threshold too high? Aug 24, 2007
Since its inception in 1999, NICE has adopted a cost effectiveness threshold range of 20,000 to 30,000 per quality adjusted life year (QALY) gained. A QALY is a combined measure of quantity and quality of life. (EurekAlert!)
Osteoporosis Screening And Treatment May Be Cost-effective For Selected Older Men Aug 9, 2007
The authors estimated the costs per quality-adjusted life-years (QALYs) gained for the densitometry and follow-up treatment strategy compared with no intervention, calculated from lifetime costs and accumulated QALYs for each strategy ... Regarding cost-effectiveness, "universal bone densitometry followed by oral bisphosphonate therapy among those found to have osteoporosis for all men aged 70 years or older regardless of fracture history or other fracture risk factors is not cost-effective... (Science Daily)
New cancer drugs prove their worth Jun 26, 2007
Related News from HealthDay. HEALTHDAY NEWS 25-Jun-2007. (Atlanta Journal-Constitution -- Health)
New adjuvant treatments for breast cancer prove cost-effective Jun 25, 2007
This combination is expressed as a quality-adjusted life year (QALY). The ratio of cost to QALY is calculated to provide a quantitative estimate of the cost-effectiveness of a therapy ... 5 years, a tamoxifen-exemestane adjuvant protocol improved disease free survival (LY and QALY) at an additional cost of Can$2,889 per patient. (EurekAlert!)
Fears over pricey NHS therapies May 21, 2007
It works out what it costs to provide a year of good health by looking at how long a drug extends life by, what the quality of health a person will have and any potential side-effects of the treatment under a system known as Quality Adjusted Life Year (Qaly) ... WHAT IS A QALY Qaly stands for Quality Adjusted Life Year It is basically a calculation of what it costs to provide a year of perfect health In calculating the cost of a Qaly, experts take into account factors such as how long life is... (BBC News -- UK)
After small-scale anthrax attack: vaccinate, treat Apr 11, 2007
6 million per QALY relative to post-attack antibiotic therapy alone, and that is assuming full adherence, the authors point out. "Our results suggest that post-attack antibiotic therapy alone may be preferred when response time is rapid (within 12 hours), which is feasible given the presence of the autonomous detection systems in postal offices," the authors state. (Scientific American)
One-Time Skin Cancer Screen Cost-Effective Jan 31, 2007
According to their analysis, one-time screening after age 50 had a cost-effectiveness ratio of $10,100 per quality adjusted life year (QALY) gained, which represents a year of being healthy. Screening every 2 years would cost $80,700 per QALY, and annual screening would cost more than $586,800 per QALY.. (MEDLINEplus)
Dismay over MS treatment decision Dec 14, 2006
" SMC decisions are based on cost-effectiveness, using the cost per quality adjusted life year (QALY), which tries to determine the value of a treatment to a person's life, rather than the actual cost of providing the drug. "Accountancy has trumped clinical evidence with this decision," Mr Jones added. "For a well-defined group of people with MS, where the disease is running out of control, this drug is highly effective, leading to 60-70% reductions in relapses. Only an economist could make that... (BBC News)
'Acupuncture For Back Pain Should Be On NHS' Sep 16, 2006
Comparing the effectiveness of the drug with its expense, they calculated the cost per "quality adjusted life year" (QALY) - a measure of the benefit of a medical intervention. They found that total NHS costs during the two year study period were higher on average for the acupuncture group (460) than for the usual care group (345). (Life Style Extra)
Acupuncture good for back pain Sep 15, 2006
The cost per quality-adjusted-life-years - or "QALY" - gained was 4,241. Cost-effective. (BBC News)
Acupuncture 'could aid NHS' Sep 15, 2006
In a separate paper, the researchers looked at the cost effectiveness for the NHS, measuring costs in terms of quality adjusted life years (QALYs) gained. They found that total NHS costs during the two-year study period were higher on average for the acupuncture group (460) than for the usual care group (345), but the cost per QALY gained was 4,241 - showing acupuncture to have a more than 90% chance of being cost effective at a 20,000 cost per QALY threshold, the study said. (Guardian Unlimited)
Acupuncture relieves low back pain and is cost-effective Sep 15, 2006
Costs were measured from both an NHS and a societal perspective, and effectiveness was measured in terms of quality adjusted life years (QALYs) gained ... However, the cost per QALY gained was 4,241 (6,223; $7,921) ... A short course of traditional acupuncture for the treatment of lower back pain in primary care confers a modest health benefit measured in QALYs for a relatively minor extra NHS cost relative to usual care, say the authors. (EurekAlert!)
Mapping oral health related quality of life to generic health state values Aug 8, 2006
A summary utility index is useful for deriving quality-adjusted life years (QALY) for cost analyses or disability weights for burden of disease studies. However, many quality of life instruments provide descriptive profiles rather than a single utility index. (BioMed Central)
[extra: Longer version] Jun 16, 2006
Andrew Dillon, the chief executive of NICE, said: "Herceptin is clinically and cost effective in the early stage of HER2 positive breast cancer." A statement from Roche, the company marketing trastuzumab, said that NICEs finding that the drug was cost effective was based on an analysiswhich included a submission from Rocheindicating that the cost of trastuzumab per quality adjusted life year (QALY) was 2387 (3500; $4400). The company compared this with the cost of statins, where the cost... (British Medical Journal)
MRI Cost-Effective for Some BRCA1/2 Carriers May 25, 2006
The researchers found that using both screening methods annually has a cost per quality-adjusted life-year (QALY) gained ranging from less than $45,000 to more than $700,000, with variation in risk having the largest effect on the cost-effectiveness of screening. At a cost-effectiveness threshold of $100,000 per QALY gained, adding annual MRI to mammography for BRCA1 mutation carriers between the ages of 35 and 54 years was cost-effective. (MEDLINEplus)
Focus: The cost of Alzheimer's Jan 22, 2006
In that fraught setting, Nice has to come to a decision about which drugs are both health and cost effective, using a complicated 'model' - a mathematical system that attempts to assess price and effectiveness, called a final cost per quality adjusted life year. How good a job has it done in the past five years on weighing the four dementia drugs. (Guardian Unlimited)
