The quality-adjusted life year (QALY) has faced criticism for its bias toward shorter life extensions and limited consideration for health-related quality of life (HRQoL). In response, alternative approaches like the ‘Equal Value of Life Years Gained’ (evLYG) and ‘Health Years in Total’ (HYT) have emerged. According to a study delves into the suitability of these alternatives in guiding resource allocation decisions in healthcare.
The study examines the efficacy of evLYG and HYT, aiming to address discrimination concerns and improve healthcare decision-making. Through a hypothetical scenario comparing three treatment options, the study dissects calculations and resulting rankings under each approach. It scrutinizes the logical consistency of these rankings against established principles of rational choice theory, uncovering challenges specific to the HYT methodology.
Assessment of Logical Consistency in Healthcare Decision Models
Findings indicate potential logical inconsistencies with HYT and evLYG, absent in traditional QALY or life year (LY) approaches. HYT’s violation of the ‘independence of irrelevant alternatives’ axiom and evLYG’s tendency to yield unstable treatment option rankings raise concerns. Moreover, HYT introduces complexities, including assumptions on the separability of utilities linked to HRQoL and life years and considerations of counterfactual HRQoL for deceased patients.
In conclusion, the study urges caution in adopting HYT and evLYG due to their propensity for logically inconsistent decisions. Decision-makers are advised against implementing these approaches without extensive validation of their logical coherence and adherence to rational decision-making principles. This research emphasizes the need for rigorous evaluation of proposed methodologies before practical application in healthcare resource allocation.
Resource: HTA Daily Dose, December 4, 2023
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