The methods used by some countries to decide which medical treatments should be made available to patients are dangerously flawed and should be abandoned. This conclusion is based on the ECHOUTCOME research project funded by the European Commission, and led by Data Mining International, a Swiss independent research agency.

The full results, recently published in a peer-reviewed scientific article, highlight major failings in the way that some Health Technology Assessment (HTA) agencies, such as the UK’s National Institute for Health and Care Excellence (NICE), recommend which treatments should be made available to patients, and warn against this system being adopted elsewhere in Europe or beyond. NICE assesses innovative medicines and recommends whether or not to provide access to treatment using Quality Adjusted Life Years (QALY), a formula that weighs life duration with quality of life.

The findings show that perception about health cannot be captured using a simple multiplication. In addition, the project tracked various situations (“counter-examples”) leading to divergent results derived from the same dataset, confirming that the QALY approach does not meet basic requirements for serious scientific evidence. According to scientific reasoning, a theory is valid until one single counter-example invalidates this theory. If so, the theory is considered as a metaphysical doctrine.

Ariel Beresniak, CEO of Data Mining International specialized in providing robust cost-effectiveness alternative solutions, said: “Patients associations should be aware that life-saving treatmentsare denied based on a flawed metric.This research provides strong scientific evidence that QALYs produce hugely inconsistent, wrong results, based on which important decisions are still being made in Europe. HTA agencies promoting QALY should abandon this metric in favour of robust methods if they want to protect citizens”.

While many users acknowledge that the QALY outcome is ‘not perfect’, they insist that it would be the ‘best method available’ for resource allocation decisions. Beresniak said that maintaining such defensive attitude could denote a lack of attention towards patient populations. In the aviation industry, when misconceptions are identified for an aircraft, the model is usually grounded until it can be either fixed or replaced.
The article concludes that QALY is an invalid method for assisting health decisions, and should be immediately replaced by other robust cost-effectiveness methods.

Beresniak A et al. Validation of the Underlying Assumptions of the Quality-Adjusted Life-Years Outcome: Results from the ECHOUTCOME European Project. Pharmacoeconomics. 2014 Sep 18

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