The QALY shortfall

The QALY Shortfall


NICE recently released an update to their methods process. The previous end-of-life modifier is due to change to a QALY shortfall modifier, but what exactly is this?

The aims is to capture and recognise disease severity by assessing the degree of quality of life lost to patients when living with a particular condition

1. The shortfall is proposed as a standardised process to better assess the severity of a health condition

This will replace the end-of-life modifier and will apply a QALY weight based on perceived disease severity

2. The shortfall can be absolute or relative

Absolute QALY shortfalls measure the total degree of health lost to a condition whilst proportional QALY shortfalls measure the fraction of remaining health lost

3. NICE are seeking views on the exact weighting to be applied

The exact QALY weight to be applied is yet to be determined. However, NICE have proposed two options (QALY weight x1.2 – x1.7 or QALY weight x1.25 – x1.5, depending on the level of proportional and absolute shortfall) which are out for deliberation. The new weightings could allow products which treat conditions with a high patient burden the ability to demonstrate cost-effectiveness at a higher ICER threshold

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