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🚨In Foreign Countries, Patients Are Routinely Denied Access to Novel Therapies. 

Policymakers must reject importing foreign health care values that would devalue people with disabilities and ration care for all Americans.
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​   ⚠️In the United Kingdom, restrictive government value assessments lead to coverage delays and denials.
   ⚠️Discriminatory metrics and the lack of patient engagement in South Korea leads to severe access challenges.
   ⚠️Canada's treatment approval system is rife with delays, leaving patients struggling to access treatment. 
   ⚠️Australia's outdated, discriminatory system consistency leads to extreme delays and lack of access to new therapies.
Check out the Value Our Health Video Campaign to learn more from the patient perspective.  
Tell Congress: Avoid Devauling Disabled Lives by Referencing Foreign Countries
Since its founding, the Partnership to Improve Patient Care (PIPC) has been at the forefront of the fight to put patients first in our nation’s healthcare system and ensure individual patients with different health care needs – including people with disabilities and older adults – are not ignored and devalued. All lives are valuable, and our health care policy should adhere to this fundamental American belief. We strongly urge policymakers to reject policies that would devalue and ration care for any American whether modeled after foreign or domestic value assessment methodologies.  

What Happens in Countries Using QALYs & Cost-Based Thresholds to Determine Coverage

Other countries are often referenced as examples of how the use of QALYs or similar cost-based thresholds impact access to care:
  • Canada - The best drugs for B-cell Acute Lymphoblastic Leukemia are just not available to this young father in Ontario.

  • United Kingdom - A patient with motor neuron disease denied drug proven to slow disease progression: "I am shattered. All this because of a massive unfairness in the NHS who has the power to decide who is worth the drug and who isn’t: who gets that chance to live longer, and who doesn’t.”
 
  • Australia - Migraine medication "The PBAC considered the drug for listing in March 2024 but did not recommend it due to concerns about its cost-effectiveness compared to existing therapies.”
 
  • South Korea - Life-saving drug for for pulmonary hypertension denied coverage: "Medical experts argue the medication meets all criteria for essential drugs under current regulations, including lack of alternative treatments and proven clinical benefits for life-threatening conditions affecting small patient populations. About 1,671 patients were on lung transplant waiting lists between 2009 and 2020, with 31 percent dying while awaiting procedures.”
 
  • France - Alzheimers treatment denied: "Experience gained, particularly in the United States where lecanemab has been available for over two years, confirms its effectiveness in practice, while side effects are generally manageable. In Europe, marketing authorization also limited its indications to enhance safety."

Case Studies

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United Kingdom
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Ireland
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Canada
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Australia
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Germany

119 organizations oppose the GLOBE and GUARD models

"Importing QALY-Based Cost-Effectiveness thresholds will make America like other countries dhat do not prioritize access to innovative and needed treatments.” 

PIPC Responds to SOTU and Most Favored Nation

"Most Favored Nation only sounds good because its supporters fail to explain to Americans how people with disabilities and chronic conditions that most need relief are devalued and therefore denied or delayed access to care in the foreign countries being modeled.” 

PIPC Response to Trump Administration's Continued Push for MFN Pricing

We urge policymakers to pursue approaches that abide by federal law and regulations that prohibit discrimination against people with disabilities.

German Health System & Its Impact on Patient Access

​Though the German system does not rely on the QALY, the flawed process by which they determine a treatment’s clinical benefits has significant implications for access to care.

NCD Statement on  International Pricing Index 

“Making prescription medicines more affordable is a proper and necessary goal for the U.S., but it is not in the best interest of Americans to import price controls from countries that use the IPI to determine U.S. drug pricing.”

Report Confirms Countries Referenced in GLOBE, GUARD Use QALYs

"There’s no denying that these two major new policy changes – proposed under the guise of “models” or “demonstrations” by the CMMI – will import the use foreign value standards that devalue people with disabilities, older adults, and other groups.” 

USC Schaeffer Responses to HEMA: Why Patients Shouldn't Bear Individual Harms for Better Population Averages

“Healthcare resource allocation should serve the needs of the individual people in a society who benefited from it and paid for it — not the needs of HTA bodies or payers.”

Chairman Coelho in San Jose Mercury News

PIPC Chairman Tony Coehlo penned an op-ed in The Mercury News outlining his concerns with the Trump administration’s proposed international drug pricing index. ​

Referencing International Prices: What Experts are Saying

A new resource from Value Our Health compiles experts' statements regarding the unintended consequences of international reference pricing policies. 

New Analysis Shows How the U.S. Could Back Into Use of QALYs 

As policymakers renew interest in referencing foreign drug prices, like Most Favored Nation proposals, how widely could this shift the U.S. to reliance on QALYs in its health care decision-making? 

International Laws Fall Short of Protecting Equal Access to Health Care ​

Other countries "fall short in providing protections for people with disabilities specific to access to health care.” 

CCD Letter to Congress

​"CCD is very concerned that these provisions effectively import a QALY-based and discriminatory system from abroad. These systems are discriminatory against people with disabilities and do not have a place in the United States health care system.”

NCD Highlights Impact of QALYs on Disability Community

As detailed in a report from the National Council on Disability, the use of QALYs continuously devalues the lives of people with disabilities by creating unnecessary barriers to access.

NCD Letter on 'Most Favored Nations Rule' 

NCD's letter to CMS outlines serious concerns about the impact of the Most Favored Nations rule on the disability community.