The Partnership to Improve Patient Care (PIPC) has issued the following statement in response to the Trump administration's consideration of "Most Favored Nations" policy in the U.S.
PIPC has consistently warned against reliance on discriminatory measures like quality-adjusted life years (QALYs) and similar measures of cost effectiveness in decisions related to reimbursement and coverage of health care. This includes policies like Most Favored Nation pricing that adopt other countries’ discriminatory QALY standards by referencing their reimbursement decisions. Knowing that these measures drive pricing and coverage decisions in foreign countries, we have always stood with the disability community against importing foreign standards that devalue disabled lives to value drugs and other health services.
While we do not know the details of recent actions by the Administration or policies that are pending at the Office of Management and Budget, we remain very concerned that these efforts could open the door to reliance on QALYs and similar cost-effectiveness metrics in U.S. policy via reference to foreign prices.
We urge policymakers to pursue approaches that abide by federal law and regulations that prohibit discrimination against people with disabilities. The United States must prioritize early access to innovations that optimize quality of life for all. We must protect against the kind of care rationing that is accepted elsewhere in the world. That means avoiding approaches that would modify U.S. coverage or pricing policy to factor in QALYs and similar measures, whether directly or by reference to other countries. The use of QALYs and similar measures have no place in the American health system.
Stories like the Williams’ family illustrate why QALYs have no place in U.S. policy. Patients do not have the luxury of time.
While we do not know the details of recent actions by the Administration or policies that are pending at the Office of Management and Budget, we remain very concerned that these efforts could open the door to reliance on QALYs and similar cost-effectiveness metrics in U.S. policy via reference to foreign prices.
We urge policymakers to pursue approaches that abide by federal law and regulations that prohibit discrimination against people with disabilities. The United States must prioritize early access to innovations that optimize quality of life for all. We must protect against the kind of care rationing that is accepted elsewhere in the world. That means avoiding approaches that would modify U.S. coverage or pricing policy to factor in QALYs and similar measures, whether directly or by reference to other countries. The use of QALYs and similar measures have no place in the American health system.
Stories like the Williams’ family illustrate why QALYs have no place in U.S. policy. Patients do not have the luxury of time.
