UK treatment decisions seriously flawed and must not be used in Europe, say researchers

The Quality Adjusted Life Years (QALY) approach to deciding what medical treatments are available on health services - used by the UK, Canada and Australia and generating much interest across Europe - is dangerously flawed and should be abandoned, according to a European Commission funded research project.

The results of the project, announced today (January 25) at a Brussels conference on health outcomes in Europe, highlights huge failings in the way some Health Technology Assessment (HTA) agencies, notably the UK’s National Institute for Health and Clinical Excellence (NICE), recommend which treatments be made available on health services, and warns against this system being adopted across Europe.

HTA agencies are charged with recommending whether new treatments should be publicly funded. The NICE, perhaps Europe’s most well known HTA agencies, uses QALY, which is an economic theory which mathematically weighs the number of life years and the improvement to quality of life provided by different treatments. On the basis of this calculation, recommendations are made about whether treatments are offered by the UK’s National Health Service. In the UK, if the incremental cost per QALY (cost of one additional year in perfect health) is below £30,000 ($47,590) then the treatment is usually recommended to be accessible to patients. While Germany has explicitly rejected it, many European countries are currently considering replicating the NICE model.