QALYs

English, potash - pot ashes L.. kalium, Arab qali, alkali) Discovered in 1807 by Davy, who obtained it from caushc potash (KOH) this was the first metal isolated by electrolysis. 

Outcome health to AIDS product Comparison of health indicators (incidence, prevalence, fife expectancy, hfe years gained, QALYs etc.) and economic indicators (e.g. wealth, growth etc.)... 

Health effects of an intervention (incidence, prevalence, life years gained, QALYs, etc.)... 

The most commonly used measure of utility in the health economics literature is the quality-adjusted life year (QALY), which weights longevity by life quality. The most commonly used preference-weighted measure of health-related quality of life in the UK is the EuroQol or EQ-5D (EuroQpl Group, 1990), but there are various other such measures. Utility scores can now be obtained from the 36-item Short Form (SF-36) quality-of-life scale, for example. Also in use are healthy-year equivalents (Mehrez and Gafni, 1989) and disability-adjusted life years (WHO, 2000), although both these measures are different in aim and construction from the QALY and are used less often in evaluations. 

It has not yet been convincingly demonstrated that QALYs as currently measured Yc validity in mental health contexts (Chisholm et al, 1997), nor that the EQ-5D or similar should replace disorder-specific quality of life measures. However, the methodological rigour and transparency of the approach is impressive, and it is certainly true that few clinical effectiveness scales currently used in... 

Chisholm DH, Healey AT, Knapp MRJ (1997). QALYs and mental health care. Soc Psychiatry PsychiatrEpidemiol ) , 68-75. 

Cost-utility analysis is similar to cost-efFectiveness analysis in approach, but uses utility as the outcome measure. The utility value is a measure that combines preferences for and values of the overall effect of an intervention on survival, physical and mental health, and social function. Utility is combined with estimates of length of life to provide an assessment of quality-adjusted life years (QALYs). As in cost-efFectiveness analysis, incremental cost-utility ratios are calculated to estimate the cost of producing one extra QALY. 

QALY (Quality adjusted life year) HALY (health adjusted life year)... 

How many years of life that is lost due to premature death and morbidity. Normally DALY = YOLL + YLD Years that would be saved following an intervention A generic term that includes the two most popular measures, the QALY and the DALY [46]... 

In order to associate a number to represent the utility of these four outcomes we have to choose between several types of economic evaluations, basically between cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. The first of these is ruled out because it measures the health outcome in natural units. Given that the side effects of drags are of a varied nature, we need to be able to aggregate the different seriousness of these side effects in order to obtain a single utility, at least for the NSEA event. Furthermore, this utility must be comparable with that of, for example, the SER event. This is not possible with cost-effectivity. If we chose cost-utility, the utility associated with each event would be measured in QALYs gained or lost in each option. As QALYs are a universal measure of health benefit, cost-utility analysis could be appropriate for this type of decision. Lastly, cost-benefit analysis would also be appropriate, as it measures the utilities associated with each outcome in monetary terms, which reflect the willingness to pay for one of the outcomes in terms of safety and effectiveness. 

There are ways to cope with all these problems, and others not mentioned here. In general, these problems can be solved by designing resource allocation models that incorporate them in the form of new constraints For example, some authors19 include the constraint that each group of patients will choose the medicine that provides them with the largest possible number of QALYs. They also include the constraint that there must always be at least one medicine for a particular disease or health problem. Therefore, problems 1 and 2 can be dealt with by introducing these constraints into the model. As for problem 3, the solution is use the constraint that the programmes chosen must be whole numbers. 

Let us suppose that the population attaches a constant value to gains of identical health units, in this case QALYs. This means that the sacrifice, in terms of utility, that they are willing to make to gain a QALY is constant. However, the willingness to pay for each additional QALY is decreasing, as a result of the decreasing marginal utility of income. 

Let us suppose that there is one type of patient (A) with a disease that reduces their health status by 2 QALYs, and another type of patient (B) with a disease that reduces theirs by 10 QALYs. They are assumed to have several drugs available to them, and the more expensive the drug, the more effective it is and the more QALYs it enables them to gain Finally, we assume that the price of a drug is related to its effectiveness, and that the price of a drag rises by 1 monetary unit for each additional QALY it enables us to gain. Therefore, type A patients need a drug that costs 2 monetary units, and type B patients need one that costs 10 monetary units. 

Cost-utility analysis Dollars Quality-adjusted life-years (QALYs)... 

Potassium - the atomic number is 19 and the chemical symbol is K. The name derives from the English potash or pot ashes since it is found in caustic potash (KOH). The chemical symbol K derives from the Latin kalium via the Arabic qali for alkali. It was first isolated by Humphry Davy in 1807 from electrolyosis of potash (KOH). 

The CUA is a form of cost-effectiveness analysis in which the health outcomes are measured in terms of quality-adjusted life-years (QALYs) gained. The QALY is a measure that associates quantity of life (e.g. survival data and life... 

Bb The new therapy is less effective than the existing one but its introduction would save more than 100000 per QALY gained ... 

Thus, it appears that the current practice by analysts to use AWP results in a value for the cost of a drug that is substantially in excess of marginal cost. If the estimated incremental cost per quality-adjusted life year (QALY) using AWP is very low or very high relative to benchmarks of acceptable ratios, or if drug therapy is dominated by another comparator, treatment of cost would not matter in the decision about whether to cover a drug under an insurance plan or include it on the formulary. But over a sizeable range of values reasonably close to the benchmark, the cost estimate used should affect the decision about acceptability of the product. So it seems appropriate to explore the conceptual framework that should be used for such analysis in more detail. 

---