Report: Novel Alternative to QALYs

Alliance for Aging Research has worked with Milliman to develop a methodology — Standard of Living Valuation — that benefits patients, promotes equity, and utilizes real-world evidence

WASHINGTON, Aug. 29, 2024 /PRNewswire/ -- With value in healthcare being a primary driver of government intervention on important issues such as Medicare prescription drug pricing and access under the Inflation Reduction Act (IRA), questions are increasing about how organizations should best assess value. We and others have pointed out the many shortcomings of using the discriminatory Quality Adjusted Life Year (QALY) metric, and the Centers for Medicare & Medicaid Services (CMS) has committed to not using it. To fill the need for transparent and sound methodology, the Alliance for Aging Research engaged Milliman to evaluate a new, reasonable, and practical alternative using real-world evidence — Standard of Living Valuation (SoLV).

"The National Council on Disability and the patient advocacy community have documented the shortcomings of QALYs, but all we've seen from health economists are tweaks to the basic QALY framework. The Medicare program has the opportunity to be a leader and innovator in this moment," said Adina Lasser, Public Policy Manager at the Alliance for Aging Research. "That's why we commissioned this work. We now have a framework that is independent of QALYs, QALY-like alternatives, and their weaknesses. The use of SoLV is advantageous for patients and gets to the root of what matters to them by incorporating data and other considerations that reflect their real-world experience of the healthcare system. Our hope is that this paper and framework aid us in broadening our understanding of 'value' in healthcare, both in what it means and how it is calculated."

The framework is detailed in a new report released today from Milliman, sponsored by the Alliance for Aging Research, "A New Framework for Quantifying Healthcare Value Using Real-Word Evidence." The report details limitations of both the QALY approach to value and its alternatives like the evLYG and explains ways that a new framework could instead use standard of living factors such as education, housing, diet, family support, and leisure activities, all of which are important factors in life expectancy. In this vein, the report proposes the SoLV framework, which:

• Links difference in household income to health outcomes.
• Uses real-word evidence evaluation for value assessment.
• Provides a methodology connecting value to socioeconomic and health disparity studies.

To read the full report, visit https://www.milliman.com/en/insight/new-framework-healthcare-value-real-world-evidence 

About the Alliance for Aging Research
Since 1986, the Alliance for Aging Research has served as a trusted source of health information for both consumers and health care professionals on diseases and conditions that disproportionately affect older adults and has led numerous successful advocacy campaigns promoting the health and independence of older adults. The Alliance is dedicated to changing the narrative to achieve healthy aging and equitable access to care. We strive for a culture that embraces healthy aging as a greater good and values science and investments to advance dignity, independence, and equity. Learn more about the Alliance at www.agingresearch.org. 

About Milliman
Milliman is among the world's largest providers of actuarial and related products and services. The firm has consulting practices in healthcare, property & casualty insurance, life insurance and financial services, and employee benefits. Founded in 1947, Milliman is an independent firm with offices in major cities around the globe. For further information, visit milliman.com.

To interview someone from the Alliance for Aging Research Health, email Katie Riley, Vice President of Communications, at [email protected]. To interview someone from Milliman, email Rebecca Smith, Senior Healthcare Consultant, at [email protected].

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SOURCE Alliance for Aging Research