In the UK, the National Institute for Health and Care Excellence (OK) updated their January 2022 Health Technology Assessment HandbookOf particular interest, Section 6.2 of the manual states that the Review Committee “will consider relevant absolute and proportional QALY shortages”. The committee defined QALY deficiencies in two ways:
- Absolute Quality Assurance Year Shortage. This number was defined as the difference in QALY levels in individuals with the disease compared to individuals of the same age and gender distribution without the disease.In other words, if the number of QALYs in a person with the disease is A sort of and the number of QALYs for individuals with similar characteristics but no disease is Secondthen the absolute QALY shortage is Bachelor of Arts.
- Proportional QALY Shortage. The proportional QALY shortfall was calculated by taking the absolute QALY shortfall and dividing this number by the expected QALY of individuals in the control group.From the above example, the proportional QALY shortage is calculated as (BA)/B.
Once proportional and absolute QALY deficiencies are calculated, NICE recommends the use of specific QALY weights described in the table below. NICE intends to apply severity multipliers only to therapeutic health techniques, not diagnostic health techniques.
NICE could also consider increasing the QALY weights for highly specialized technologies (HSTs) and measure large increments in QALYs over the lifetime of the new technology. The table below describes how these will apply.While the application of these weights is highly mechanistic, identifying deficiencies requires data analysis of counterfactuals of QALY in the absence of disease
These two modifications aim to address two violations of constant QALY valuation, such as
go through Nelson et al. 2021 Among other things: Scope insensitive and severity independent.
