Presentation (CTI)

OBJECTIVES: Quality-adjusted life-years (QALYs) are widely used by policymakers to evaluate the value of healthcare interventions. However, concerns about their potential discriminatory nature toward less healthy populations have spurred interest in alternatives like the equal value of life-years gained (evLYG), introduced by the Institute for Clinical and Economic Review. This study re-analyzed cost-effectiveness analyses (CEAs) from Canada’s Drug Agency (CDA) reports to determine whether using evLYG results in different conclusions compared to QALYs.
METHODS: CEAs conducted by the CDA in CDA reports from June 2021 to June 2024 were reviewed. Exclusions included reports with multiple comparators, insufficient disaggregated results, or interventions not extending life-years. Inputs included life-years (LYs) and QALYs gained, incremental LYs and costs from CDA reports, and the Canadian societal norm of utility (weighted average of norms for males and females from published literature). evLYG and incremental cost per evLYG were then calculated.
RESULTS: Of the 95 analyses across 75 included reports, 14.9% had incremental cost-effectiveness ratios (ICERs) below $50,000 CAD using evLYG. Among these, 21.4% were determined not cost-effective evaluated using QALYs, with original ICERs ranged between $50,000 to $80,000 CAD. Most analyses showed decreased ICERs using evLYG compared to QALYs, while 6.38% exhibited increased ICERs due to interventions generating utilities greater than the societal norm (0.863).
CONCLUSIONS: This re-analysis demonstrates that evLYG can alter CEA conclusions when comparing against the willingness-to-pay threshold. Incorporating evLYG as a complementary metric to QALYs may provide policymakers with a more equitable framework for decision-making.