OBJECTIVES: The Protecting Health Care for All Patients Act of 2023 is a ground breaking legislation that aims to provide equal access to healthcare for all individuals in the United States. A significant aspect of this Act is the decision to no longer recognize the Quality-Adjusted Life Year (QALY) as a valid measure in healthcare evaluations.

METHODS: The QALY is a traditional metric that assesses the value of healthcare interventions by assigning a numerical value to a patient's health outcome, considering both the quantity and quality of life gained. The decision to abandon the QALY in this Act is based around several key concerns. Firstly, the QALY has faced criticism for potentially perpetuating discrimination in healthcare: the metric often fails to adequately consider the unique needs and values of different patient populations, leading to disparities in access to treatments. This undermines the principle of equitable healthcare for all and may disproportionately disadvantage certain groups, such as older adults or individuals with disabilities. Secondly, the QALY is seen as limited in capturing the multifaceted nature of health outcomes. Health encompasses not only physical well-being but also mental, emotional, and social aspects. Reducing it to a single metric oversimplifies the complex impact of healthcare interventions on patients' lives. Furthermore, the QALY fails to account for the individual experiences and preferences of patients. It relies heavily on population-based preferences, disregarding the unique circumstances and values of each person.

RESULTS: Patient-centered factors such as personal goals, cultural considerations, and treatment burdens should be considered in healthcare decision-making.

CONCLUSIONS: By abandoning the QALY, the Protecting Health Care for All Patients Act emphasizes a more comprehensive and patient-centered approach to healthcare evaluations. It strives to ensure that healthcare decisions consider a broader range of factors and prioritize equal access to care, while respecting the dignity and autonomy of every patient.