Session (CTI)

Purpose: Due to restrictions on QALYs in U.S. federal health decisions, alternative cost-effectiveness metrics have emerged, including EVLYG, HYT, and GRACE. These tools differ in how they value life extension, quality-of-life improvement, or both—especially for patients with poor baseline health. This session helps researchers, payers, and industry stakeholders understand the underlying assumptions of these non-QALY approaches, assess where they may be better or worse suited for evaluating the value of a given healthcare intervention, and understand the implications for HTA bodies. Description: Dr. Devine (5 mins) will introduce speakers, briefly describe the non-QALY evolution in the US, and moderate the Q&A. Dr. Basu (15 mins) will present an overview of these topics, laying out different assumptions for each metric and show new evidence on links between EQ-5D weights and GRACE methodology. Mr. Ektare (15 mins) will demonstrate the implementation of these alternative metrics in three anonymized product profiles (late-stage haem-onc therapy, chronic pain palliative, pediatric SMA gene therapy). Dr. Banks (15 mins) illustrates the challenges of using non-QALY measures in the EU context and the implications for EU HTA if the US continues to rely on these measures and also pursues most-favored-nation prices. We will engage the audience with real-time polling at the beginning and end of the panel, and 10 minutes of Q&A to discuss the strengths and limitations of each of the metrics.