伟大的质量调整生命年灾难。
The Great I-QALY Disaster.
作者信息
Langley Paul C
机构信息
Adjunct Professor, College of Pharmacy, University of Minnesota.
出版信息
Innov Pharm. 2020 Jul 31;11(3). doi: 10.24926/iip.v11i3.3359. eCollection 2020.
Abstract
The QALY is an impossible construct; it defies common sense. It fails completely once we consider the axioms of fundamental measurement. Utilities as ordinal scales cannot be used to create QALYS. The QALY should never have been introduced to support the value assessment of pharmaceutical products and devices. The result is 30 years of QALY based assessments of pharmaceutical products and devices which are conceptually and technically wrong. They are a charade and will have contributed mistakenly to thousands of formulary decisions. In the search for a common metric to evaluate cost-effectiveness the impossibility of a QALY was overlooked. The result is a disaster, unfolding over decades. Our next steps must be to abandon the QALY paradigm and look ahead to a new value assessment framework.
摘要
质量调整生命年（QALY）是一个不合理的概念；它违背常识。一旦我们考虑基本测量的公理，它就完全站不住脚了。作为序量表的效用不能用于创建质量调整生命年。质量调整生命年根本就不应该被引入来支持药品和器械的价值评估。结果是，基于质量调整生命年对药品和器械进行了30年的评估，这些评估在概念和技术上都是错误的。它们是一场骗局，会错误地影响成千上万的处方决策。在寻找一个通用指标来评估成本效益时，质量调整生命年的不合理性被忽视了。结果是一场灾难，几十年来一直在不断显现。我们接下来必须摒弃质量调整生命年范式，展望新的价值评估框架。
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