Analysis Suggests ICER’s QALY Approach Violates ADA

February 12, 2020

A new analysis by the Pioneer Institute, “The Legality of QALY under the ADA,” suggests that the Institute for Clinical and Economic Review’s (ICER) quality-adjusted life year (QALY) approach to cost-effectiveness reviews violates the Americans with Disabilities Act (ADA).

According to the report, the QALY would violate the ADA in that it could restrict disabled individuals’ access to necessary treatments and increase the likelihood of institutionalization of individuals with mental disabilities.

“QALY has the potential to unlawfully discriminate against disabled or chronically ill persons who may never experience full restoration to a certain quality of life defined by QALY,” the report states. “Consequently, the QALY methodology may cause Medicaid programs to have a disparate impact, or discriminatory effect, on disabled persons. Disparate impact could stem from QALY assigning lower values to treatments for disabilities; thus, rendering them less available to those whom they benefit.”

To read more on the Pioneer Institute, click here.

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