Advanced Math

Quality Adjusted Life Years (QALY) is defined as a year of life adjusted for the value/quality of life during that year. A year of perfect health carries the full weight of 1.0. A year of poor health has a reduced weight. The reduction corresponds to the discount in the quality of life experienced by the patient. QALY is used in conjunction with Life Years Saved (LYS) to measure the cost-effectiveness of a therapy. A low cost-effective ratio indicates a cost-effective therapy.

A QALY factor of 1.0 represents perfect health and 0.5 represents bed-ridden, according to Webster's New World™ Medical Dictionary. Based on that, my own QALY factor is somewhere between 0.5 and 1.0. I estimate it to be 0.68. That is to say, my quality of life is 32% less than perfect.

In the U.S. the following values have been established when considering adding new treatments and technologies to Medicare :
•highly cost-effective: less than $20,000 per LYS
•relatively cost-effective: $20,000 - $40,000/LYS
•borderline: >$40,000 - $60,000/LYS
•expensive: >$60,000 - $100,000/LYS

I could use this page to calculate the change in quality of life and the rate at which LYs are saved to demonstrate the cost-effectiveness of gastric pacing therapy. It would be an opportunity to use some things I learned in Dr. McCready's fourth-year economics class, but it's very dull stuff.

The simplest fact is, the cost of treating a patient with Enterra™ Therapy falls within the range of Relatively Cost-Effective based on the U.S. Guidelines if the patient gains just 1 Life Year.

A $40,000 investment by the Ministry of Health now, would return me to 0.9 QALY (nobody's perfect). In terms of incremental savings, re-inserting the gastric pacemaker pays for itself in less than 1 year. In terms of quality of life indicators, it represents an immediate 25% improvement with additional incremental improvements in less than 1 year. We already know that these improvements are long-term...8 years, for sure; longer if I hadn't had problems with that infection!

It really would be absurd, ridiculous and illogical for OHTAC to deny the application and prohibit my doctor from providing the best treatment available for my disease.

Top