The problem with measuring 'quality of life' in dollars ...

… is that it means placing a monetary value on human life, which is an inherently fraught proposition. That’s why William S. Smith, a fellow at the Pioneer Institute, argues that such calculations have no place in health care.

A cornerstone of how society considers the merits of new medicines is a metric called quality-adjusted life years, or QALYs. If a drug can, say, relieve all the debilitating symptoms of multiple sclerosis for less than $150,000 a year, then it’s likely to be deemed cost effective by price watchdogs.

But to Smith, that dollar figure is completely arbitrary, and adhering to it makes little sense.

“A cancer drug that provides ‘only’ eight additional months of life won’t achieve a maximum QALY score,” he writes in STAT. “Yet to someone with a cancer treated by that drug who may be facing certain death, a drug that delivers an extra eight months of life should get the highest possible rating.”

Smith argues that “the entire superstructure of the QALY methodology is built upon philosophical sand,” making it too crude a metric to properly inform life-and-death decisions.

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