19 June 2024 - The quality-adjusted life year (QALY) is over 50 years old. Debate about the ethical basis for the QALY and its use in cost effectiveness analysis and policy decision making are almost as old.

Few of the arguments for or against the use of QALYs are new, although the rhetoric and policy discourse have evolved. On-going debates around the QALY run the gamut from technical methods issues, such as how best to establish health-related quality of life (HR-QoL) values, to policy implications, such as how the cost/QALY threshold should be determined. At the centre of the debate the fundamental question about whether the QALY itself is a valid measure persists.

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