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Will admit I don't fully understand the QALY

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Mellowmood77 Member Level  Friday, 09/13/19 04:29:30 PM
Re: sts66 post# 214206
Post # of 220223 
Quote:
Will admit I don't fully understand the QALY and evLYG numbers - have no idea what this sentence even means, for instance:

Quote:

For icosapent ethyl, the relevant cost per evLYG price range is $6,501 to $9,423 for the $100,000 to $150,000 per evLYG thresholds.



Guess I'll just leave it at "ICER estimates 33.5M eligible patients".



STS, I posted a little about this not too long ago. QALY is simply how many life years you gain multiplied by the quality of your life (measured from 0-1).

So Vascepa on top of statin gives you 12.26 life years at .83 quality of life which gives you 10.19 QALY's.

SOC (Statin and optical medical management) gives you 11.73 life years at .82 quality of life for 9.69 QALY's.

So Vascepa gives you overall .5 more QALY's than SOC.

Total cost of Vascepa is $40,000 over lifetime of patient vs $31,000 for SOC for a $9000 difference.

$9000/.5 QALY's gained gives you $18,000 for every QALY gained over SOC.

Now let's talk about the thresholds. ICER uses 3 thresholds $50,000 QALY, $100,000 QALY, $150,000 QALY to determine levels of cost effectiveness.

A lot of people argue that $50,000 is too low and the lower boundary of cost effectiveness should start at $100,000 QALY. Well Vascepa doesn't even have to worry about that because it sits WELL below the lower boundary at $18k QALY.

Now just forget about evLYG for a second and replace that with QALY.

What the statement you were referring to earlier simply means is how much you can charge for the drug/year to reach the respective thresholds.

Net Price/Year of Vascepa is $1625 according to ICER. You can charge $2,849/year to reach the lower boundary of $50k threshold, $6,282 to reach $100k threshold, and $9,204 to reach $150k threshold.

evLYG (equal value of life years gained) is very similar to QALY except it treats all life years evenly (removes quality of life) and the numbers vary slightly.

I listed some examples in my previous post which showed most drugs in ICER's reports have to lower the cost of the drug to reach those same benchmarks (including drugs like repatha).

So basically if the lower threshold at what an insurer is willing to pay is $50k/QALY. Vascepa is looking mightily good at $18k (16k if you include revascularizations).






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