Can we rely on QALYs for assistive technologies?

Abstract

In decision making on the adoption of health care programmes, assistive technologies (ATs), and AT services for people with disabilities, cost-effectiveness analysis is increasingly important. The quality-adjusted life-year (QALY), which incorporates quality of life as well as survival, has become a standard unit of comparative efficacy, although there are methodological challenges in its use. The applicability of the concept of cost per QALY gained through intervention was investigated in one study of rollators and one of hearing aids. It was shown that two widely used instruments for deriving QALYs, HUI3 and EQ-5D, yield differing results, which may also differ depending on the type of disability. Because the magnitude of these differences could affect decision makers' willingness to provide reimbursement, the variability of cost-effectiveness results due to methodology should be considered in the policy-making process.