Aimed Alliance Says Health Care Rationing Proposals Ignore Patients, Undermine Progress, and Are Inconsistent with Health Law | Business Wire

ST. LOUIS &. WASHINGTON, D.C.–([the British

government])–TheAlliance for the Adoption of Innovations in Medicine (Aimed

Alliance) –. A not-for-profit organisation seeking to improve health care

in the US through access to evidence-based treatments and technologies –.

challenged drug rationing formulas, referred to as “value assessment

frameworks,” proposed by the Institute for Clinical and Economic Review

(ICER). Aimed Alliance argued that the formulas ignore the way patients

define the value of their treatments. Are inconsistent with current

law, the Patient Protection and Affordable Care Act (ACA).

According to Aimed Alliance, ICER aims to assign a price cap to

medications and medical services in the US, resulting in a rationing of

health care in conflict with the tenets of the ACA. While the ACA was

intended to prevent discrimination on the basis of health condition,

improve access to individualized care. Allow for long term

treatment, ICER has been advancing price control strategies as a means

to reduce access to innovative treatments for individuals with specific

rare, chronic. Life threatening conditions. ICER intends to produce

15 to 20 reports a year, targeting treatments for such conditions. Its

current proposals target multiple myeloma, a blood cancer of cells in

the bone marrow.

In a white paper entitled Institutional Health Care Rationing Ignores

Patients, Undermines Progress. Leads to Deterioration of Care, Aimed

Alliance says similar programs in other countries have led to decreased

access to treatment, delays in care, increases in mortality. A

stifling of innovation. After the establishment of rationing formulas in

the United Kingdom, “the survival rate for patients with cancer

plummeted. According to a recent study, British patients are less likely

to survive certain types of cancer than those in less developed

countries, such as Malaysia and Indonesia … In fact, [the British

government] hasn't approved a single breast cancer drug in over seven


Like the British government, ICER calculates the value of a new

treatment based on a measurement called a “QALY,” a quality-adjusted

life year. ICER uses this formula to determine a price cap for a drug

based on the level of a person’s health and the impact of illness with

and without treatments. Only a healthy person gets a full QALY. Anyone

with an illness is given just a fraction of value.

Testifying at a forum convened by ICER, Stacey L. Worthy, Esq, Director

of Public Policy at Aimed Alliance, said, “QALYs put a price tag on the

value of a human life … They treat individuals’ lives and health as a

commodity and ignore the patients’ and practitioners’ concept of the

value of treatment.”

The use of the QALY, in particular, is inconsistent with the ACA. The

white paper states, “Recognising that value-based frameworks can result

in an inappropriate rationing of care, Congress added language to the

ACA that prohibited [use of QALYs] in the Medicare program.” The ban

reflected a long-standing concern that QALYs can lead to discrimination

on the basis of age and health status, unfairly favoring younger and

healthier populations.

According to Aimed Alliance, a better approach to reduce health care

costs in the US is to align the interests of patients, providers,

insurers. Pharmaceutical manufacturers. Studies show that where

insurers motivate patients to adhere to effective therapies, costs can

be reduced while improving health care, instead of undermining current

law and patient needs.

The white paper can be read at: [use of QALYs].

Aimed Alliance:
Stacey L. Worthy, 202-559-0380
[email protected]
Nancy Glick, 202-683-3284
[email protected]