As populations around the world continue to age and healthcare budgets become more constrained, new research suggests that the value assigned to a healthy year of life may depend heavily on who benefits from it and where they live. A recent study published in Scientific Reports examines how factoring in age and country-specific demographics when estimating quality-adjusted life years (QALY) could improve policy decisions and resource allocation in healthcare.
The study highlights that advances in medical technology and public health have led to longer lifespans globally, which has contributed to rising healthcare costs. For example, projections indicate that by 2040, Japan’s healthcare spending will nearly double, raising concerns about the sustainability of its system.
Healthcare policies often use two key measures: the value of statistical life (VSL), which quantifies the monetary worth people place on reducing mortality risk, and QALY, which combines quality of life with life expectancy into a single metric. These tools allow policymakers to compare different interventions and allocate resources based on evidence. The United Kingdom’s National Institute for Health and Care Excellence is one organization that uses QALY for evaluating medical technologies and guiding resource use.
However, using a standard QALY value across all ages can introduce bias because it does not account for differences in health status or life expectancy among age groups. Additionally, adopting QALY values from other countries without considering local factors can lead to inefficient distribution of resources.
To address these issues, the study proposes a new approach to calculating QALY based on VSL. This method takes into account age-specific health status and life expectancy while focusing on the monetary value of extending life rather than solely improving quality of life. Researchers applied an economic model using VSL to estimate the value of life extension (LEV) under various scenarios.
They then combined LEV with quality-of-life measures to calculate the monetary value of one QALY for each age group and scenario. The analysis did not directly model policies aimed at improving quality of life but instead assessed the value of extending lifespan under different trajectories.
Results showed that total VSL estimates ranged from 452.9 million Japanese yen (JPY) to 468.6 million JPY across four scenarios. In every scenario analyzed, the monetary value per QALY increased with age. When population-weighted averages were calculated—multiplying each age group’s QALY values by their share in the population—the highest average was found in scenario SCN1.
Comparisons revealed that between ages 20 and 60, scenario SCN3 yielded the highest monetary QALY values while scenario SCN2 had the lowest. Cost reductions were also estimated by comparing conventional QALY values with those adjusted for age and scenario; some scenarios led to negative cost reductions if set at five million JPY per QALY.
The researchers conclude that as populations live longer, healthcare systems face increasing financial pressures. Their proposed approach enhances policy relevance by integrating demographic details such as age and quality of life into calculations for allocating health resources more efficiently.
While both traditional and revised QALY estimates generally aligned, this new method uncovered greater variation based on age group and quality-of-life considerations—potentially allowing for better-targeted spending within strained budgets. However, they note that their analysis does not factor in costs related to preventive or social interventions needed for actual health improvements.
The authors suggest further research is necessary before this estimation method can be widely applied in real-world policy settings. They recommend exploring alternative calculation models—including nonlinear approaches or adjustments for income-health interactions—and validating results with international data beyond Japan.
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