Good news, QALY fans, the answer (thanks to Alastair Fischer at NICE) to the question does not take NICE's £20k-£30k per QALY range, but uses the recent calculations by Pete Smith and colleagues at York of a cost per life year gained for cancer and circulatory diseasea (based on the DH national Programme Budget data (see http://www.york.ac.uk/inst/che/pdf/rp24.pdf.))
Using this PCT spend data and variations in population health measures (mortaility), they suggest a cost per life year of around £13k for cancer spending and around £8k for circulatory disease spending. Total English NHS cancer spend in 2004/5 was around £3.7 bn, so LYs produced = 284,000. Circulatory spending was £6 bn, so LYs produced = 750,000.
For the whole of the UK NHS spend in 2004/5 of £82.5 bn, assuming that cost per LY for all activities is somewhere between a pretty low number and a fairly high number - let's say, £13,000 on average....the NHS produces around 6.4 million LYs per year. And lastly, assuming that these LYs are not all of perfect quality (say, 0.9), then, quality adjusted life years produced by the UK NHS in one year will be of the order of...5.8 million (about 1.2 months per head of population).
And in terms of what we got for the extra £7.8 bn spent on the UK NHS between 2003/4 and 2004/5, this suggests around 540,000 QALYs.
So, the next question is: what proportion of this increase in QALYs could be attributable to improvements in the quality as opposed to the volume of health care?
john
John Appleby
Chief Economist
King's Fund
11-13 Cavendish Square
London W1G 0AN
Visiting Professor, City University
T: 0207 307 2540
M: 07831 638774
F: 0207 307 2807
________________________________
From: This is a closed list of the UK Health Economists' Study Group (HESG) [mailto:[log in to unmask]] On Behalf Of Fordham Richard Dr (MED)
Sent: 27 March 2007 08:22
To: [log in to unmask]
Subject: Re: QALYs produced by NHS
Gentleman gentleman,
If the NHS is spending £60bn of taxpayers money presumably in the cause of improving or saving lives then then assuming it does this 'efficiently' at the marginal rate of transformation of 30,000/QALY then it must be producing about 200,000 pa. Of course, 42 might be the actual answer..
Regards,
Ric
________________________________
From: This is a closed list of the UK Health Economists' Study Group (HESG) [mailto:[log in to unmask]] On Behalf Of [log in to unmask]
Sent: Tuesday, March 27, 2007 7:34 AM
To: [log in to unmask]
Subject: Re: QALYs produced by NHS
You have all forgotten to divide it by 3.14........scandalous!
Dr Tom Jefferson
Via Adige 28a
00061 Anguillara Sabazia
(Roma)
Italy
www.attentiallebufale.it
Tel/Fax ++39 06 999 00 989
Mobile ++39 32 92025051
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-----Original Message-----
From: [log in to unmask]
To: [log in to unmask]
Sent: Mon, 26 Mar 2007 7.07PM
Subject: Re: QALYs produced by NHS
Plus or minus?
>>> Alan Maynard <[log in to unmask] <javascript:parent.ComposeTo("akm3%40YORK.AC.UK", "");> > 03/26/07 5:12 PM >>>
Forty two?
On Mar 26 2007, John Appleby wrote:
>Any even half-evidenced guess as to the total number of QALYs the NHS
>produces each year?
>
>John Appleby
>Chief Economist
>King's Fund
>11-13 Cavendish Square
>London W1G 0AN
>
>Visiting Professor, City University
>
>T: 0207 307 2540
>M: 07831 638774
>F: 0207 307 2807
>
>
>
