[Pharmacoeconomics in uro-oncology: the concept of QALYs]

The QALY (quality-adjusted life year) is often used in pharmacoeconomic evaluations. It combines the two dimensions 'quality of life' and 'life expectancy' into one index. Quality of life is expressed as a utility, corresponding to a value between 0 (death) and 1 (perfect health). Life expectancy is then multiplied by the utility corresponding to the quality of life of the respective life time. Accordingly, 1 QALY corresponds to 1 year in perfect health (1 year multiplied by utility 1) or 2 years with a quality of life reduced by 50% (2 years multiplied by utility 0.5). Results of pharmacoeconomic evaluations are often reported as additional costs in relation to the added value of a new treatment, expressed as cost per additional QALY gained for the patient with the new therapeutic intervention. The main advantage of the QALY concept is its validity for all patients and indications. And the use of benefit measures which are not restricted to a specific indication is most important for resource allocation, i.e. to avoid that varying amounts of money are paid for the same health benefit in different disease areas.