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EN
According to the statement of the World Health Organization, the quality of life is the individual’s perception of their position in life in the context of given standards and value systems and in relation to their accomplishments, expectations and concerns. In the past twenty-five years, the role of quality of life assessment in medicine has been growing. Health-related quality of life is the self-assessment of patients with respect to the influence of a disease and treatment on the functioning in basic aspects: physical, mental, social and spiritual. The quality of life measure is a very useful tool for the assessment of the value of medical procedures. Quality of life is measured using the QALY index (quality-adjusted life years), which is the average further duration of life adjusted by the limitation of activity due to a disease or disability. Each medicinal technology, the costs of which are reimbursed from public funds, is subject to pharmacoeconomic assessment, and QALY is one of its elements. Quality of life is significant for patients but it is difficult to express in methodological categories. The basic evaluation methods include patient-reported outcomes of treatment with the use of one-dimensional analogue, numerical and verbal scales or multidimensional questionnaires.
PL
Zgodnie ze stanowiskiem Światowej Organizacji Zdrowia jakością życia nazywamy indywidualny odbiór przez człowieka jego pozycji życiowej w kontekście określonych standardów i systemu wartości oraz w odniesieniu do osiągnięć, oczekiwań i zainteresowań. W ostatnim ćwierćwieczu systematycznie rośnie znaczenie oceny jakości życia w medycynie. Jakość życia uwarunkowana zdrowiem to samoocena chorego odnośnie do wpływu choroby i stosowanego leczenia na funkcjonowanie w podstawowych aspektach: fizycznym, psychicznym, społecznym i duchowym. Pomiar jakości życia jest bardzo przydatnym narzędziem oceny wartości procedur medycznych. Do mierników jakości życia należy wskaźnik QALY (quality-adjusted life years), czyli przeciętne dalsze trwanie życia skorygowane o ograniczenie aktywności w wyniku choroby lub niepełnosprawności. Każda lekowa technologia medyczna, której koszty mają być refundowane z funduszy publicznych, podlega ocenie farmakoekonomicznej, a QALY to jeden z elementów tej oceny. Jakość życia jest istotna dla chorych, lecz trudna do wyrażenia w kategoriach metodologicznych. Do podstawowych metod ewaluacji należy samoocena wyników leczenia dokonywana przez chorego za pomocą jednowymiarowych skal analogowych, numerycznych i słownych czy też wielowymiarowych kwestionariuszy.
EN
A very important tool to evaluate value of medical procedures is measuring the quality of life. One of the quality life measurement tools is QALY, particularly important in cancerous diseases, palliative care and cases of long term after-effects of disease. All around the world, public budgets associated with medications are gradually increasing, hence the regulations that increase the supervision over these expenses. Reimbursement principles concerning medicinal technologies are regulated statutorily. Any drug medical technology reimbursed from public funds is subject to a pharmacoeconomic assessment. The most restrictive requirements of ICER (cost/QALY) rating and formal ‘rigid’ cost-effectiveness thresholds apply in Great Britain and Poland. Regardless of the universality and utility, the QALY unit has limitations that may be particularly important during economical assessment of proceedings methods in oncology. It should be also stressed out that there is currently no alternative to QALY – the only common and universal measure of therapeutic effects in different clinical situations. The purpose of the current review is presentation of using QALY in oncology in different countries. The economic aspect of QALY, problems with using it, as well as advantages and disadvantages of using it in end of life period have been considered.
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