It looked like Congress might bar federal agencies from using quality-adjusted life years, a metric used to evaluate the cost-effectiveness of drugs and treatments after top Democrats on the Energy and Commerce committee signaled openness to a deal with Republicans, both saying the metric is discriminatory. But when the House Energy and Commerce Committee considered a bill by its chair, Cathy McMorris Rodgers (R-Wash.), to bar its use, the ranking member Frank Pallone (D-N.J.) was a no, along with 19 other Democrats on the panel. The vote on Friday to advance the measure to the full House was 27-20, with Rep. Anna Eshoo (D-Calif.), the chair of the panel’s health subcommittee voting present. She expressed optimism that a deal could still come. Rodgers said the widely used metric undervalues the benefits that therapies provide to people who have disabilities or are elderly. Pallone thinks the language is overbroad and, if enacted, the bill would interfere with upcoming Medicare drug-price negotiations by prohibiting other measures of cost-effectiveness. During a subcommittee markup earlier this month, though, Democrats suggested a compromise was close. During the full committee’s consideration Friday, Pallone said those negotiations have fallen short. “I need assurances that nothing in the legislation would go beyond banning the use of QALYs or could be used to delay or disrupt the implementation of the drug price negotiations,” Pallone said. Why it matters: Health industry and patient advocacy groups are divided on the legislation. The Campaign for Sustainable Rx Pricing, whose members include AARP, insurer trade group AHIP, the American Hospital Association and the Pharmaceutical Care Management Association, which represents pharmacy benefit managers, wrote to Rodgers opposing the legislation. The coalition argued it would restrict the information that patients and providers would have about treatment values and effectiveness. They also said it would put unnecessary restrictions on drug pricing negotiations. Still, groups representing people with disabilities, including the National Down Syndrome Society, among others, support the bill. And PhRMA, the trade group for brand name drugmakers, has raised concerns that QALYs could discriminate against “disadvantaged communities” and reinforce health disparities. However, a PhRMA spokesperson said that the group hasn’t taken a position on the bill. | 
