I'm 99% sure that the US doesn't use QALYs. Congress doesn't want to get into the icky business of determining quality of life, and assigning a numerical value to it.

I'm actually not entirely sure how it all works in the USA. You're talking about the NHS system, right? I'm actually Australian although I've been living in the USA for the last few years.

There are, in fact, hard facts on this. This should get you started: