Using Age-Specific Values for Pediatric HRQoL in Cost-Effectiveness Analysis: Is There a Problem to Be Solved? If So,...

Area of Science:

• Health Economics
• Pediatric Quality of Life Measurement
• Psychometrics

Background:

• Value sets for the EQ-5D-Y-3L (child-specific instrument) show distinct characteristics compared to adult EQ-5D value sets.
• Key differences include higher values for the worst health states and fewer negative values in pediatric sets.

Purpose of the Study:

• To investigate the reasons behind the differences between child and adult health values.
• To explore the implications of these differences for using EQ-5D-Y-3L values in economic evaluations for healthcare resource allocation.

Main Methods:

• The study posits four potential explanations for observed value set differences.
• These include differences in descriptive severity, adult perceptions of child health, elicitation of preferences for others, and anchoring of 'dead=0' for child survival.

Main Results:

• Existing evidence does not exclude upward bias in values due to eliciting preferences for others or child survival considerations.
• These factors may influence the interpretation and application of pediatric health-related quality of life (HRQoL) values.

Conclusions:

• Differences in EQ-5D-Y-3L value sets compared to adult sets necessitate careful consideration in economic evaluations.
• Alternative, non-age-specific methods for valuing pediatric HRQoL may mitigate non-comparability issues.
• Health technology assessment bodies must address specific considerations for child quality-adjusted life-year gains.