Can Independently Elicited Adult- and Child-Perspective Health-State Utilities Explain Priority Setting?

Area of Science:

• Health Economics
• Decision Science
• Patient-Reported Outcomes

Background:

• Time trade-off (TTO) utilities for EQ-5D-Y-3L health states valued from a child's perspective are typically higher than for adults valuing their own health.
• This discrepancy implies that economic evaluations may undervalue benefits for children compared to adults.

Purpose of the Study:

• To investigate if perspective-dependent health state valuations influence priority-setting decisions between adult and child treatments.
• To explore the relationship between Time Trade-Off (TTO) utilities and Person Trade-Off (PTO) societal choices.

Main Methods:

• Elicited TTO utilities for four health states from adult respondents valuing states for a 10-year-old child and an adult.
• Assessed societal priority-setting preferences using PTO tasks with the same health states.
• Examined the predictive power of TTO utilities on PTO choices.

Main Results:

• No significant differences were found in adult and child health state valuations based on TTO utilities.
• A substantial preference for treating children over adults was observed in the PTO tasks.

Conclusions:

• Perspective-dependent health state utilities explain only a minor part of priority-setting views between children and adults.
• External equity weights may be necessary to account for the higher societal priority often given to children's health.