Open Access
09-05-2024 | Editorial
Meeting the Challenges of Preference-Weighted Health-Related Quality-of-Life Measurement in Children
Authors:
Wendy J. Ungar, Michael Herdman
Published in:
PharmacoEconomics
|
Special Issue 1/2024
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Excerpt
The value of a universal outcome measure such as the quality-adjusted life-year (QALY) has long been recognized for health funding allocation decisions that span diverse patient populations. Consequently, guidelines for economic evaluations produced and disseminated by health technology assessment organizations around the globe recommend a cost-utility analysis as the preferred analytic technique [
1‐
3]. The preference for cost-utility analysis evidence by decision makers has brought into stark relief significant challenges in measuring QALYs in pediatric populations. The challenges include but are not limited to: a lack of valid preference-weighted health-related quality-of-life (HRQoL) measures for children of different ages, particularly infants, toddlers, and preschoolers; cognitive barriers for direct elicitation of utilities; the need to rely on proxy reports for child health states; and disagreement regarding whose perspective—child or adult—is most relevant for valuing and measuring child health states [
4‐
10]. Facing difficult funding allocation decisions regarding child heath interventions where QALY evidence is lacking, health technology assessment agencies around the globe have taken note of these challenges. Among the initiatives undertaken in recent years to examine these issues more closely include a 2020 joint National Institute for Health and Care Excellence-International Society for Pharmacoeconomics and Outcomes Research roundtable attended by 22 participants representing 11 health technology assessment agencies and a 2021 EuroQol workshop on valuing health in children. …