Valuing child and adolescent health states for use in economic evaluation: A good practices report of an ISPOR task force

Economic evaluations of interventions that target or include children require health state utilities (HSUs). Despite the availability of preference-weighted measures for children, methods for valuing child health states and estimating child utilities are not as well established as those for adult HSUs. The objective of this Task Force was to develop emerging good practice recommendations for valuing child and adolescent health to generate HSUs for use in economic evaluation.

This Task Force identified and described the interrelated methodological choices regarding valuation of child health to generate HSUs. The Task Force considered available evidence related to four key issues: (a) whose preferences should be sought; (b) whose health is imagined; (c) which method should be used; and (d) the comparability between adult and child utilities.

Best practices may vary depending on the modeling context, characteristics of the health states, and the health technology assessment setting in which the HSUs will be used. For any individual study, methods will be informed by empirical evidence, value judgments, and recommendations from healthcare decision-makers. Rather than recommending an approach that would apply to every study, this Task Force presents options to consider when determining the preference elicitation approach to generate utilities for child health states, along with strengths and limitations of each. Given that child HSUs can impact the outcomes of a cost-utility analysis and subsequent decisions about healthcare resource allocation, this Task Force recommends that researchers be transparent about methodological choices and their impact on HSUs.