OP55 Health Technology Assessment In Children And Adolescents: Adolescent Preferences For Child Health Utility 9D Health States

2017 ◽  
Vol 33 (S1) ◽  
pp. 24-25 ◽  
Author(s):  
Julie Ratcliffe ◽  
Gang Chen ◽  
Elisabeth Huynh ◽  
Frank Xu ◽  
Katherine Stevens ◽  
...  

INTRODUCTION:Preference-based measures of health-related quality of life play a key role in the calculation of Quality-Adjusted Life Years (QALYs) for Health Technology Assessment (HTA). The Child Health Utility 9D (CHU9D) is a new preference-based instrument designed specifically for application in children and adolescents (aged 7 to 17 years). This study aimed to compare Chinese and Australian adolescent population preferences for CHU9D health states using profile case best worst scaling (BWS) methods.METHODS:Fifty CHU9D health states (blocked into five survey versions) were generated for valuation using a fractional factorial design. Study participants were recruited through an online panel company in Australia, and through primary and secondary schools in China. A latent class modelling framework was adopted for econometric analysis.RESULTS:A total of 1,982 respondents (51 percent female) in Australia and 902 respondents (43 percent female) in China provided useable survey responses. Latent class analysis indicated the existence of preference heterogeneity for both population groups. In the Australian sample, respondents in Class I placed the most importance on the mental health dimensions of the CHU9D (for example, Worried and Annoyed) and the least importance on daily activities (for example, Activities, Daily routine, Sleep), whilst respondents in Class II placed equal weights on all attributes. In the Chinese sample, respondents in Class I placed the most importance on the Activities dimension of the CHU9D and the least importance on the Annoyed dimension, whist Class II placed the most importance on the Schoolwork dimension and the least importance on Pain.CONCLUSIONS:This study has provided important cross-country insights into the use of profile case BWS methods to elicit health state preferences with young people for application in HTA in children and adolescents. The differential latent classes identified between Australia and China highlights the necessity to derive country-specific adolescent scoring algorithms for the CHU9D instrument for application in HTA.

Author(s):  
Marian Sorin Paveliu ◽  
Elena Olariu ◽  
Raluca Caplescu ◽  
Yemi Oluboyede ◽  
Ileana-Gabriela Niculescu-Aron ◽  
...  

Objective: To provide health-related quality of life (HRQoL) data to support health technology assessment (HTA) and reimbursement decisions in Romania, by developing a country-specific value set for the EQ-5D-3L questionnaire. Methods: We used the cTTO method to elicit health state values using a computer-assisted personal interviewing approach. Interviews were standardized following the most recent version of the EQ-VT protocol developed by the EuroQoL Foundation. Thirty EQ-5D-3L health states were randomly assigned to respondents in blocks of three. Econometric modeling was used to estimate values for all 243 states described by the EQ-5D-3L. Results: Data from 1556 non-institutionalized adults aged 18 years and older, selected from a national representative sample, were used to build the value set. All tested models were logically consistent; the final model chosen to generate the value set was an interval regression model. The predicted EQ-5D-3L values ranged from 0.969 to 0.399, and the relative importance of EQ-5D-3L dimensions was in the following order: mobility, pain/discomfort, self-care, anxiety/depression, and usual activities. Conclusions: These results can support reimbursement decisions and allow regional cross-country comparisons between health technologies. This study lays a stepping stone in the development of a health technology assessment process more driven by locally relevant data in Romania.


2019 ◽  
Vol 109 (2) ◽  
pp. 250-257
Author(s):  
Tita Mensah ◽  
Anders Hjern ◽  
Kickan Håkanson ◽  
Pia Johansson ◽  
Ann Kristine Jonsson ◽  
...  

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1411.2-1411
Author(s):  
D. Rojas-Gualdrón ◽  
J. C. Diaz-Coronado ◽  
D. Hernandez-Parra ◽  
Y. Durango-Durango ◽  
R. Pined ◽  
...  

Background:As the basis for quality-adjusted life years (QALYs) calculation, health state utilities are essential for health technology assessment and economic evaluation.Objectives:To provide a reference value set of health state utility for patients with rheumatoid arthritis.Methods:A cross-sectional study was conducted in 1,545 patients diagnosed with rheumatoid arthritis. Disease activity was evaluated with the DAS-28 score. Health state utility (HSU) was estimated with the EUROQOL-5D-3L, using as reference the Spanish-speaking Hispanic predicted preference weights for 243 EQ-5D health states. Mean HSU differences were analyzed with the generalized linear model. A p-value <0.05 was considered statistically significant.Results:Patients mean age was 58.2 years (SD = 12.5), 82.4% were female. Disease activity was high in 137 (8.9%), moderate in 305 (19.7%) and low in 231 (56.4%) patients; 872 (56.4%) patients were in remission. HSU differed significantly by sex age and disease activity. Figures 1a (women) and 1b (men) shows the HSU by age and disease activity.Figure 1.Health State utilities by sex, age and disease activityConclusion:The way patients value different health states according to their sex, age and disease activity must be considered in health technology assessment and economic evaluations of interventions for rheumatoid arthritis patients. We provide a reference set for Latin-American patients.References:[1]Zarate V, Kind P, Chuang L-H. Hispanic Valuation of the EQ-5D Health States: A Social Value Set for Latin Americans. Value in Health. 2008;11(7):1170-7.Disclosure of Interests:None declared


Author(s):  
Avram E. Denburg ◽  
Mita Giacomini ◽  
Wendy Ungar ◽  
Julia Abelson

Background: Public policy approaches to funding paediatric medicines in advanced health systems remain understudied. In particular, the ethical and social values dimensions of health technology assessment (HTA) and drug coverage decisions for children have received almost no attention in research or policy. Methods: To elicit and understand the social values that influence decision-making for public funding of paediatric drugs, we undertook a series of in-depth, semi-structured interviews with a stratified purposive sample (n = 22) of stakeholders involved with or affected by drug funding decisions for children at the provincial (Ontario) and national levels in Canada. Constructivist grounded theory methodology guided data collection and thematic analysis. Results: Our study provides empirical evidence about the unique ethical and social values dimensions of HTA for children, and describes a novel social values typology for paediatric drug policy decision-making. Three principal categories of values emerged from stakeholder reflections on HTA and drug policy-making for children: procedural values, structural values, and sociocultural values. Key findings include the importance of attention to the procedural legitimacy of HTA for children, with emphasis on the inclusion of child health voices in processes of technology appraisal and policy uptake; a role for HTA institutions to consider the equity impacts of technologies, both in setting review priorities and in assessing the value of technologies for public coverage; and the potential benefits of a distinct national framework to guide drug policy for children. Conclusion: Current approaches to HTA are not well designed for the realities of child health and illness, nor the societal priorities regarding children that our study identified. This research generates new knowledge to inform decision-making on paediatric drugs by HTA institutions and government payers in Canada and other publicly-funded health systems, through insights into the relevant social values for child drug funding decisions from varied stakeholder groups.


2019 ◽  
Vol 35 (6) ◽  
pp. 461-466 ◽  
Author(s):  
Saudamini Vishwanath Dabak ◽  
Yot Teerawattananon ◽  
Thiri Win

AbstractObjectivesHealth technology assessment (HTA) has been widely used to inform coverage decisions in high-income countries over the past few decades and has been getting increasing attention in middle-income countries as a tool for healthcare decision making in recent years. This study aims to use the case of the Maternal and Child Health Voucher Scheme (MCHVS) in Myanmar to understand how HTA can have a policy impact in a low or lower middle-income country.MethodsThe stages heuristic framework was used to describe the policy-making process. A document review was conducted and tacit knowledge of researchers involved was recorded.ResultsThe opportunity for a grant propelled maternal and child health to the policy agenda. An ex-ante HTA, which included a model-based health economic evaluation, informed the design of the scheme. The framework and key parameters from the ex-ante HTA were used for a mid-term review, which provided feedback to the policy implementation process. An ex-post HTA involved fielding a household survey to assess the impact of the scheme.ConclusionsHTA can be a useful method for informing resource allocation throughout the policy process in low and lower middle-income settings where no formal mechanism for making coverage decisions exists.


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