The Child Health Utility 9D (CHU9D) is a child-friendly generic preference-based measure of health-related quality of life and has been widely applied in children and adolescents in several settings. In Japan, there was no such the instrument for cost-effectiveness analysis targeting young population. This study aims to develop a scoring algorithm based on adolescents’ preference.

A profile case best-worst scaling (BWS) and a time trade-off (TTO) method were performed to derive a Japanese-specific tariff for the CHU9D-Japanese version. The study recruited junior-high and high school students aged 12 to 18 years using a multi-stage random sampling and administrated in the schools. By using Ngene, a software to design the choice metric, 50 health states for the BWS case were randomly selected and allocated into 5 blocks. Consequently, the questionnaire had 5 versions, each of which includes socio-demographic questions, the PedsQL questions and 10 BWS cases and randomly sent to the surveyed schools. The TTO survey was implemented online targeting young adults aged 18-29 years. The data were analyzed using latent class conditional logit models, to estimate utilities for each level of the nine attributes.

The study participants included answers of 1279 junior-high and high school students for the BWS survey and 1727 young adults for the TTO survey. The BWS estimates were re-anchored onto the QALY scale using the TTO generated health state values via a mapping approach. The optimal results were based on the responses to the best attributes.

The study adds value to generate the value set in the adolescent population in Japan. Similar to the previous findings in Australia and China, the preferences among adolescents tended to be affected by different decision rules of best vs. worst choices. The adolescent-specific value set will facilitate economic evaluations of public health programs targeting children and adolescents.