OBJECTIVES: The international protocol for the EQ-5D-Y-3L valuation generates growing interest in developing value set for preference-based instruments for children and adolescents. However, there are methodological challenges for valuing youth health. In Canada, limited research has been conducted in this area. This qualitative study aimed to understand the views of Canadian stakeholders on these important issues.

METHODS: Stakeholders from HTA agencies, pharmaceutical industry, healthcare providers, and academia were invited to attend an hour interview through zoom. Semi-structured interviews were designed to focus on: (1) the target population for completing valuation tasks; (2) the perspective for the valuation questions; and (3) the elicitation approaches used for valuation, i.e., discrete choice experiment (DCE) and its variants vs time trade-off (TTO). Participants were probed to think about ethical concerns, cognitive capacity, and recommendations of HTA agencies around youth valuation. All interviews were recorded and transcribed verbatim. Content analysis with the incidence density method was used to analyze the data.

RESULTS: 15 interviews were conducted between May and September 2022. 66.7% (n=10) of respondents having experiences with economic evaluations and 86.7% (n=13) had child(ren). 12 (80%) respondents preferred asking older adolescents directly to value their own health. Six respondents disagreed with the view of using adults because they are voters and taxpayers. They argued that adolescents are members of the public and users of healthcare systems, and therefore their preferences should be used. 11 (73%) respondents preferred DCE to TTO as DCE is more straightforward, less cognitive burden, and closer to reality. 53% (n=8) of the respondents did not think that there is ethical concern when talking to adolescents about life or death subjects in hypothetical scenarios.

CONCLUSIONS: The view of Canadian stakeholders supports asking adolescents directly for youth valuation tasks. Compared with the TTO approach, the DCE approach is preferred.