Valuing Child Health Isn’t Child’s Play [Editor's Choice]
Evaluating the effectiveness and cost-effectiveness of treatments for children is essential to support good healthcare decisions, yet the evidence on child health-related quality of life (HRQoL) submitted to health technology appraisal (HTA) has, in general, been very poor. Reviews of National Institute for Health and Care Excellence technical appraisals in children and adolescents younger than 18 years1 and in preschool children2 found only limited use of HRQoL measures appropriate for children; most used measures and health state values intended for adults. Similarly, evidence on child HRQoL submitted to the Pharmaceutical Benefits Advisory Committee “involved inconsistent approaches, use of adult measures and weights, and substantial gaps in evidence.”3 A systematic review of HRQoL values used in economic evaluations of childhood vaccines noted “considerable gaps and weaknesses in the current evidence base.”4 No HTA body anywhere in the world currently provides methods guidance on how to measure and value HRQoL in younger populations,5 although the National Institute for Health and Care Excellence is currently developing such guidance.
Nancy J. Devlin