Can Independently Elicited Adult- and Child-Perspective Health-State Utilities Explain Priority Setting?

Arthur E. Attema*, Zhongyu Lang, Stefan A. Lipman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objectives: Time trade-off (TTO) utilities for EQ-5D-Y-3L health states valued by adults taking a child's perspective are generally higher than their valuations of the same state for themselves. Ceteris paribus, the use of these utilities in economic evaluation implies that children gain less from treatments returning them to full health for a specified amount of time than adults. In this study, we explore if this implication affects individuals’ views of priority-setting choices between treatments for adults and children. Methods: We elicited TTO utilities for 4 health states in online interviews, in which respondents valued states for a 10-year-old child and another adult their age. Views on priority setting were studied with person trade-off (PTO) tasks involving the same health states. We tested the ability of the subjects’ TTO utilities to predict these societal choices in PTO. Results: There are no significant differences between adult and child health state valuations in our study, but we do observe a substantial preference for treating children over adults in the PTO task. Conclusions: Our findings suggest that perspective-dependent health-state utilities only explain a small part of views on priority setting between adults and children. External equity weights might be useful to better explain the higher priority given to children.

Original languageEnglish
Pages (from-to)1645-1654
Number of pages10
JournalValue in Health
Issue number11
Early online date31 Aug 2023
Publication statusPublished - Nov 2023

Bibliographical note

Funding/Support: This research was supported by a grant from the EuroQol Group, project number EQ Project 236-2020RA.

Publisher Copyright:
© 2023 International Society for Pharmacoeconomics and Outcomes Research, Inc.


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