Valuation of Child Health-Related Quality of Life by Child Age and Problem Duration Using a Novel Method.

OBJECTIVES: In the U.S., the valuation of health-related quality of life (HRQoL) on a quality-adjusted life years scale has been criticized due to its discriminatory aspects. Therefore, in this EQ-5D-Y-3L valuation study, we assess the value of child HRQoL on a novel "experience" scale, which ranges from 0 ("no experience"/unconscious) to 1 ("experience full health"), and test whether value depends on the child's age and the duration of the problems. METHODS: In Spring 2024, 2,577 U.S. adults were assigned to one of 16 arms that differed only in the child's age and problem duration. Each participant completed a discrete choice experiment (DCE) with five paired comparisons and 20 kaizen tasks. Using this stated preference evidence, we estimated a conditional logit model for each arm and tested for differences in EQ-5D-Y-3L values. RESULTS: In each arm, all 10 incremental differences in levels were positive (p-value < 0.05) with the highest value on alleviating a child's pain and discomfort. Child age affected the value of self-care, such as relieving "problems taking a bath or showering by myself or getting dressed by myself". The results didn't indicate any differences in main effects by problem duration. The value of the worst EQ-5D-Y-3L profile (33333) relative to being "in a coma" differed by child age and problem duration, ranging from 0.202 to -0.346 across 16 arms (p-value < 0.05). CONCLUSION: In the U.S., the value of relieving problems with self-care depends on a child's age, possibly due to perceived differences in developmental norms.