Guidelines for conducting health economic evaluations have become increasingly standardized, however, they don't address the unique concerns of the pediatric population. The challenges of measuring costs and consequences in children, from neonate to late adolescence, are numerous and complex. With the growing acceptance of economic evidence to guide decisions in health systems facing economic constraints, it is imperative that these challenges be considered so that this population is not left out of evidence-based decisions. This book is divided into three sections: Methods, Applications, and Using Evidence for Decision-Making, with chapters contributed by international experts. The Methods section presents detailed discussions of measuring lifetime costs and consequences, capturing productivity losses, obtaining unbiased self-and proxy reports, incorporating externalities, choosing valid outcome measures, assessing utility, and designing studies using value of information. The Applications section reviews economic evidence in common childhood conditions and areas of investigation, including newborn screening, harm prevention, mental health services, brain injury, asthma, and immunization. The final section explores the use of economic evidence in division-making, and includes a description of the WHO-CHOICE approach, the role of clinical research, how to value health gains by children, and the emerging field of health technology assessment. In addition to an emphasis on methods, a deliberate effort was made to include issues relevant to developing countries, where the burden of childhood disease is greatest, and for whom high quality economic evidence is critical.
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Wendy Ungar MSc, PhD is a Senior Scientist in Child Health Evaluative Sciences at the Hospital for Sick Children, Toronto, Canada, an Associate Professor in Health Policy, Management and Evaluation, University of Toronto, and an Adjunct Scientist at the Institute for Clinical Evaluative Sciences, Toronto, Canada. Dr. Ungar is the University of Toronto Program Director for the International Masters in Health Technology Assessment & Management (Ulysses program) and has held a Canadian Institutes of Health Research New Investigator career award.
Dr. Ungar leads a program of research in the application of health economic methods to the paediatric population and also investigates the relationship between policies governing access to prescription medicines and health outcomes in children. Dr. Ungar and her research team created and maintain the PEDE database (http://pede.ccb.sickkids.ca/pede/), a popular on-line health technology assessment tool for examining health economic evidence in children.
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