Systematic Review of the Relative Social Value of Child and Adult Health

Tessa Peasgood, Martin Howell (), Rakhee Raghunandan, Amber Salisbury, Marcus Sellars, Gang Chen, Joanna Coast, Jonathan C. Craig, Nancy J. Devlin, Kirsten Howard, Emily Lancsar, Stavros Petrou, Julie Ratcliffe, Rosalie Viney, Germaine Wong, Richard Norman and Cam Donaldson
Additional contact information
Tessa Peasgood: University of Melbourne
Martin Howell: Charles Perkins Centre D17, The University of Sydney
Rakhee Raghunandan: Charles Perkins Centre D17, The University of Sydney
Amber Salisbury: Charles Perkins Centre D17, The University of Sydney
Marcus Sellars: Australian National University
Gang Chen: Monash University
Joanna Coast: University of Bristol
Jonathan C. Craig: Flinders University
Nancy J. Devlin: University of Melbourne
Kirsten Howard: Charles Perkins Centre D17, The University of Sydney
Emily Lancsar: Australian National University
Stavros Petrou: University of Oxford
Julie Ratcliffe: Flinders University
Rosalie Viney: University of Technology Sydney
Germaine Wong: Charles Perkins Centre D17, The University of Sydney
Richard Norman: Curtin University
Cam Donaldson: Australian National University

PharmacoEconomics, 2024, vol. 42, issue 2, No 5, 177-198

Abstract: Abstract Objectives We aimed to synthesise knowledge on the relative social value of child and adult health. Methods Quantitative and qualitative studies that evaluated the willingness of the public to prioritise treatments for children over adults were included. A search to September 2023 was undertaken. Completeness of reporting was assessed using a checklist derived from Johnston et al. Findings were tabulated by study type (matching/person trade-off, discrete choice experiment, willingness to pay, opinion survey or qualitative). Evidence in favour of children was considered in total, by length or quality of life, methodology and respondent characteristics. Results Eighty-eight studies were included; willingness to pay (n = 9), matching/person trade-off (n = 12), discrete choice experiments (n = 29), opinion surveys (n = 22) and qualitative (n = 16), with one study simultaneously included as an opinion survey. From 88 studies, 81 results could be ascertained. Across all studies irrespective of method or other characteristics, 42 findings supported prioritising children, while 12 provided evidence favouring adults in preference to children. The remainder supported equal prioritisation or found diverse or unclear views. Of those studies considering prioritisation within the under 18 years of age group, nine findings favoured older children over younger children (including for life saving interventions), six favoured younger children and five found diverse views. Conclusions The balance of evidence suggests the general public favours prioritising children over adults, but this view was not found across all studies. There are research gaps in understanding the public’s views on the value of health gains to very young children and the motivation behind the public’s views on the value of child relative to adult health gains. Clinical Trial Registration The review is registered at PROSPERO number: CRD42021244593. There were two amendments to the protocol: (1) some additional search terms were added to the search strategy prior to screening to ensure coverage and (2) a more formal quality assessment was added to the process at the data extraction stage. This assessment had not been identified at the protocol writing stage.

Date: 2024
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DOI: 10.1007/s40273-023-01327-x

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