Time is a precious commodity, especially when evaluating health interventions for children and young people (CYP). However, current economic evaluations often overlook the opportunity cost of time for this demographic. The lack of clear guidelines and uncertainty about when it’s appropriate to include CYP time-related costs have been significant barriers. In addressing these gaps, a recent Delphi study offers valuable insights for researchers in this field.
Study Design and Methods
The study undertook a Delphi approach, engaging 73 panellists from 16 countries over two rounds to establish key considerations for including CYP time in economic evaluations. Panellists were invited to propose and rate a series of considerations and provide detailed thoughts on their ratings. Descriptive statistics summarized the ratings, while thematic analysis was applied to text comments.
Key Findings
The findings underscore several critical considerations. Panellists rated the importance of aligning the inclusion of CYP time costs with the specified perspective of the evaluation (median score: 9). They emphasized the necessity to check if CYP’s time is already accounted for in other evaluation parts (median score: 8) and the significance of the amount of forgone time in absolute or relative terms (median score: 7). Moreover, the inclusion of CYP’s time costs must be of interest to decision-makers (median score: 7).
Moderately important considerations included whether the research community would be interested in such inclusion (median score: 6) and if the displaced time is ‘school’ or ‘play’ time (median score: 5). Additionally, the age of CYP was considered, with panellists questioning whether younger children’s time should be deemed valuable (median score: 5).
Concrete Inferences
- The alignment of CYP time costs with the evaluation’s perspective is paramount for credibility and relevance.
- Evaluations should meticulously check other sections to avoid double-counting CYP time.
- Quantifying forgone time in absolute and relative terms ensures that evaluations capture the true economic impact.
- The relevance to decision-makers can drive the practical application of the research findings.
These considerations are crucial for ensuring that economic evaluations are comprehensive and reflective of all relevant opportunity costs, particularly in the context of CYP. By adopting these insights, researchers can enhance the robustness and applicability of their evaluations, thereby facilitating better-informed decision-making and improved resource allocation in healthcare.
Original Article:
Pharmacoeconomics. 2024 Aug 17. doi: 10.1007/s40273-024-01411-w. Online ahead of print.
ABSTRACT
BACKGROUND: People’s time is a finite resource and a valuable input that ought to be considered in economic evaluations taking a broad, societal perspective. Yet, evaluations of interventions focusing on children and young people (CYP) rarely account for the opportunity cost of time in this population. As a key reason for this, health economists have pointed to uncertainty around when it is appropriate to include CYP time-related costs in an economic evaluation and highlighted the lack of clear guidance on the topic.
METHODS: With this in mind, we carried out a Delphi study to establish a list of relevant considerations for researchers to utilise whilst making decisions about whether and when to include CYP time in their economic evaluations. Delphi panellists were asked to propose and rate a set of possible considerations and provide additional thoughts on their ratings. Ratings were summarised using descriptive statistics, and text comments were interrogated through thematic analysis.
FINDINGS: A total of 73 panellists across 16 countries completed both rounds of a two-round Delphi study. Panellists’ ratings showed that, when thinking about whether to include displaced CYP time in an economic evaluation, it is very important to consider whether: (1) inclusion would be in line with specified perspective(s) (median score: 9), (2) CYP’s time may already be accounted for in other parts of the evaluation (median score: 8), (3) the amount of forgone time is substantial, either in absolute or relative terms (median score: 7) and (4) inclusion of CYP’s time costs would be of interest to decision-makers (median score: 7). Respondents thought that considerations such as (1) whether inclusion would be of interest to the research community (median score: 6), (2) whether CYP’s time displaced by receiving treatment is ‘school’ or ‘play’ time (median score: 5), and (3) whether CYP’s are old enough for their time to be considered valuable (median score: 5) are moderately important. A range of views was offered to support beliefs and ratings, many of which were underpinned by compelling normative questions.
PMID:39153138 | DOI:10.1007/s40273-024-01411-w
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