Methodological issues raised by economic evaluations in the perinatal and paediatric contexts

Health economics evidence has made an important contribution towards policy and practice in perinatal and paediatric health and health care in recent years. However, significant gaps remain in our understanding of the production, distribution and evaluation of health and health care for pregnant women, mothers and children where health economics evidence could usefully contribute to an efficient and equitable allocation of scarce resources. This presentation will focus on methodological issues raised by economic evaluations in the perinatal and paediatric contexts and their implications for evidence-based policy and practice. The methodological issues covered will include: when to start ‘counting’ the life of the fetus or unborn child in economic evaluations of perinatal interventions; issues surrounding utility measurement in children, including the relevant attributes to incorporate into the measurement instrument and appropriate respondents for the measurement task; the value of the cost-effectiveness threshold for measures of health gain by children and whether this should differ to those for adults; and the appropriate valuation of parameter inputs into economic evaluations that span childhood and adulthood. The presentation will summarise the scope and scientific quality of existing evidence in order to identify gaps in our knowledge and to consider the future research agenda in this area.