Centre for Health Economics at Warwick, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK.
Pharmacoeconomics. 2024 Nov;42(11):1267-1277. doi: 10.1007/s40273-024-01411-w. Epub 2024 Aug 17.
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.
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.
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.
人们的时间是一种有限的资源，也是一种有价值的投入，从广泛的社会角度来看，应该在考虑经济评估时将其考虑在内。然而，针对儿童和青少年（CYP）的干预措施的评估很少考虑到这一人群的时间机会成本。卫生经济学家指出，这主要是因为他们不确定何时应将 CYP 时间相关成本纳入经济评估，并且缺乏关于该主题的明确指导。
考虑到这一点，我们进行了一项 Delphi 研究，以确定一系列相关考虑因素，供研究人员在决定是否以及何时将 CYP 时间纳入其经济评估时使用。Delphi 小组成员被要求提出并对一组可能的考虑因素进行评分，并就其评分提供更多的想法。使用描述性统计对评分进行总结，并通过主题分析对文本评论进行分析。
共有来自 16 个国家的 73 名小组成员完成了两轮两轮 Delphi 研究。小组成员的评分表明，在考虑是否将替代 CYP 时间纳入经济评估时，非常重要的是要考虑以下几点：（1）纳入是否符合规定的观点（中位数得分：9）；（2）CYP 的时间是否已经在评估的其他部分得到考虑（中位数得分：8）；（3）错过的时间量很大，无论是绝对值还是相对值（中位数得分：7）；（4）纳入 CYP 的时间成本是否对决策者感兴趣（中位数得分：7）。受访者认为，诸如（1）纳入是否对研究界感兴趣（中位数得分：6），（2）接受治疗所替代的 CYP 时间是“学校”还是“玩耍”时间（中位数得分：5），以及（3）CYP 是否足够大，可以认为他们的时间有价值（中位数得分：5）等考虑因素较为重要。许多人提出了一系列观点来支持信念和评分，其中许多观点都基于有说服力的规范性问题。
