, Volume 22, Issue 2, pp 71–81

The Generation Gap

Differences Between Children and Adults Pertinent to Economic Evaluations of Health Interventions
Current Opinion

DOI: 10.2165/00019053-200422020-00001

Cite this article as:
Keren, R., Pati, S. & Feudtner, C. PharmacoEconomics (2004) 22: 71. doi:10.2165/00019053-200422020-00001


Differences between children and adults have both technical and ethical implications for the design, interpretation and employment of economic analyses of health-related programmes. Even though policy makers increasingly turn to economic analyses to inform decisions about resource allocation, pertinent child-adult differences have received fragmented discussion in leading methodological references.

Key areas warranting attention include: the ways in which a child’s distinctive biology modifies the cost and effectiveness of healthcare interventions; challenges in assessing utilities for infants and young children given their limited but developing cognitive capacity; how a child’s age, dependency and disability affect the selection of the appropriate time horizon and scope of the analysis; whether a child’s non-wage earning productivity should be incorporated into analyses, and if so, what metric to use; what principles of equity policy makers should employ in using economic evaluations to choose between child- and adult-focused interventions; and whether special protective measures should be introduced to secure the rights and interests of children who cannot advocate for themselves.

Copyright information

© Adis Data Information BV 2004

Authors and Affiliations

  • Ron Keren
    • 1
    • 2
    • 3
  • Susmita Pati
    • 1
    • 2
    • 3
  • Chris Feudtner
    • 1
    • 2
    • 3
    • 4
  1. 1.General Pediatrics, Pediatric Generalist Research GroupThe Children’s Hospital of Philadelphia and the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Center for Clinical Epidemiology and BiostatisticsThe University of PennsylvaniaPhiladelphiaUSA
  3. 3.The Leonard Davis Institute of Health EconomicsThe University of PennsylvaniaPhiladelphiaUSA
  4. 4.The Center for BioethicsThe University of PennsylvaniaPhiladelphiaUSA
  5. 5.The Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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