Utility Elicitation for Allergic Rhinoconjunctivitis and Asthma in Children

OBJECTIVES: This study aimed to generate utility and disutility values for seasonal allergic rhinoconjunctivitis (ARC) and asthma in children, in order to demonstrate the impact of these conditions on patients' health-related quality of life. METHODS: Health state descriptions were developed using clinical guidelines, Allergic Rhinitis and its Impact on Asthma (ARIA) and Global Initiative for Asthma (GINA) to incorporate symptoms, impact on daily life, as well as treatments required. Descriptions were amended with clinician and patient input, and adapted for lower reading ages. An online survey presented respondents with the health state descriptions in a randomised order. After each description, respondents rated the health state using a visual analogue scale (VAS).The survey was distributed to children aged 8 to 11 from four European countries (UK, France, Germany, Slovakia) via consenting parents recruited by a third party panel company. Average utility and disutility values were calculated. RESULTS: 1082 respondents completed the survey. Except for severe ARC, respondents who reported experience with ARC (55.1%) and asthma (23.8%) provided similar utility values as respondents that did not report these experiences. Average utility values reported for each health state were: mild ARC 0.705, moderate ARC 0.675, severe ARC 0.666, mild ARC with well-to-partly controlled asthma (WPCA) 0.677, moderate ARC with WPCA 0.668 and severe ARC with WPCA 0.663. Average disutility for increased severity from mild to moderate ARC was -0.131, from mild to severe ARC was -0.121, and from moderate to severe ARC was -0.101. Disutilities for comorbid WPCA in addition to mild, moderate and severe ARC were -0.089, -0.098 and -0.094, respectively. CONCLUSIONS: More severe health states resulted in lower utility values. Disutility values were highest for changes between the mildest and most severe health states. ARC with and without WPCA has considerable negative impact on quality of life in children.