Wendy Ungar, PhD
Child Health Evaluative Sciences
University of Toronto
Health Policy, Management and Evaluation
Institute for Clinical Evaluative Sciences
Wendy Ungar is a Senior Scientist in Child Health Evaluative Sciences at The Hospital for Sick Children (SickKids) in Toronto, a Professor in Health Policy, Management and Evaluation at the University of Toronto, and an Adjunct Scientist at the Institute for Clinical Evaluative Sciences. Dr. Ungar is a member of the Ontario Health Technology Advisory Committee (OHTAC) and chairs the Ontario Genetic Advisory Committee with a mandate to advise OHTAC on the clinical utility, validity, and value for money of new and existing genetic and genomic tests in Ontario. In 2010, Dr. Ungar’s book, Economic Evaluation in Child Health, was published by Oxford University Press.
Why do health care costs keep rising? How can we continue to afford it? Is all the new technology increasingly used in patient care actually making us healthier? With a focus on genomics, these are some of the questions that Dr. Ungar and her team address in her program of research investigating the application of health economic methods to the paediatric population.
Dr. Ungar also studies the relationship between policies governing access to prescription medicines and health outcomes in children. In 2007, Dr. Ungar started TASK (Technology Assessment at SickKids), a Health Technology Assessment (HTA) unit focusing on technology assessment of paediatric health interventions. Dr. Ungar and her research team created and maintain the PEDE database, a popular on-line health technology assessment tool for examining health economic evidence in children.
- Paediatric economic evaluation methods research
- Pharmaceutical policy and health outcomes in children with asthma
- Economic burden of chronic paediatric conditions
- Cost-effectiveness of interventions and programs for children
- Parent and child preferences for treatment attributes
Measurement of quality of life and preferences for health states (utility) poses a number of challenges in children. Current research is examining novel approaches to utility and quality of life assessment for incorporation in cost-utility analysis and clinical research.
Through detailed health technology assessments, additional research is exploring the cost-effectiveness of treatments in maternal and child health, including biologics for juvenile idiopathic arthritis, genotyping to guide therapy in children with acute lymphoblastic leukemia, CYP2D6 testing to guide postnatal pain management in lactating women and teratogen counseling in pregnant women requiring anti-depressants. These evaluations can be used for informing health policy and allocation decision-making.
The provision of medications is a major component of health care not universally covered by provincial health programs. Payment for medications can impose a significant financial burden on the families of children with acute or chronic diseases requiring medical treatment. A current avenue of research focuses on the health consequences in children with asthma of policies governing access to medications.
- Canadian Institutes for Health Research
- Genome Canada
- AllerGen Networks of Centres for Excellence
- Ontario Ministry of Health and Long-Term Care Drug Innovation Fund
- Ontario Lung Association
- Organization of Teratology Information Services
Sullivan SM, Tsiplova K, Ungar WJ. A scoping review of pediatric economic evaluation 1980-2014: Do trends over time reflect changing priorities in evaluation methods and childhood disease? In press, Expert Review of Pharmacoeconomics and Outcomes Research, 2017.
Ungar WJ. A further examination of the problem of double-counting in incremental cost-utility analysis. Expert Review of Pharmacoeconomics and Outcomes Research, 16(3): 333-335, 2016, doi: 10.1080/14737167.2016.1182865.
Luca NJ, Burnett HF, Ungar WJ, Moretti ME, Beukelman T, Feldman BM, Schwartz G, Bayoumi AM. Cost-effectiveness analysis of early biologic treatment in polyarticular juvenile idiopathic arthritis. In press Arthritis Care and Research, ePub 5 April 2016, doi: 10.1002/acr.22903
Roy L, Zur RM, Uleryk E, Carew C, Ito S, Ungar WJ. Thiopurine s-methyltransferase testing for averting drug toxicity in patients receiving thiopurines: A systematic review. Pharmacogenomics, 17(6): 633-56, 2016, doi: 10.2217/pgs.16.12.
Bashir N, Ungar WJ. The 3-I Framework: A framework for developing public policies regarding pharmacogenomics (PGx) testing in Canada. Genome, 58(12): 527-540, 2015. doi 10.1139/gen-2015-0100
Ungar WJ, Hadioonzadeh A, Najafzadeh M, Tsao NW, Dell S, Lynd LD. Parents and adolescents preferences for asthma control: A best-worst scaling choice experiment using an orthogonal main effects design. BMC Pulmonary Medicine, Nov 17;15:146. 2015, doi: 10.1186/s12890-015-0141-9. .
Ungar WJ. Next generation sequencing and health technology assessment in autism spectrum disorder. Canadian Journal of Child and Adolescent Psychiatry, 24(2): 123-127, 2015 (featured on journal cover).
Schuh S, Freedman S, Coates A, Allen U, Parkin P, Stephens D, Ungar W, Da Silva Z, Willan A. Impact of oximetry on hospitalization in bronchiolitis - a randomized trial. JAMA, 312(7):712-718, 2014, doi:10.1001/jama.2014.8637.
Burnett HF, Ungar WJ, Regier DA, Feldman BM, Miller FA. Parent willingness-to-pay for biologic treatments in juvenile idiopathic arthritis. Value in Health, 17(8):830-837, 2014.
Ungar WJ, Prosser LA, Burnett H. Values and evidence colliding: Health technology assessment in child health. Expert Review of Pharmacoeconomics and Outcomes Research, 13(4):417-419, 2013 (lead article).
Caulfield T, Evans J, McGuire A, McCabe C, Bubela T, Cook-Deegan R, Fishman J, Hogarth S, Miller FA, Raviskty V, Biesecker B, Borry P, Cho M, Carroll JC, Etchegary H, Joly Y, Kato K, Soo-Jin Lee S, Rothenberg K, Sankar P, Szego MJ, Ossorio P, Pullman D, Rousseau F, Ungar WJ, Wilson B. Reflections on the cost of “low-cost” whole genome sequencing: Framing the health policy debate. PLoS Biology 11(11): e1001699. doi:10.1371/journal.pbio.1001699, 2013
Ungar WJ, Costa V, Burnett H, Feldman BM, Laxer RM. The use of biologic response modifiers in polyarticular-course juvenile idiopathic arthritis: A systematic review. Seminars in Arthritis and Rheumatism, 42(6):597-618, 2013.
Gauvreau C, Ungar WJ, Köhler JC, Zlotkin S. The use of cost-effectiveness analysis for pediatric immunization in developing countries. The Milbank Quarterly, 90(4):762-790, 2012.
Hancock-Howard RL, Ungar WJ, Marshall D, Einarson A, Koren G. Public preferences for counseling regarding antidepressant use during pregnancy: A discrete choice experiment. Birth Defects Research Part A: Clinical and Molecular Teratology, Jul; 94(7):532-539, 2012.
Ungar WJ, Boydell K, Dell S, Feldman BM, Marshall D, Willan A, Wright J. A parent-child dyad approach to the assessment of health status and health-related quality of life in children with asthma. PharmacoEconomics, 30(8):697-712, 2012.
Burnett HF, Regier DA, Feldman BM, Miller FA, Ungar WJ. Parents’ preferences for drug treatments in juvenile idiopathic arthritis: A discrete choice experiment. Arthritis Care & Research, 64(9):1382-1391,
Kromm SK, Bethell J, Kraglund F, Edwards S, Laporte A, Coyte PC, Ungar WJ. Characteristics and quality of pediatric cost-utility analyses. Quality of Life Research, 21(8):1315-1325, 2012.
Ungar WJ. Medication cost-sharing and health outcomes in children with asthma. JAMA, March; 307(12):1316-1318, 2012.
Ungar WJ. Challenges in health state valuation in pediatric economic evaluation: Are QALYs contraindicated? PharmacoEconomics, 29(8):641-652, 2011
Ungar WJ, Paterson JM, Gomes T, Bikangaga P, Gold M, To T, Kozyrskyj AL. Relationship of asthma management, socioeconomic status, and medication insurance characteristics to exacerbation frequency in children with asthma. Annals of Allergy, Asthma & Immunology, 106:17–23, 2011.
Ungar WJ, Costa V, Hancock-Howard RL, Feldman B, Laxer RM. Cost-effectiveness of biologics in polyarticular-course juvenile idiopathic arthritis patients unresponsive to disease modifying anti-rheumatic drugs. Arthritis Care & Research, January; 63(1):111–119, 2011.