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Paediatric Economic Database Evaluation
Technology Assessment at SickKids (TASK)

Brief Biography

Wendy Ungar M.Sc., PhD is a Senior Scientist in Child Health Evaluative Sciences at The Hospital for Sick Children, Toronto, Canada, an Associate Professor in Health Policy, Management and Evaluation, University of Toronto, and an Adjunct Scientist at the Institute for Clinical Evaluative Sciences. Dr. Ungar is the University of Toronto Program Director for the International Masters in Health Technology Assessment & Management (Ulysses program) and has held a Canadian Institutes of Health Research New Investigator career award.

Why do health care costs keep rising? How can we continue to afford it? Is all this new technology in health care actually making us healthier? 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.

Research Interests

• 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

Research Activities

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.

Future Research Interests

Future research will study the use of stated preference techniques, including discrete choice experiments, to evaluate parent, child and family preferences with regard to treatment choice, health states and willingness-to-pay. Understanding the inter-dependent relationship among family members with regard to quality-of-life and the use of and payment for health care services is critical for designing health care policies that are responsive to the needs of children and families. Additional studies will compare the stated preferences of families to asthma health care providers to improve the design of clinical practice guidelines and asthma education programs.

External Funding

• Ontario Ministry of Health and Long-Term Care Drug Innovation Fund
• AllerGen Network Centre for Excellence
• Canadian Institutes for Health Research
• Ontario Lung Association
• Organization of Teratology Information Services

Publications

Ungar WJ (Editor). Economic Evaluation in Child Health. Oxford: Oxford University Press, 2010.

Hancock-Howard RL, McMahon M, Menon-Nair A, Woo G, Aziza A,  Laporte A, Nauenberg E, Connolly BL, Wales PW, Ungar WJ. A cost effectiveness analysis of port insertion using image guided therapy versus conventional operating room methods. Journal of Vascular and Interventional Radiology, May;21(5):677-84, 2010

Ungar WJ, Cope SF, Kozyrskyj A, Paterson JM. Socioeconomic factors and home allergen exposure in children with asthma. Journal of Pediatric Health Care 24(2):108-115, 2010

Yong JHE, Schuh S, Rashidi R, Vanderby S, Lau R, Laporte A, Nauenberg E, Ungar WJ. A cost-effectiveness analysis of omitting radiography in diagnosis of acute bronchiolitis. Pediatric Pulmonology 44(2):122-127, 2009

Cope SF, Ungar WJ, Glazier RH. International differences in asthma guidelines for children. International Archives of Allergy and Immunology 148(4):265-278, 2009

Wan M, Doria A, Krahn M, Ungar WJ, Medina S, Sung L. Acute appendicitis in young children: cost-effectiveness of US versus CT in diagnosis--a Markov decision analytic model. Radiology, 250(2): 378-86, 2009

Sharieff W, Zlotkin S, Ungar WJ, Feldman BM, Krahn M, Tomlinson G. The economics of preventing premature mortality and impaired cognitive development in children through home-fortification: a health policy perspective. International Journal of Technology Assessment and Health Care 24(3):303-311, 2008

Cope SF, Ungar WJ, Glazier RH. Socioeconomic factors and asthma control in children. Pediatric Pulmonology 43(8):745-752, 2008

Ungar WJ, Paterson M, Cope S, Kozyrskyj A. Improving drug benefits for children with asthma: building a research agenda. Healthcare Policy 3(4):66-76, 2008

Guerriere DN, Tranmer JE, Ungar WJ, Manoharan V, Coyte PC. Valuing care recipient and family caregiver time: a comparison of methods. International Journal of Technology Assessment in Health Care, 24(1):52-59, January 2008

Ungar WJ, Kozyrskyj A, Paterson M, Ahmad F. Impact of cost-sharing on asthma medication use in children. Archives of Pediatrics & Adolescent Medicine 2008; 162(2):104-110

Han RK, Ungar WJ, Macarthur C. Cost effectiveness analysis of a proposed public health legislative/educational strategy to reduce tap water scald injuries in children. Injury Prevention 2007; 13: 248-253

Ungar WJ, Davidson-Grimwood SR, Cousins M. Parents were accurate proxy reporters of urgent pediatric asthma health services – a retrospective agreement analysis. Journal of Clinical Epidemiology 2007; 60(11):1176-1183

Ungar WJ. Paediatric health economic evaluations: a world view. Healthcare Quarterly 2006; 10(1): 134-140

Ungar WJ, Mirabelli C, Cousins M, Boydell KM. A qualitative analysis of a dyad approach to quality of life measurement in children with asthma. Social Science & Medicine 2006; 63(9):2354-66

Kozyrskyj AL, Dahl ME, Ungar WJ, Becker AB, Law BJ. Antibiotic treatment of wheezing in children with asthma: what is the practice? Pediatrics 2006; 117(6):e1104-10

Motiwala S, Gupta S, Lilly M, Ungar WJ, Coyte PC. The cost-effectiveness of expanding intensive behavioural intervention (IBI) to all autistic children in Ontario. Healthcare Policy 2006; 1(2):135-151

Ungar WJ, Witkos M. Public drug plan coverage for children across Canada: a portrait of too many colours. Healthcare Policy 2005; 1(1):100-122

Ungar WJ, Santos MT. The quality of pediatric health economic evaluations. International Journal of Technology Assessment and Health Care 2005; 21(2):203-210

Ungar WJ, Ariely R. Health insurance, access to prescription medicines and health outcomes in children. Expert Review of Pharmacoeconomics & Outcomes Research 2005; 5(2):215-225