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Family Spillover Effects: Are Economic Evaluations Misrepresenting the Value of Healthcare Interventions to Society?

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  • Ashley A. Leech

    (Vanderbilt University School of Medicine
    Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center)

  • Pei-Jung Lin

    (Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center)

  • Brittany D’Cruz

    (Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center)

  • Susan K. Parsons

    (Center for Health Solutions, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center
    Tufts Medical Center)

  • Tara A. Lavelle

    (Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center)

Abstract

The societal impacts of health interventions are seldom incorporated into health economic evaluations, including the impact that illness can have on informal or unpaid caregivers and other family members (i.e., “family spillover effects”). Previous research has demonstrated that by excluding family spillover effects, the value of health interventions may be underestimated on average. In this commentary, we discuss how the inclusion of spillover effects influences how we value interventions and, given the extent to which caregiver/family effects are largely not captured or known, propose ways in which these data could be more systematically collected or estimated and used by researchers. These recommendations include prioritizing data collection alongside clinical trials and patient registries, engaging expert opinion panels, and developing mapping algorithms for estimating caregiver/family utility values from non-preference-based caregiver health-related quality-of-life measures and/or from patient preference-based measures.

Suggested Citation

  • Ashley A. Leech & Pei-Jung Lin & Brittany D’Cruz & Susan K. Parsons & Tara A. Lavelle, 2023. "Family Spillover Effects: Are Economic Evaluations Misrepresenting the Value of Healthcare Interventions to Society?," Applied Health Economics and Health Policy, Springer, vol. 21(1), pages 5-10, January.
  • Handle: RePEc:spr:aphecp:v:21:y:2023:i:1:d:10.1007_s40258-022-00755-8
    DOI: 10.1007/s40258-022-00755-8
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    References listed on IDEAS

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    1. Al-Janabi, Hareth & Coast, Joanna & Flynn, Terry N., 2008. "What do people value when they provide unpaid care for an older person? A meta-ethnography with interview follow-up," Social Science & Medicine, Elsevier, vol. 67(1), pages 111-121, July.
    2. Lisa A. Prosser & Kara Lamarand & Acham Gebremariam & Eve Wittenberg, 2015. "Measuring Family HRQoL Spillover Effects Using Direct Health Utility Assessment," Medical Decision Making, , vol. 35(1), pages 81-93, January.
    3. Tara Lavelle & Eve Wittenberg & Kara Lamarand & Lisa Prosser, 2014. "Variation in the Spillover Effects of Illness on Parents, Spouses, and Children of the Chronically Ill," Applied Health Economics and Health Policy, Springer, vol. 12(2), pages 117-124, April.
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