Inclusion of Caregiver Costs and Quality of Life in Cost Effectiveness Analyses of Treatments for Neurological Conditions: Review of HTA Guidance Documents and Appraisals
Author(s)
Erin Wong, PhD1, Alicyia Walczyk Mooradally, PhD1, Ashley Concessio, MBiotech2, Laura Pastor, MSc1, Sumeet Singh, MSc1, Adam E. Haynes, MSc2, Se Ryeong Jang, MPH3;
1EVERSANA, Burlington, ON, Canada, 2Eisai Limited, Mississauga, ON, Canada, 3Eisai Inc., Nutley, NJ, USA
1EVERSANA, Burlington, ON, Canada, 2Eisai Limited, Mississauga, ON, Canada, 3Eisai Inc., Nutley, NJ, USA
OBJECTIVES: Caregiver burden associated with neurological conditions can be substantial, with potential impacts on health care costs and quality of life. This study aims to understand health technology assessment (HTA) agencies’ preferences and guidance regarding inclusion of caregiver burden in economic models submitted to support reimbursement of new treatments for neurological conditions.
METHODS: Guidance documents of key HTA agencies (England, Scotland, Canada, Australia, Sweden, Denmark, Norway, France, Netherlands, Italy, Japan, and China) published in the last five years were reviewed. The review evaluated guidance regarding the inclusion of caregiver costs and utilities, whether in the base case or in scenario analyses, along with the recommended methods for incorporating these elements. Once the broader assessment was completed, relevant HTA agencies were selected to assess the number of appraisals including caregiver burden in the economic model and the specific methodology utilized.
RESULTS: From the review of HTA guidance documents, seven agencies required the inclusion of caregiver costs and/or utilities within the base case, when relevant: England (NICE), Canada (CDA-AMC and INESSS), Sweden (TLV), Netherlands (ZiN), France (HAS), and Scotland (SMC). However, only three (CDA-AMC, TLV, and ZiN) provided detailed methodological guidance on how caregiver burden should be included within the economic model. Further investigation on the appraisals conducted by the seven agencies will be conducted to understand if and how caregiver cost and utility were incorporated within economic models for neurological products. Results from this review of neurological product appraisals will be presented at the conference.
CONCLUSIONS: The evidence presented herein suggests that while HTA guidance documents encourage the inclusion of caregiver burden within economic models, the application and depth of methodological guidance on how to include caregiver cost and utility varies among agencies and within neurological product appraisals.
METHODS: Guidance documents of key HTA agencies (England, Scotland, Canada, Australia, Sweden, Denmark, Norway, France, Netherlands, Italy, Japan, and China) published in the last five years were reviewed. The review evaluated guidance regarding the inclusion of caregiver costs and utilities, whether in the base case or in scenario analyses, along with the recommended methods for incorporating these elements. Once the broader assessment was completed, relevant HTA agencies were selected to assess the number of appraisals including caregiver burden in the economic model and the specific methodology utilized.
RESULTS: From the review of HTA guidance documents, seven agencies required the inclusion of caregiver costs and/or utilities within the base case, when relevant: England (NICE), Canada (CDA-AMC and INESSS), Sweden (TLV), Netherlands (ZiN), France (HAS), and Scotland (SMC). However, only three (CDA-AMC, TLV, and ZiN) provided detailed methodological guidance on how caregiver burden should be included within the economic model. Further investigation on the appraisals conducted by the seven agencies will be conducted to understand if and how caregiver cost and utility were incorporated within economic models for neurological products. Results from this review of neurological product appraisals will be presented at the conference.
CONCLUSIONS: The evidence presented herein suggests that while HTA guidance documents encourage the inclusion of caregiver burden within economic models, the application and depth of methodological guidance on how to include caregiver cost and utility varies among agencies and within neurological product appraisals.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
SA33
Topic
Study Approaches
Topic Subcategory
Literature Review & Synthesis
Disease
SDC: Neurological Disorders