Estimating the Family Spillover Effects of Cardiovascular Diseases: Evidence from the Medical Expenditure Panel Survey
Author(s)
Ruixi Yu, MA1, Suning Zhao, MPH1, Fangli Geng, PhD2, Boshen Jiao, MPH, PhD1;
1University of Southern California, Department of Pharmaceutical and Health Economics, Alfred E. Mann School of Pharmacy, Los Angeles, CA, USA, 2Brown University, School of Public Health, Providence, RI, USA
1University of Southern California, Department of Pharmaceutical and Health Economics, Alfred E. Mann School of Pharmacy, Los Angeles, CA, USA, 2Brown University, School of Public Health, Providence, RI, USA
Presentation Documents
OBJECTIVES: Cardiovascular diseases (CVD) impose significant burdens not only on patients but also on the health-related quality of life (HRQoL) of their family members, driven by emotional stress and caregiving responsibilities. Medical interventions that reduce this burden could help mitigate these spillover effects. However, the absence of systematic data on these impacts often leads to their exclusion from cost-effectiveness analyses (CEAs), potentially underestimating the full value of CVD interventions. This study aims to develop a catalog of estimates quantifying the impact of CVD on family members’ HRQoL.
METHODS: Using data from the 2008-2019 Medical Expenditure Panel Survey, we identified CVD patients based on ICD-9/10 codes, including myocardial infarction, heart failure, ischemic stroke, angina pectoris, cardiac dysrhythmias, and peripheral artery disease. Families without CVD patients served as a control group. HRQoL was measured using EQ-5D utility values derived through the time trade-off method. A zero-one inflated beta regression model was employed to assess the association between family members’ HRQoL, CVD status, patients’ EQ-5D scores, and age, adjusting for sociodemographic characteristics. Leveraging the fitted model, we generated predictions of family HRQoL loss across different levels of patients’ HRQoL loss and age.
RESULTS: Family members of CVD patients had a mean EQ-5D utility score 0.021 (95% CI: [0.019, 0.023]) lower than the control group. The impact ranged from a 0.039 loss in family members for a 0.1 decrement in patients’ utility to a 0.219 loss for a full 1.0 decrement. Although this effect generally increased with patient age, family members of patients under 30 years old experienced disproportionately larger impacts.
CONCLUSIONS: This study provides a catalog of estimates to facilitate the integration of family spillover effects related to CVD into CEA, allowing for a more accurate assessment of the societal value of interventions aimed at reducing its burden.
METHODS: Using data from the 2008-2019 Medical Expenditure Panel Survey, we identified CVD patients based on ICD-9/10 codes, including myocardial infarction, heart failure, ischemic stroke, angina pectoris, cardiac dysrhythmias, and peripheral artery disease. Families without CVD patients served as a control group. HRQoL was measured using EQ-5D utility values derived through the time trade-off method. A zero-one inflated beta regression model was employed to assess the association between family members’ HRQoL, CVD status, patients’ EQ-5D scores, and age, adjusting for sociodemographic characteristics. Leveraging the fitted model, we generated predictions of family HRQoL loss across different levels of patients’ HRQoL loss and age.
RESULTS: Family members of CVD patients had a mean EQ-5D utility score 0.021 (95% CI: [0.019, 0.023]) lower than the control group. The impact ranged from a 0.039 loss in family members for a 0.1 decrement in patients’ utility to a 0.219 loss for a full 1.0 decrement. Although this effect generally increased with patient age, family members of patients under 30 years old experienced disproportionately larger impacts.
CONCLUSIONS: This study provides a catalog of estimates to facilitate the integration of family spillover effects related to CVD into CEA, allowing for a more accurate assessment of the societal value of interventions aimed at reducing its burden.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE403
Topic
Economic Evaluation
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)