FAMILY SPILLOVER EFFECTS IN PHARMACOECONOMIC EVALUATION: A SYSTEMATIC REVIEW OF INTERNATIONAL GUIDELINES
Author(s)
Yuyanzi Zhang, BS,PhD student1, CHEN JIANG, MSc1, ZHANG RUI, MS2, Xin Guan, PhD1, Hongchao Li, MSc, PhD1, Luying Wang, BS, MS, PhD1.
1China Pharmaceutical University, Nanjing, China, 2China Pharmaceutical University, Nanjing, China.
1China Pharmaceutical University, Nanjing, China, 2China Pharmaceutical University, Nanjing, China.
OBJECTIVES: To systematically review the requirements related to family spillover effects in pharmacoeconomic and health technology assessment guidelines across countries or regions worldwide.
METHODS: The scope of guidelines was informed by published guideline review studies and the ISPOR 2020 Global Pharmacoeconomic Guidelines Directory, with supplementary updates. Data extraction included mandatory status of inclusion, perspective, types of spillover costs, caregiver health outcomes, methods for integrating caregiver and patient outcomes, and sensitivity analysis requirements. A descriptive comparative analysis was employed to summarize and compare the relevant provisions across guidelines.
RESULTS: A total of 60 guidelines from countries or regions were included, of which 43 (71.7%) mentioned family spillover effects. Regarding the mandatory status of inclusion, 9 (20.9%) explicitly required the inclusion of caregiver costs or health outcomes in the base-case analysis, 14 (32.6%) recommended or permitted inclusion, and 20 (46.5%) required inclusion under restricted conditions (e.g., supplementary or scenario analyses only). In terms of study perspective, 33 (76.7%) mentioned a societal perspective (with some guidelines mentioning multiple perspectives), while the remainder involved healthcare system (n=3), payer (n=5), or patient/family (n=4) perspectives. For spillover costs, indirect costs (e.g., caregiver productivity loss) were most common, followed by direct non-medical costs, while few guidelines addressed direct medical costs[Lulu1] for family caregivers. Ten guidelines specified cost integration methods, either incorporating caregiver costs directly into total costs or presenting them separately. On spillover health outcomes, 20 guidelines mentioned caregiver HRQoL or QALYs, with most requiring or permitting their inclusion in supplementary, scenario, or sensitivity analyses. Only 7 guidelines (16.3%) explicitly required sensitivity analyses for caregiver health outcomes or costs.
CONCLUSIONS: Although the majority of guidelines mentioned family spillover effects, few provided detailed and explicit specifications across study perspective, spillover costs, health outcomes, integration methods, and sensitivity analyses, and substantial heterogeneity exists in the specific requirements across guidelines.
METHODS: The scope of guidelines was informed by published guideline review studies and the ISPOR 2020 Global Pharmacoeconomic Guidelines Directory, with supplementary updates. Data extraction included mandatory status of inclusion, perspective, types of spillover costs, caregiver health outcomes, methods for integrating caregiver and patient outcomes, and sensitivity analysis requirements. A descriptive comparative analysis was employed to summarize and compare the relevant provisions across guidelines.
RESULTS: A total of 60 guidelines from countries or regions were included, of which 43 (71.7%) mentioned family spillover effects. Regarding the mandatory status of inclusion, 9 (20.9%) explicitly required the inclusion of caregiver costs or health outcomes in the base-case analysis, 14 (32.6%) recommended or permitted inclusion, and 20 (46.5%) required inclusion under restricted conditions (e.g., supplementary or scenario analyses only). In terms of study perspective, 33 (76.7%) mentioned a societal perspective (with some guidelines mentioning multiple perspectives), while the remainder involved healthcare system (n=3), payer (n=5), or patient/family (n=4) perspectives. For spillover costs, indirect costs (e.g., caregiver productivity loss) were most common, followed by direct non-medical costs, while few guidelines addressed direct medical costs[Lulu1] for family caregivers. Ten guidelines specified cost integration methods, either incorporating caregiver costs directly into total costs or presenting them separately. On spillover health outcomes, 20 guidelines mentioned caregiver HRQoL or QALYs, with most requiring or permitting their inclusion in supplementary, scenario, or sensitivity analyses. Only 7 guidelines (16.3%) explicitly required sensitivity analyses for caregiver health outcomes or costs.
CONCLUSIONS: Although the majority of guidelines mentioned family spillover effects, few provided detailed and explicit specifications across study perspective, spillover costs, health outcomes, integration methods, and sensitivity analyses, and substantial heterogeneity exists in the specific requirements across guidelines.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE766
Topic
Economic Evaluation, Health Technology Assessment
Topic Subcategory
Novel & Social Elements of Value, Work & Home Productivity - Indirect Costs
Disease
No Additional Disease & Conditions/Specialized Treatment Areas