Abstract

We thank the Letter to the Editor author for their thoughtful commentary on our recently published article in Value in Health. Their 3 constructive suggestions will enhance the application of our findings in both economic evaluations and clinical practice.

Regarding the first point, we strongly agree that a dynamic, time-varying framework is essential for modeling caregiver spillovers. We particularly appreciate their emphasis on anticipatory grief, which represents an important but often underexamined component of the grief trajectory. Although our survey did not capture anticipatory grief outcomes, we explored this topic in our accompanying qualitative study,² in which parents frequently described experiencing grief beginning at the time of their child’s diagnosis. Future longitudinal research that follows families from diagnosis through bereavement would be valuable to characterize these dynamic stages of grief more fully and to assess how their initiation, intensity, and duration vary across family, clinical, and contextual factors.