SHEER: Good practices for incorporating family and caregiver spillovers into health economic evaluations

Illnesses impact not only the patients, but oftentimes impact caregivers and family members as well. However, most economic analyses do not incorporate a diseases’ spillover impacts on caregivers.

…a recent review of NICE evaluations revealed that only 3% of technology appraisals included caregiver health-related quality of life (HRQoL) in cost-utility analyses (CUAs). Similarly, Lamsal [2022] found that of 139 CUAs of maternal-perinatal treatments or programmes, 38 (27%) included health outcomes of the mother and child in analyses, and of 747 paediatric CUAs, 20 (3%) accounted for family health spillover effects. This tendency toward omission was also observed by Scope et al. [2022] who reported just 40 of all identified CUAs of patient interventions incorporating family member quality-adjusted life-years (QALYs). 

To address this issue, the Spillovers in Health Economic Evaluation and Research (SHEER) task force was convened to identify good practices for measuring disease spillovers onto caregivers within health economic anlysis. As described in Henry et al. (2024),the task force defined these spillovers as follows:

…Family and caregiver health spillovers, in the context of CEA, consist of the impact of an individual’s health status on family members’ and/or caregivers’ HRQoL, both positive and negative.

The specific recommendations provided by the SHEER task force are shown below.

https://link.springer.com/article/10.1007/s40273-023-01321-3

The paper describes each recommendation in more detail and also lists a number of areas for future research. You can read the full paper here.