Including carer health-related quality of life in NICE health technology assessments in the United Kingdom.

IF 3 3区 医学 Q2 HEALTH POLICY & SERVICES Health Economics Policy and Law Pub Date : 2024-10-08 DOI:10.1017/S1744133124000124
Tim A Kanters, Valérie van Hezik-Wester, Andy Boateng, Holly Cranmer, Ingelin Kvamme, Irene Santi, Hareth Al-Janabi, Job van Exel
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Abstract

The impact of health technologies may extend beyond the patient and affect the health of people in their network, like their informal carers. The National Institute for Health and Care Excellence (NICE) methods guide explicitly allows the inclusion of health-related quality of life (HRQoL) effects on carers in economic evaluations when these effects are substantial, but the proportion of NICE appraisals that includes carer HRQoL remains small. This paper discusses when inclusion of carer HRQoL is justified, how inclusion can be substantiated, and how carer HRQoL can be measured and included in health economic models. Inclusion of HRQoL in economic evaluations can best be substantiated by data collected in (carers for) patients eligible for receiving the intervention. To facilitate combining patient and carer utilities on the benefit side of economic evaluations, using EQ-5D to measure impacts on carers seems the most successful strategy in the UK context. Alternatives to primary data collection of EQ-5D include vignette studies, using existing values, and mapping algorithms. Carer HRQoL was most often incorporated in economic models in NICE appraisals by employing (dis)utilities as a function of the patient's health state or disease severity. For consistency and comparability, economic evaluations including carer HRQoL should present analyses with and without carer HRQoL.

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将护理人员与健康相关的生活质量纳入英国 NICE 健康技术评估。
医疗技术的影响可能会超出患者的范围,影响到患者网络中的人的健康,比如他们的非正式照顾者。美国国家健康与护理卓越研究所(NICE)的方法指南明确规定,如果对护理者的健康相关生活质量(HRQoL)影响很大,则允许将这些影响纳入经济评估中,但纳入护理者 HRQoL 的 NICE 评估比例仍然很小。本文将讨论何时有理由纳入护工 HRQoL、如何证明纳入的合理性,以及如何测量护工 HRQoL 并将其纳入健康经济模型。将 HRQoL 纳入经济评价的最佳方法是收集符合干预条件的患者(护理者)的数据。为了便于在经济评价中将患者和护理者的效用结合起来,在英国,使用 EQ-5D 来衡量对护理者的影响似乎是最成功的策略。EQ-5D 原始数据收集的替代方法包括小故事研究、使用现有数值和映射算法。在 NICE 评估中,照护者 HRQoL 最常被纳入经济模型中,方法是将效用作为患者健康状况或疾病严重程度的函数。为了保持一致性和可比性,包含护工 HRQoL 的经济评估应提供有护工 HRQoL 和无护工 HRQoL 的分析。
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来源期刊
Health Economics Policy and Law
Health Economics Policy and Law HEALTH POLICY & SERVICES-
CiteScore
5.30
自引率
0.00%
发文量
55
期刊介绍: International trends highlight the confluence of economics, politics and legal considerations in the health policy process. Health Economics, Policy and Law serves as a forum for scholarship on health policy issues from these perspectives, and is of use to academics, policy makers and health care managers and professionals. HEPL is international in scope, publishes both theoretical and applied work, and contains articles on all aspects of health policy. Considerable emphasis is placed on rigorous conceptual development and analysis, and on the presentation of empirical evidence that is relevant to the policy process.
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