Family Spillover Effects in Pediatric Cost-Utility Analyses

Lavelle, Tara A.; D’Cruz, Brittany; Mohit, Babak; Ungar, Wendy J.; Prosser, Lisa A.; Tsiplova, Kate; Vera-Llonch, Montserrat; Lin, Pei‐Jung

doi:10.1007/s40258-018-0436-0

Cited by 51 publications

(52 citation statements)

References 61 publications

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“…However, an important health consequence—spillover health effects on family members and informal caregivers of patients, which might be considered irrespective of the perspective chosen—is also often omitted [ 55 ]. For example, CEAs of interventions for Alzheimer’s disease or a pediatric population are more likely to include both types of spillover effects than the overall literature, but spillover health effects were considered substantially less often than spillover costs [ 56 , 57 ]. Recent advances in methodology and applications for measuring and valuing spillover effects have provided a set of useful resources for analysts to incorporate the spillover effects into CEAs from both a healthcare sector and a societal perspective [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Perspective and Costing in Cost-Effectiveness Analysis, 1974–2018

et al. 2020

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Objective Our objective was to examine perspective and costing approaches used in cost-effectiveness analyses (CEAs) and the distribution of reported incremental cost-effectiveness ratios (ICERs). Methods We analyzed the Tufts Medical Center’s CEA and Global Health CEA registries, containing 6907 cost-per-quality-adjusted-life-year (QALY) and 698 cost-per-disability-adjusted-life-year (DALY) studies published through 2018. We examined how often published CEAs included non-health consequences and their impact on ICERs. We also reviewed 45 country-specific guidelines to examine recommended analytic perspectives. Results Study authors often mis-specified or did not clearly state the perspective used. After re-classification by registry reviewers, a healthcare sector or payer perspective was most prevalent (74%). CEAs rarely included unrelated medical costs and impacts on non-healthcare sectors. The most common non-health consequence included was productivity loss in the cost-per-QALY studies (12%) and patient transportation in the cost-per-DALY studies (21%). Of 19,946 cost-per-QALY ratios, the median ICER was $US26,000/QALY (interquartile range [IQR] 2900–110,000), and 18% were cost saving and QALY increasing. Of 5572 cost-per-DALY ratios, the median ICER was $US430/DALY (IQR 67–3400), and 8% were cost saving and DALY averting. Based on 16 cost-per-QALY studies (2017–2018) reporting 68 ICERs from both the healthcare sector and societal perspectives, the median ICER from a societal perspective ($US22,710/QALY [IQR 11,991–49,603]) was more favorable than from a healthcare sector perspective ($US30,402/QALY [IQR 10,486–77,179]). Most governmental guidelines (67%) recommended either a healthcare sector or a payer perspective. Conclusion Researchers should justify and be transparent about their choice of perspective and costing approaches. The use of the impact inventory and reporting of disaggregate outcomes can reduce inconsistencies and confusion.

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Section: Discussionmentioning

confidence: 99%

Perspective and Costing in Cost-Effectiveness Analysis, 1974–2018

et al. 2020

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“…Our study further demonstrates the potential spillover effects experienced by caregivers of young children with food allergies. In pediatric economic evaluations, incorporating family spillover effects and health outcomes is substantial and makes health interventions more cost‐effective 26 . In the case of food allergy, our panel rated parental anxiety as an important psychological consideration.…”

Section: Discussionmentioning

confidence: 99%

Food allergy treatment value: Child caregiver and patient perspectives

Abdelwadoud

Eftekhari

Jaffee

et al. 2021

Pediatric Allergy Immunology

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Background Food allergy is a major health problem that significantly impacts quality of life (QoL). There is growing focus to evaluate food allergy‐related QoL and treatment options’ value beyond the clinical effectiveness perspective by engaging patients and caregivers. We aimed to identify and prioritize outcomes important to food allergy parents of children and patients allergic to milk, egg, and/or peanut, to guide comparative effectiveness research (CER) that focuses on evaluating food allergy treatment decisions. Methods We conducted a modified 3‐round Delphi study to identify and derive consensus on priority treatment outcomes for parents of children and adult patients with diagnosed allergies to at least one of three major allergenic foods (milk, egg, and peanut) from across the United States. Results Round 1 yielded 44 statements for round 2, and 39 statements reached the agreement level for round 3 ranking. Statements were organized under 4 sections: 1) food allergy problems, 2) treatment experiences, 3) important treatment outcomes, and 4) value of different treatment options. Conclusion Food allergy parents and patients face several social, psychological, medical, healthcare, financial, food selection, and awareness challenges. The areas of consensus on important treatment outcomes revealed shared priority for reducing the risk of potentially fatal allergic reactions and having reliable treatments. The most valued treatment options reflect hope for permanent cure and fear of serious allergic reactions.

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“…17,24 This registry uses an algorithm that has been launched on Medline to retrieve references of economic evaluations. Other authors have used this database, [25][26][27] and more details about the registry are provided on the website of the Tufts Medical Centre. 28…”

Section: Methodsmentioning

confidence: 99%