How to Include Informal Care in Economic Evaluations

Abstract

Economic evaluations of health interventions aim to support decision making in healthcare. To effectively do so, evaluations need to include all relevant costs and effects of an intervention. Informal care provided by family or friends is an important element of care for many patients, but can have a profound impact on the health and well-being of carers. Therefore, informal care should be considered in economic evaluations of health interventions. Different methods to do so exist. This paper provides an overview of state-of-the-art methods available for this purpose, illustrated with practical examples. Since the choice of measurement and valuation technique depends on the type and perspective of the economic evaluation, this paper supports researchers in choosing the appropriate techniques to include informal care in their economic evaluation of a health intervention. We discuss the different approaches to measuring and valuing informal care, covering both partial and full valuation methods, allowing inclusion as costs or effects.

Costs in different states of prostate cancer

“…in fact, ignoring productivity costs may have a large effect on the outcome of evaluation, and may even be decisive in considering whether an intervention can be considered cost-effective or not [21]. This may also be true in the case of informal care [22]. our results support this, and highlight the importance of taking all cost elements into consideration, especially if an evaluation is meant to be performed from a societal perspective.…”

“…in the proxy good method the value per hour is based on the shadow price of a market substitute. This provides valuable insight into the costs of replacing informal care with formal care [7].…”

From Good to Better: New Dutch Guidelines for Economic Evaluations in Healthcare

“…Several methods for measuring, valuing and including these costs exist [8], but the current guidelines suggest they should be included on the cost side of the economic evaluation. This facilitates their inclusion in the most common type of economic evaluation: cost-utility analysis.…”

Cuestiones controvertidas en evaluación económica (I): perspectiva y costes de intervenciones sanitarias

“…Finalmente, al plantearse si alguna de las metodologías de estimación de los costes de cuidados informales podría ser la más adecuada en todas las circunstancias o, alternativamente, qué ventajas e inconvenientes podían ser señalados en cada caso 16,19 , el método del coste de oportunidad fue calificado como sencillo de implementar y se resaltó su grado de objetividad, facilitando la comparabilidad entre estudios. No obstante, también se apuntó que la incertidumbre puede tener mucho peso en la estimación de los costes informales mediante este método.…”

“…En el caso de los cuidados informales, al ser menos conocidos que los anteriores, una prioridad es generar más información sobre su relevancia en estudios de coste de la enfermedad y a través de su incorporación en las evaluaciones económicas 19 . Existe un amplio recorrido investigador en el campo de los cuidados informales, del cual la valoración del tiempo de cuidado es sólo una parte 19 .…”