Inclusion of Environmental Spillovers in Applied Economic Evaluations of Healthcare Products

Desterbecq, Charlotte; Tubeuf, Sandy

doi:10.1016/j.jval.2023.03.008

Cited by 12 publications

(3 citation statements)

References 64 publications

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“…Furthermore, assessments of the carbon footprint of healthcare services are increasingly available in the literature [128][129][130]. In the context of health economic evaluations, Desterbecq and Tubeuf [131] document studies that have incorporated environmental costs as an additional cost component. These costs represent spillovers, according to our definition.…”

Section: Environmentmentioning

confidence: 99%

On spillovers in economic evaluations: definition, mapping review and research agenda

Mendoza-Jiménez,

van Exel,

Brouwer

2024

Eur J Health Econ

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An important issue in economic evaluations is determining whether all relevant impacts are considered, given the perspective chosen for the analysis. Acknowledging that patients are not isolated individuals has important implications in this context. Increasingly, the term “spillovers” is used to label consequences of health interventions on others. However, a clear definition of spillovers is lacking, and as a result, the scope of the concept remains unclear. In this study, we aim to clarify the concept of spillovers by proposing a definition applicable in health economic evaluations. To illustrate the implications of this definition, we highlight the diversity of potential spillovers through an expanded impact inventory and conduct a mapping review that outlines the evidence base for the different types of spillovers. In the context of economic evaluations of health interventions, we define spillovers as all impacts from an intervention on all parties or entities other than the users of the intervention under evaluation. This definition encompasses a broader range of potential costs and effects, beyond informal caregivers and family members. The expanded impact inventory enables a systematic approach to identifying broader impacts of health interventions. The mapping review shows that the relevance of different types of spillovers is context-specific. Some spillovers are regularly included in economic evaluations, although not always recognised as such, while others are not. A consistent use of the term “spillovers”, improved measurement of these costs and effects, and increased transparency in reporting them are still necessary. To that end, we propose a research agenda.

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Section: Environmentmentioning

confidence: 99%

On spillovers in economic evaluations: definition, mapping review and research agenda

Mendoza-Jiménez,

van Exel,

Brouwer

2024

Eur J Health Econ

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“…While much of the focus on "sustainability" has understandably been driven by recognition of the increasingly urgent need for action on decarbonization and climate change, most strategies clearly recognize the importance of other aspects of environmental sustainability beyond climate change (3) and the broad-spectrum ecological crisis that now sees human impacts pushing outside the safe operating spaces for six out of nine "planetary boundaries" (4). Unsurprisingly, health technology assessment (HTA) agencies, researchers, and industry have also become increasingly interested in these sustainability challenges and in whether and how best to incorporate them within HTA processes (5)(6)(7)(8). Yet much of the discussion of how to include environmental impacts within HTA evaluation has tended to move very quickly to methodological issues (e.g.…”

Section: Introductionmentioning

confidence: 99%

Health technology assessment and healthcare environmental sustainability: Prioritizing effort and maximizing impact

Hensher

2024

Int J Technol Assess Health Care

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The growing global focus on and sense of urgency toward improving healthcare environmental sustainability and moving to low-carbon and resilient healthcare systems is increasingly mirrored in discussions of the role of health technology assessment (HTA). This Perspective considers how HTA can most effectively contribute to these goals and where other policy tools may be more effective in driving sustainability, especially given the highly limited pool of resources available to conduct environmental assessments within HTA. It suggests that HTA might most productively focus on assessing those technologies that have intrinsic characteristics which may cause specific environmental harms or vulnerabilities, while the generic environmental impacts of most other products may be better addressed through other policy and regulatory mechanisms.

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“…Desterbecq et al provide a summary of environmental impacts of various disease areas and healthcare products. 9 The number of studies included in their review increased from 1 in 2004 to 10 in 2022. Several studies were carried out on vaccine preventable disease including pertussis, influenza, respiratory syncytial virus and COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Herpes zoster in older adults: Impact on carbon footprint in the United States

Curran,

Bitetti,

Catterall

et al. 2024

Human Vaccines & Immunotherapeutics

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We provide estimates for (I) annual herpes zoster (HZ) cases, (II) carbon costs related to healthcare utilization, and (III) annual carbon emissions due to HZ among ≥50 years of age (YOA) United States (US) population. We estimated the annual number of HZ cases in the US based on available incidence data and demographic data of individuals ≥50 YOA. Both the healthcare resource utilization (HCRU) associated with HZ cases and the unit carbon dioxide equivalent (i.e. CO 2 e) costs associated with each type of HCRU in the US were estimated based on literature and studies available online. The carbon footprint associated with HZ annually among US adults ≥50 YOA was estimated by multiplying the unit carbon estimates by the HCRU. In the US population aged ≥50 YOA in 2020 (i.e. approximately 118 million), approximately 1.1 million cases of HZ occur annually assuming no vaccination. Based on 2 sources of HCRU the average kgCO 2 e per HZ patient ranged from 61.0 to 97.6 kgCO 2 e, with values by age group ranging from 40.9 kgCO 2 e in patients aged 50–59 to 195.9 kgCO 2 e in patients ≥80 YOA. The total annual HZ associated carbon ranged between 67,000 and 107,000 tons of CO 2 e in the US population aged ≥50 YOA. The impact of HZ on carbon footprint in the US results in considerable greenhouse gas (GHG)emissions. Assuming no vaccination, the burden of HZ is projected to rise over the coming years with the aging populations consequently worsening its impact on GHG emissions. (Figure 1)

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Inclusion of Environmental Spillovers in Applied Economic Evaluations of Healthcare Products

Cited by 12 publications

References 64 publications

On spillovers in economic evaluations: definition, mapping review and research agenda

On spillovers in economic evaluations: definition, mapping review and research agenda

Health technology assessment and healthcare environmental sustainability: Prioritizing effort and maximizing impact

Herpes zoster in older adults: Impact on carbon footprint in the United States

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