Incorporating Carer Effects into Economic Evaluation

摘要: Background: Despite great interest in the development of methods used economic evaluation health technologies, effects carer costs and quality life (QOL) on cost effectiveness treatments has not been widely explored. Yet are clearly evident literature relevant to perspective many published evaluations. Objective: To examine whether patient QOL is associated with time QOL. Methods: We two datasets investigate effects. Firstly, we 40 312 cases from Health Outcomes Data Repository (HODaR) assess relationship between utility, using EuroQoL (EQ)-5D, number days care needed friends relatives. The stability across subgroups was assessed by replicating analysis ten disease groups. Secondly, 64 a study patients Alzheimer's their primary carer. These data allowed us estimate relationships EQ-5D, utility burden Community Dementia Quality Life Profile (CDQLP). Results: For time, linear model showed that each 0.1-point reduction 2.5-day increase over 6-week period. A more general model, based EQ-5D domain scores, better specified decreased functioning within increased time. Problems self-care usual activities have greatest impact models do appear be stable different low explanatory power poorly specified. clearer shown such when sociodemographic covariates introduced, reaches conventional levels statistical significance (p < 0.05). Conclusions: preliminary work described here shows improving may reduce need for improve QOL. Incorporating into evaluations will change cost-per-QALY estimates, size dependent domains affected treatment. Clinical studies capture so can understand these effects, how they evaluation.