Modelling Informal Carers' Health-Related Quality of Life: Challenges for Economic Evaluation.

Area of Science:

• Health economics
• Decision science
• Patient-reported outcomes

Background:

• Carers' health-related quality of life (HRQoL) is increasingly recognized as important in healthcare decision models.
• Current models often predict carer HRQoL based on patient health states, potentially oversimplifying complex influences.
• There is a lack of standardized guidance for incorporating carer HRQoL into economic evaluations.

Approach:

• Identifies and discusses key challenges in modeling intervention effects on carer HRQoL.
• Examines issues such as utility assignment, network size, aggregation of outcomes, patient mortality, and long-term effects.
• Reviews and critiques alternative methods like trial-based analyses, qualitative approaches, cost-consequence analysis, and multicriteria decision analysis.

Key Points:

• Predicting carer HRQoL solely from patient health states may not capture the full picture.
• Specific modeling challenges include linking carer utilities to patient disease states and accounting for patient death.
• Alternative methods for incorporating carer HRQoL have their own limitations and complexities.

Conclusions:

• A framework is proposed to guide the consideration and addressing of challenges in modeling carer HRQoL.
• Highlights the need for improved methods to accurately reflect carer outcomes in decision models.
• Suggests avenues for current practice improvements and future research in this area.