ArticlePharmacoEconomics2023
Modelling Spillover Effects on Informal Carers: The Carer QALY Trap.
Article in PharmacoEconomics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Pooled it
- A Systematic Review of Methods and Practice for Integrating Maternal, Fetal, and Child Health Outcomes, and Family Spillover Effects into Cost-Utility Analyses.PharmacoEconomics · 2024Pooled it
- Spillover Effects of Medical Innovations: A Universal and Scalable Approach to Measure the Societal Value of Avoided Informal Care Time.Applied health economics and health policy · 2026Article
- Recommendations for the use of clinical outcome assessments in rare disease drug development.EClinicalMedicine · 2026Review
- Economic Evaluation of Interventions for Children with Neurodevelopmental Disorders: Practical Guidance.PharmacoEconomics · 2026Review
- The broad societal value of pembrolizumab for women's cancer in Canada.Future oncology (London, England) · 2026Article
- Measuring and valuing spillover effects in caregivers and families: A scoping review.PloS one · 2026Article
- Caring for and Caring about in Economic Evaluation: Modelling the Family and Caregiving Effects.PharmacoEconomics · 2026Article
- Economic Consequences of Increasing the NICE Cost-Effectiveness Threshold.PharmacoEconomics · 2026Article
- Carer Health-Related Quality of Life: A Review of Modelling Considerations in National Institute for Health and Care Excellence Technology Appraisals (2000-2023).PharmacoEconomics - open · 2025Article
- Does the Informal Carer Identification Method Matter? Evidence from Self-Declaration and Time Diary Approaches.PharmacoEconomics · 2025Article
- Understanding the health-related quality of life impacts of caring for children and adolescents with rare progressive life-limiting conditions: key challenges and future research priorities.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- How Does Bereavement Affect the Health-Related Quality of Life of Household Members Who Do and Do Not Provide Unpaid Care? Difference-in-Differences Analyses Using the UK Household Longitudinal Survey.PharmacoEconomics · 2025Article
- Food for thought: more explicit guidance for inclusion of caregiver perspectives in health technology assessment.International journal of technology assessment in health care · 2024Article
- Could or Should We Use Cost-Effectiveness Thresholds in the French Value-Based Pricing Process for New Drugs?PharmacoEconomics · 2024Article
- Economic Evaluations of Treatments for Duchenne Muscular Dystrophy: The Caregiver QALY Trap.PharmacoEconomics · 2024Article
Corrections and comments
- Commented on by
Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The provision of informal (unpaid) care can impose significant 'spillover effects' on carers, and accounting for these effects is consistent with the efficiency and equity objectives of health technology assessment (HTA). Inclusion of these effects in health economic models, particularly carer health-related quality of life (QOL), can have a substantial impact on net quality-adjusted life year (QALY) gains and the relative cost effectiveness of new technologies. Typically, consideration of spillover effects improves the value of a technology, but in some circumstances, consideration of spillover effects can lead to situations whereby life-extending treatments for patients may be considered cost ineffective due to their impact on carer QOL. In this piece we revisit the classic 'QALY trap' and introduce an analogous 'carer QALY trap' which may have practical implications for economic evaluations where the inclusion of carer QOL reduces incremental QALY gains. Such results may align with a strict QALY-maximisation rule, however we consider the extent to which this principle may be at odds with the preferences of carers themselves (and possibly society more broadly), potentially leading decision makers into the carer QALY trap as a result. We subsequently reflect on potential solutions, highlighting the important (albeit limited) role that deliberation has to play in HTA.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.