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How to Include Informal Care in Economic Evaluations

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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.

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Notes

  1. An informal carer is defined here as a person who provides care and support to a family member, friend, or acquaintance with a chronic illness, disability, or other long-lasting care need due to ill health or aging. Informal care is typically provided on a voluntary basis, arising from a prior social relationship, and without financial compensation or specific training. This definition combines several aspects from descriptions of informal care in the literature (e.g., Colombo et al. [4, Hoefman et al. 30, and Al-Janabi et al. 101], Hoefman et al. [4, 30, 101], and Al-Janabi et al. [4, 30, 101]).

  2. These methods can also partially value informal care, depending on the valuation exercise, e.g., when a willingness-to-pay question specifically excludes health or labor participation effects, the valuation is clearly partial when such effects do occur.

  3. Values are in 2012 euros. Values in euros before 2012 can be converted to 2012 euros by multiplying with the annual average rates of change in harmonized indices of consumer prices (HICPs) [102]. Currencies other than euros were first converted with historical currency rates.

  4. In these experiments, only the number of hours per week change; all other things, such as the recipient’s need for care, are assumed to remain equal in order to avoid contamination of values with other aspects (such as the health of the patient).

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RH drafted the manuscript. JE and WB provided comments to draft versions of the manuscript. WB supervised the project. All authors read and approved the final manuscript.

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  1. Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands

    Renske J. Hoefman, Job van Exel & Werner Brouwer

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  1. Renske J. Hoefman
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Hoefman, R.J., van Exel, J. & Brouwer, W. How to Include Informal Care in Economic Evaluations. PharmacoEconomics 31, 1105–1119 (2013). https://doi.org/10.1007/s40273-013-0104-z

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