IDEAS home Printed from https://ideas.repec.org/p/lee/wpaper/1803.html
   My bibliography  Save this paper

Family health spillovers in cost-effectiveness analysis: Evidence from self-harming adolescents in England

Author

Listed:
  • Sandy Tubeuf

    (Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds)

  • Eirini-Christina Saloniki

    (Centre for Health Services Studies and PSSRU, University of Kent, UK)

  • David Cottrell

    (Leeds Institute of Health Sciences, University of Leeds, United Kingdom (UK))

Abstract

Objective - This paper presents alternative spillover quantification methods in the context of a randomised controlled trial comparing family therapy with treatment as usual as an intervention for self-harming adolescents, and discusses the practical limitations of those methods. Methods - The trial followed a sample of 754 participants aged 11 to 17 years. Health utilities are measured using answers to EQ-5D-3L for the adolescent and to HUI2 for one parent at baseline, 6 and 12 months. We use regression analyses to evaluate the association between parent’s and adolescent’s health utilities, controlling for additional health assessment for the adolescent, type and number of self-harm events as well as variables for both the adolescent and the parent. Cost-effectiveness over a 12-month period is presented using mean incremental cost-effectiveness ratios. Results - We find that the parent’s health utility increased over the duration of the trial and is significantly and positively associated with adolescent’s health utility at 6 and 12 months only. When considering adolescents’ health gain only, the ICER is £45,330 per QALY. When including health spillovers to one parent, the ICERs estimates range from £33,690 per QALY to £45,330 per QALY and can also be a dominated option depending on the quantification method used. Conclusion - We argue that the use of a single disutility value for any parent denies the heterogeneity observed in parents of self-harming adolescents and ignores the QALY gain of parents over the duration of the trial. We demonstrate how adding QALY gains for both the adolescent and the parent might also lead to a dilemma of judging an intervention costeffective when it benefits the rest of the family but not the patient. We finally propose the use of a household welfare function along with an equivalence scale to measure health spillover for cost-effectiveness analysis.

Suggested Citation

  • Sandy Tubeuf & Eirini-Christina Saloniki & David Cottrell, 2018. "Family health spillovers in cost-effectiveness analysis: Evidence from self-harming adolescents in England," Working Papers 1803, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
  • Handle: RePEc:lee:wpaper:1803
    as

    Download full text from publisher

    File URL: http://medhealth.leeds.ac.uk/download/4085/auhe_wp1803
    File Function: First version, 2011
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Hareth Al‐Janabi & Job Van Exel & Werner Brouwer & Caroline Trotter & Linda Glennie & Laurie Hannigan & Joanna Coast, 2016. "Measuring Health Spillovers for Economic Evaluation: A Case Study in Meningitis," Health Economics, John Wiley & Sons, Ltd., vol. 25(12), pages 1529-1544, December.
    2. Yemi Oluboyede & Sandy Tubeuf & Chris McCabe, 2013. "Measuring health outcomes of adolescents: report from a pilot study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 11-19, February.
    3. Hareth Al-Janabi & Job van Exel & Werner Brouwer & Joanna Coast, 2016. "A Framework for Including Family Health Spillovers in Economic Evaluation," Medical Decision Making, , vol. 36(2), pages 176-186, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 15th October 2018
      by Chris Sampson in The Academic Health Economists' Blog on 2018-10-15 11:00:13

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Helen Weatherly & Rita Faria & Bernard Van den Berg & Mark Sculpher & Peter O’Neill & Kay Nolan & Julie Glanville & Jaana Isojarvi & Erin Baragula & Mary Edwards, 2017. "Scoping review on social care economic evaluation methods," Working Papers 150cherp, Centre for Health Economics, University of York.
    2. Joanna Coast & Cara Bailey & Alastair Canaway & Philip Kinghorn, 2021. "“It is not a scientific number it is just a feeling”: Populating a multi‐dimensional end‐of‐life decision framework using deliberative methods," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1033-1049, May.
    3. Jere R. Behrman & Flávio Cunha & Esteban Puentes & Fan Wang, 2018. "You Are What Your Parents Think: Height and Local Reference Points," PIER Working Paper Archive 18-007, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 22 Apr 2018.
    4. Hareth Al‐Janabi, 2018. "Do capability and functioning differ? A study of U.K. survey responses," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 465-479, March.
    5. Hannah Christensen & Hareth Al-Janabi & Pierre Levy & Maarten J. Postma & David E. Bloom & Paolo Landa & Oliver Damm & David M. Salisbury & Javier Diez-Domingo & Adrian K. Towse & Paula K. Lorgelly & , 2020. "Economic evaluation of meningococcal vaccines: considerations for the future," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 297-309, March.
    6. Hareth Al-Janabi & Andrea Manca & Joanna Coast, 2017. "Predicting carer health effects for use in economic evaluation," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-18, September.
    7. Sandy Tubeuf & Eirini-Christina Saloniki & David Cottrell, 2019. "Parental Health Spillover in Cost-Effectiveness Analysis: Evidence from Self-Harming Adolescents in England," PharmacoEconomics, Springer, vol. 37(4), pages 513-530, April.
    8. Grace S Chung & David W Hutton, 2020. "Epidemiological impact and cost-effectiveness of universal meningitis b vaccination among college students prior to college entry," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-13, October.

    More about this item

    Keywords

    economic evaluation; self-harm; adolescent; EQ-5D-3L; HUI2; spillovers;
    All these keywords.

    JEL classification:

    • D62 - Microeconomics - - Welfare Economics - - - Externalities
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:lee:wpaper:1803. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://edirc.repec.org/data/heleeuk.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Judy Wright (email available below). General contact details of provider: https://edirc.repec.org/data/heleeuk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.