Tubeuf, S orcid.org/0000-0001-9001-1157, Saloniki, ECC and Cottrell, D orcid.org/0000-0001-8674-0955 (2019) Parental health spillover in cost-effectiveness analysis: Evidence from self-harming adolescents in England. PharmacoEconomics, 37 (4). pp. 513-530. ISSN 1170-7690
Abstract
Objective:
This article presents alternative parental health 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 11–17 years. Health utilities are measured using answers to the EuroQoL 5 Dimensions 3 Levels (EQ-5D-3L) for the adolescent and the Health Utility Index (HUI2) for one parent at baseline, 6 and 12 months. We use regression analyses to evaluate the association between the parent’s and adolescent’s health utilities as part of an explanatory regression model including health-related and demographic characteristics of both the adolescent and the parent. We then measure cost-effectiveness over a 12-month period as mean incremental cost-effectiveness ratios using various spillover quantification methods. We propose an original quantification based on the use of a household welfare function along with an equivalence scale to generate a health gain within the family to be added to the adolescent’s quality-adjusted life-year gain.
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 but not at baseline. When considering the adolescent’s health gain only, the incremental cost-effectiveness ratio is £40,453 per quality-adjusted life-year. When including the health spillover to one parent, the incremental cost-effectiveness ratio estimates range from £27,167 per quality-adjusted life-year to £40,838 per quality-adjusted life-year and can be a dominated option depending on the quantification method used.
Conclusion:
According to the health spillover quantification method considered, the incremental cost-effectiveness ratios vary from within the National Institute for Health and Care Excellence (NICE) cost-effectiveness threshold range to not being cost-effective.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2018. corrected publication 2019. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
Keywords: | economic evaluation; self harm; adolescent; EQ-5D; HUI; health spillover |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds) |
Funding Information: | Funder Grant number Leeds Community Healthcare NHS Trust Not Known NCCHTA National Coordinating Centre for Health Technology Assessment HTA 07/33/01-SHIFT NCCHTA National Coordinating Centre for Health Technology Assessment 07/33/01 NCCHTA National Coordinating Centre for Health Technology Assessment 07/33/01 |
Depositing User: | Symplectic Publications |
Date Deposited: | 24 Aug 2018 11:47 |
Last Modified: | 25 Jun 2023 21:29 |
Status: | Published |
Publisher: | Springer International Publishing |
Identification Number: | 10.1007/s40273-018-0722-6 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:134942 |
Commentary/Response Threads
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Tubeuf, S, Saloniki, ECC and Cottrell, D
Parental health spillover in cost-effectiveness analysis: Evidence from self-harming adolescents in England. (deposited 24 Aug 2018 11:47)
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- Tubeuf, S, Saloniki, EC and Cottrell, D Correction to: Parental Health Spillover in Cost‑Effectiveness Analysis: Evidence from Self‑Harming Adolescents in England. (deposited 11 Dec 2019 13:14)
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