NICE’s Reference Case for the Methods of Technology Appraisal (TA) states that “the perspective on outcomes should be all direct health effects, whether for patients or other people”. NICE does not currently specify how the health effects for people other than the patient should be incorporated, and so there is variation in how these are considered in TAs. There is variation in both the source of carer quality of life data, and in the way that this is incorporated in the modelling. This project focuses on the health effects of interventions for patients on people beyond the patient, termed “spillover” effects in the literature.
This report describes our review of NICE Technology Appraisals and Highly Specialised Technologies to identify those which considered the impact of an intervention on carer or family members QALYs. We discuss the data sources and approach to modelling carers used, identify key issues and suggest areas for further research.