SHEER Task Force Recommendations on Family and Caregiver Health Spillovers
These recommendations guide how to include the health impacts on family members and caregivers when evaluating healthcare interventions. Often, these effects are ignored, but they can be important. The guidelines suggest ways to consistently measure and report them in economic studies, especially in cost-effectiveness analyses, and highlight areas where more research is needed.
At a glance
Use when
Conducting or reviewing health economic evaluations where interventions may affect the health of family members or caregivers, particularly from societal or extended perspectives.
Avoid when
When the intervention has no plausible impact on caregivers or family members, or when strict adherence to narrow, non-societal perspectives (e.g., limited healthcare payer views) explicitly excludes spillovers.
Inputs
Health economic evaluations that assess interventions with potential impacts on family members or caregivers; expert consensus processes; evidence from literature reviews.
Outputs
11 consensus recommendations for good practice and 12 proposed research priorities on incorporating family and caregiver health spillovers in economic evaluations.
How it works
Developed by the Spillovers in Health Economic Evaluation and Research (SHEER) Task Force using a modified nominal group technique, these 2023 consensus-based recommendations provide emerging good practice for incorporating family and caregiver health spillovers in cost-effectiveness and cost-utility analyses. The guidelines advocate inclusion across multiple perspectives (e.g., healthcare payer, societal), emphasize sufficient time horizons, preference for primary data collection, transparency in reporting, and consideration of distributional impacts and displaced activities. Twelve research priorities are also proposed to advance the field.
- HTA domains
- Costs & Economic Evaluation, Patient and Social Aspects
- Categories
- AppraisalContext & Implementation
- Assumptions
- Health spillovers on caregivers and family members are relevant to decision-making; current methods for inclusion are inconsistent; improved guidance will lead to more systematic incorporation in evaluations.
- Strengths
- Developed through structured expert consensus using a modified nominal group technique,Based on both evidence review and expert judgment,Balances practical guidance with recognition of evolving methodology,Promotes transparency, inclusivity, and equity considerations
- Limitations
- Represents emerging good practice, not established standards,May not be directly applicable to all healthcare systems or decision contexts,Lacks detailed methodological specifications for implementation
- Also known as
- SHEER Recommendations, SHEER Task Force Guidelines, Family and Caregiver Spillover Recommendations
Questions this answers
- › How should health spillovers affecting family members and caregivers be included in economic evaluations?
- › From which perspectives should spillovers be considered in cost-effectiveness analysis?
- › What data sources are recommended for capturing spillover effects?
- › How should time horizons be set when measuring caregiver and family health impacts?
- › What aspects of equity and distribution should be considered when including spillovers?
- › What future research is needed to improve the inclusion of spillovers in HTA?
References & sources
Related methods
Similar by meaning
Beta record. Based on the original catalogue summary; primary-source enrichment pending.