How relevant is the societal perspective in economic evaluations? Evidence from five case studies

Throughout this document, we confirm that the inclusion of social costs in economic evaluations is quite rare, although major differences have been observed in different diseases. For example, the percentage of full economic evaluations that consider social costs (i.e. productivity losses and/or informal care costs) is 58% of the assessments identified through our search in the case of Alzheimer´s disease, but barely 11% of the identified articles in the case of rare diseases-related interventions. Moreover, wide variations have also been found with respect to the changes in the results and conclusions of the economic evaluations. The consideration of social costs changed results of a 18%-30% of the economic evaluations, depending on the case study considered. However, the changes in conclusions were modest. More precisely, the conclusions changed in 4% of the economic evaluations in rare diseases, but almost 15% of the healthcare interventions related to multiple sclerosis modified their conclusions once productivity losses or informal care costs were considered