Measuring health spillovers for economic evaluation : a case study in meningitis

Research output: Contribution to journalArticlepeer-review


  • Job Van Exel
  • Werner Brouwer
  • Caroline Trotter
  • Linda Glennie
  • Laurie Hannigan

External organisations

  • Health Economics Unit, School of Health and Population Sciences, Public Health Building, University of Birmingham, Birmingham, B15 2TT.
  • Institute of Health Policy and Management; Erasmus University Rotterdam; Rotterdam Netherlands
  • University of Cambridge
  • Meningitis Research Foundation; Bristol UK


The health of carers and others close to the patient will often be relevant to economic evaluation, but it is very rarely considered in practice. This may reflect a lack of understanding of how the spillover effect of illness can be appropriately quantified. In this study we used three different approaches to quantify health spillovers resulting from meningitis. We conducted a survey of 1218 family networks affected by meningitis and used regression modelling to estimate spillover effects. The findings show that meningitis had long-term effects on family members' health, particularly affecting the likelihood of family members reporting anxiety and depression. These effects extended beyond a single close family member. These findings suggest that vaccinating against meningitis will bring significant health benefits not just to those that might have contracted the illness but also to their family networks. In methodological terms, different approaches for quantifying health spillovers provided broadly consistent results. The choice of method will be influenced by the ease of collecting primary data from family members in intervention contexts.


Original languageEnglish
Pages (from-to)1529–1544
JournalHealth Economics
Issue number12
Early online date14 Oct 2015
Publication statusPublished - 9 Nov 2016


  • economic evaluation, health valuation, informal care, EQ-5D, spillovers