Estimating the societal impact of medical interventions: a case study in metastatic breast cancer
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: Additional value elements like productivity are currently rarely included in economic evaluations since quantitative assessment may be complex or lack clear guidance. In this study we present a practical framework for estimating the societal impact of medical interventions by incorporating additional value elements into economic evaluations. Materials & methods: We applied this framework in the case of trastuzumab deruxtecan (T-DXd) for patients with metastatic breast cancer in five European countries (EU5). In this study we considered the following elements: productivity losses in paid and unpaid work, quality-adjusted life years (QALYs) valued at willingness-to-pay thresholds, the impact on childcare responsibilities, costs associated with formal caregivers, the effect on informal caregivers and impact on governmental accounts including tax revenue, pension and disability benefits. Results: Our findings indicated that some of the value elements included may lead to a positive societal value for the intervention, while others may result in additional costs. Positive impacts were seen in gains to patient productivity (€589 million), QALYs (€1.7 billion), unpaid work (€259 million), childcare responsibilities (€5 million) and tax revenue (€165 million). Conversely, our findings highlighted a greater demand for formal and informal care (-€29 million and -€7 million, respectively) and increased public spending on disability benefits (-€380 million) and pensions (-€44 million) attributed to T-DXd. The main causes of increased costs were the improvement in progression-free and overall survival achieved with T-DXd. Conclusion: Overall, this framework aims to quantify the societal value of new healthcare interventions. This metastatic breast cancer case study illustrates how key value elements can be integrated into economic evaluations, beyond the classical cost–effectiveness analysis, to further support reimbursement decisions.
Plain language summary
What is this article about?
Current economic evaluations typically focus on clinical end points and direct medical costs. This research introduces a scalable framework, serving as a user guide for evaluating broader value elements. Specifically, this analysis presents six additional value elements that could be integrated into economic evaluations expanding the economic perspective toward a broader definition of value generated by innovative health interventions.
What methodology is described
The proposed framework outlines the calculation steps needed to include selected value elements into economic evaluations. It provides guidance on assessing patient productivity effects, economic impact for formal and informal caregivers, and the fiscal impacts on government accounts.
Why is this important?
The analysis contributes to ongoing discussions about incorporating broader value components into economic evaluations. Positioning this research as a user guide may serve as a foundation for future assessments of additional value elements.
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Received: 7 January 2026
Accepted: 14 April 2026
Published online: 22 May 2026
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Estimating the societal impact of medical interventions: a case study in metastatic breast cancer. (2026) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2026-0005
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