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They used 5 source studies 2 compared carer EQ-5D scores with controls, 2 measured carer utility only (1 health utilities index and 1 EQ-5D), and 1 estimated family QALY loss from a child's death. Two used disutility estimates not from the literature. Including carer HRQL increased the incremental QALYs and decreased incremental cost-effectiveness ratios in all cases. The inclusion of carer HRQL in NICE appraisals is relatively uncommon and has been limited by data availability. The inclusion of carer HRQL in NICE appraisals is relatively

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