OBJECTIVES: Caregivers of patients with mental illness can face significant burdens across various physical, psychosocial, and economic domains. This research explores whether health technology assessment (HTA) agencies consider caregiver burden in their decision-making when reviewing new treatments for mental disorders.

METHODS: We reviewed HTA reports published between 2014 and 2024 by the National Institute for Health and Care Excellence (NICE), Haute Autorité de Santé (HAS), and the Federal Joint Committee or Gemeinsamer Bundesausschuss (G-BA) for drugs indicated for the treatment of depression and schizophrenia. We analyzed discussions on caregiver burden and the extent of consideration in the final HTA decision.

RESULTS: In the past 10 years, three new drugs for the treatment of depression (major depressive disorder [MDD] and treatment-resistant depression [TRD]) and two new drugs for schizophrenia have been reviewed by HTA agencies. Across markets, caregiver burden had no direct impact on the final HTA outcomes for all drugs reviewed in all indications. Notably, HAS and G-BA did not mention caregiver burden in their assessments. Of the three HTA agencies reviewed, only NICE acknowledged the caregiver perspective in their assessment, by discussing caregiver disutilities in an economic model for TRD, noting the consideration of caregivers’ views in treatment choice in schizophrenia, and recognizing the impact of MDD on caregivers.

CONCLUSIONS: Caregiver burden has not been widely acknowledged and has had limited direct influence on final HTA decisions of treatments for mental illnesses in the UK, France and Germany. However, more recent assessments have shown some consideration to the caregiver perspective in treatment pathways and economic modelling. As HTA agencies begin to recognize the indirect health and economic impact of mental illnesses on caregivers, we expect to see greater consideration of the value of reducing caregiver burden in HTA assessments of new technologies in this treatment space.