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Choice Experiments to Quantify Preferences for Health and Healthcare: State of the Practice

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Abstract

Stated-preference methods increasingly are used to quantify preferences in health economics, health technology assessment, benefit-risk analysis and health services research. The objective of stated-preference studies is to acquire information about trade-off preferences among treatment outcomes, prioritization of clinical decision criteria, likely uptake or adherence to healthcare products and acceptability of healthcare services or policies. A widely accepted approach to eliciting preferences is discrete-choice experiments. Patient, physician, insurant or general-public respondents choose among constructed, experimentally controlled alternatives described by decision-relevant features or attributes. Attributes can represent complete health states, sets of treatment outcomes or characteristics of a healthcare system. The observed pattern of choice reveals how different respondents or groups of respondents implicitly weigh, value and assess different characteristics of treatments, products or services. An important advantage of choice experiments is their foundation in microeconomic utility theory. This conceptual framework provides tests of internal validity, guidance for statistical analysis of latent preference structures, and testable behavioural hypotheses. Choice experiments require expertise in survey-research methods, random-utility theory, experimental design and advanced statistical analysis. This paper should be understood as an introduction to setting up a basic experiment rather than an exhaustive critique of the latest findings and procedures. Where appropriate, we have identified topics of active research where a broad consensus has not yet been established.

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Acknowledgments

No external funding was used in support of this study. The authors wish to thank Susanne Bethge for assistance with the study design section and Andrew Sadler for assistance with the analytical-framework and statistical-analysis sections.

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Authors and Affiliations

  1. Health Economics and Healthcare Management, Hochschule Neubrandenburg, Neubrandenburg, Germany

    Axel Mühlbacher

  2. Duke Global Health Institute, Duke University, Durham, NC, USA

    Axel Mühlbacher

  3. Duke Clinical Research Institute, Duke University, Durham, NC, USA

    F. Reed Johnson

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  1. Axel Mühlbacher
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Correspondence to F. Reed Johnson.

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Mühlbacher, A., Johnson, F.R. Choice Experiments to Quantify Preferences for Health and Healthcare: State of the Practice. Appl Health Econ Health Policy 14, 253–266 (2016). https://doi.org/10.1007/s40258-016-0232-7

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