Preferences for Health Care Programmes: Results from a general population discrete choice survey

With the rapid growth in the development of new health care technologies, including both drugs and devices, health care decision makers worldwide are facing the challenge of making technology coverage decisions. Decisions have to be made concerning which technologies to fund, and these decisions have to be made in both public and private insurance settings. In order to ensure that health care resources are used in the most appropriate manner health care decision makers need to adopt robust processes for setting priorities. Recent developments in the UK, such as the launch of the National Institute for Health and Clinical Excellence (NICE), have encouraged a more open debate about the principles and issues concerned in health care resource allocation decisions (Entwistle et al., 1996; New, 1996; Rawlins, 1999). However, the appropriate criteria that should be used in setting priorities in a publicly funded health care system are far from clear. From a health economics perspective, one criterion that might be considered as part of the decision-making process when setting health care priorities is the maximisation of quality-adjusted life years (QALYs). A QALY-maximisation approach would then involve the targeting of resources towards health care interventions and services that were expected to deliver the largest gain in QALYs, for every dollar (or pound, euro, etc.) spent.