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Patient preferences: a Trojan horse for evidence-based medicine?

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  • Afschin Gandjour

    (Frankfurt School of Finance and Management)

Abstract

The evidence-based medicine (EBM) movement has long acknowledged the relevance of patient preferences and values. According to EBM, clinicians first clarify the medical evidence about the benefits and burdens of the treatment in question and then, as a second step, elicit values and preferences from patients. Importantly, however, values are placed on patient-relevant outcomes. Surrogate endpoints are only used if their validity is proven. This article shows that some recent patient-preference studies attribute value to surrogate endpoints even when there is no improvement in patient-relevant outcomes. The article points out their foundation in neoclassical economics and discusses their clash with principles of EBM and medical ethics.

Suggested Citation

  • Afschin Gandjour, 2018. "Patient preferences: a Trojan horse for evidence-based medicine?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 167-172, January.
    • Handle: RePEc:spr:eujhec:v:19:y:2018:i:1:d:10.1007_s10198-017-0916-4
    DOI: 10.1007/s10198-017-0916-4
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    References listed on IDEAS

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    1. Afschin Gandjour, 2010. "Theoretical Foundation of Patient v. Population Preferences in Calculating QALYs," Medical Decision Making, , vol. 30(4), pages 57-63, July.
    2. Axel Mühlbacher & Susanne Bethge, 2015. "Patients’ preferences: a discrete-choice experiment for treatment of non-small-cell lung cancer," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(6), pages 657-670, July.
    3. Joseph S. Pliskin & Donald S. Shepard & Milton C. Weinstein, 1980. "Utility Functions for Life Years and Health Status," Operations Research, INFORMS, vol. 28(1), pages 206-224, February.
    4. Schlefer, Jonathan, 2012. "The Assumptions Economists Make," Economics Books, Harvard University Press, number 9780674052260, Spring.
    5. George A. Akerlof & Robert J. Shiller, 2015. "Phishing for Phools: The Economics of Manipulation and Deception," Economics Books, Princeton University Press, edition 1, number 10534.
    6. Utens, Cecile M.A. & Dirksen, Carmen D. & van der Weijden, Trudy & Joore, Manuela A., 2016. "How to integrate research evidence on patient preferences in pharmaceutical coverage decisions and clinical practice guidelines: A qualitative study among Dutch stakeholders," Health Policy, Elsevier, vol. 120(1), pages 120-128.
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    More about this item

    Keywords

    Evidence-based medicine; Medical ethics; Neoclassical economics; Patient preferences;
    All these keywords.

    JEL classification:

    • B1 - Schools of Economic Thought and Methodology - - History of Economic Thought through 1925
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General

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