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What, who and when? Incorporating a discrete choice experiment into an economic evaluation

Author

Listed:
  • Michela Tinelli

    (LSE Health and Social Care, the London School of Economics and Political Science)

  • Mandy Ryan

    (University of Aberdeen)

  • Christine Bond

    (University of Aberdeen)

Abstract

Background Economic evaluation focuses on Quality-Adjusted-Life-Years (QALYs) as the main valuation method. However, it is well known that factors beyond health related quality of life are important to patients and the public. Whilst discrete-choice-experiments (DCE) have been extensively used to value such factors, their incorporation within an economic evaluation framework is limited. This study is the first to incorporate patient preferences for factors beyond QALYs into an economic evaluation and compare results with the standard cost-per-QALY approach, using randomised-controlled-trial (RCT) participants. Methods Costings, clinical-effectiveness (appropriateness-of-treatment), QALYs and patient satisfaction data were collected at baseline and 12-month follow-up for a new pharmacy-service within a randomised-controlled-trial. Trial participants who replied to the follow-up survey and had not subsequently withdrawn from the study were mailed a DCE questionnaire at 24-months. WTP for the standard and new service was derived from the DCE. Results from QALYs and the DCE were compared. Results At 12 months, costs, clinical-effectiveness and QALYs did not differ between the intervention and control; however there was a significant increase in satisfaction in the intervention. The DCE valued this increased satisfaction in the intervention (positive net-benefit). The longer the time patients experienced the new service the greater the reported net-benefit. Conclusion When incorporating a DCE into an economic evaluation a number of questions are raised: what factors should be valued, whose values (trial-groups vs. all–trial-population) and when should they be elicited (still-receiving-the-intervention or afterwards). Consideration should also be given to status quo bias.

Suggested Citation

  • Michela Tinelli & Mandy Ryan & Christine Bond, 2016. "What, who and when? Incorporating a discrete choice experiment into an economic evaluation," Health Economics Review, Springer, vol. 6(1), pages 1-9, December.
    • Handle: RePEc:spr:hecrev:v:6:y:2016:i:1:d:10.1186_s13561-016-0108-4
    DOI: 10.1186/s13561-016-0108-4
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. McIntosh, Emma & Clarke, Philip & Frew, Emma & Louviere, Jordan (ed.), 2010. "Applied Methods of Cost-Benefit Analysis in Health Care," OUP Catalogue, Oxford University Press, number 9780199237128.
    3. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D., 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304, January.
    4. Fernando San Miguel & Mandy Ryan & Mabelle Amaya‐Amaya, 2005. "‘Irrational’ stated preferences: a quantitative and qualitative investigation," Health Economics, John Wiley & Sons, Ltd., vol. 14(3), pages 307-322, March.
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    Cited by:

    1. David J. Mott & Laura Ternent & Luke Vale, 2023. "Do preferences differ based on respondent experience of a health issue and its treatment? A case study using a public health intervention," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(3), pages 413-423, April.
    2. Mesfin G. Genie & Mandy Ryan & Nicolas Krucien, 2023. "Keeping an eye on cost: What can eye tracking tell us about attention to cost information in discrete choice experiments?," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1101-1119, May.

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