IDEAS home Printed from https://ideas.repec.org/a/spr/pharme/v26y2008i8p661-677.html
   My bibliography  Save this article

Conducting Discrete Choice Experiments to Inform Healthcare Decision Making

Author

Listed:
  • Emily Lancsar
  • Jordan Louviere

Abstract

Discrete choice experiments (DCEs) are regularly used in health economics to elicit preferences for healthcare products and programmes. There is growing recognition that DCEs can provide more than information on preferences and, in particular, they have the potential to contribute more directly to outcome measurement for use in economic evaluation. Almost uniquely, DCEs could potentially contribute to outcome measurement for use in both cost-benefit and cost-utility analysis. Within this expanding remit, our intention is to provide a resource for current practitioners as well as those considering undertaking a DCE, using DCE results in a policy/commercial context, or reviewing a DCE. We present the fundamental principles and theory underlying DCEs. To aid in undertaking and assessing the quality of DCEs, we discuss the process of carrying out a choice study and have developed a checklist covering conceptualizing the choice process, selecting attributes and levels, experimental design, questionnaire design, pilot testing, sampling and sample size, data collection, coding of data, econometric analysis, validity, interpretation and welfare and policy analysis. In this fast-moving area, a number of issues remain on the research frontier. We therefore outline potentially fruitful areas for future research associated both with DCEs in general, and with health applications specifically, paying attention to how the results of DCEs can be used in economic evaluation. We also discuss emerging research trends. We conclude that if appropriately designed, implemented, analysed and interpreted, DCEs offer several advantages in the health sector, the most important of which is that they provide rich data sources for economic evaluation and decision making, allowing investigation of many types of questions, some of which otherwise would be intractable analytically. Thus, they offer viable alternatives and complements to existing methods of valuation and preference elicitation. Copyright Adis Data Information BV 2008

Suggested Citation

  • Emily Lancsar & Jordan Louviere, 2008. "Conducting Discrete Choice Experiments to Inform Healthcare Decision Making," PharmacoEconomics, Springer, vol. 26(8), pages 661-677, August.
  • Handle: RePEc:spr:pharme:v:26:y:2008:i:8:p:661-677
    DOI: 10.2165/00019053-200826080-00004
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.2165/00019053-200826080-00004
    Download Restriction: Access to full text is restricted to subscribers.

    File URL: https://libkey.io/10.2165/00019053-200826080-00004?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Phil Shackley & Cam Donaldson, 2000. "Willingness to pay for publicly-financed health care: how should we use the numbers?," Applied Economics, Taylor & Francis Journals, vol. 32(15), pages 2015-2021.
    2. Small, Kenneth A & Rosen, Harvey S, 1981. "Applied Welfare Economics with Discrete Choice Models," Econometrica, Econometric Society, vol. 49(1), pages 105-130, January.
    3. Mickael Bech & Dorte Gyrd‐Hansen, 2005. "Effects coding in discrete choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1079-1083, October.
    4. Adamowicz, Wiktor & Swait, Joffre & Boxall, Peter & Louviere, Jordan & Williams, Michael, 1997. "Perceptions versus Objective Measures of Environmental Quality in Combined Revealed and Stated Preference Models of Environmental Valuation," Journal of Environmental Economics and Management, Elsevier, vol. 32(1), pages 65-84, January.
    5. Flynn, Terry N. & Louviere, Jordan J. & Peters, Tim J. & Coast, Joanna, 2007. "Best-worst scaling: What it can do for health care research and how to do it," Journal of Health Economics, Elsevier, vol. 26(1), pages 171-189, January.
    6. Swait, Joffre & Adamowicz, Wiktor, 2001. "The Influence of Task Complexity on Consumer Choice: A Latent Class Model of Decision Strategy Switching," Journal of Consumer Research, Journal of Consumer Research Inc., vol. 28(1), pages 135-148, June.
    7. Hanley, Nick & Mourato, Susana & Wright, Robert E, 2001. "Choice Modelling Approaches: A Superior Alternative for Environmental Valuation?," Journal of Economic Surveys, Wiley Blackwell, vol. 15(3), pages 435-462, July.
    8. Arne Risa Hole, 2007. "A comparison of approaches to estimating confidence intervals for willingness to pay measures," Health Economics, John Wiley & Sons, Ltd., vol. 16(8), pages 827-840, August.
    9. Bryan, Stirling & Gill, Paramjit & Greenfield, Sheila & Gutridge, Kerry & Marshall, Tom, 2006. "The myth of agency and patient choice in health care? The case of drug treatments to prevent coronary disease," Social Science & Medicine, Elsevier, vol. 63(10), pages 2698-2701, November.
    10. Vick, Sandra & Scott, Anthony, 1998. "Agency in health care. Examining patients' preferences for attributes of the doctor-patient relationship," Journal of Health Economics, Elsevier, vol. 17(5), pages 587-605, October.
    11. Bleichrodt, Han, 1995. "QALYs and HYEs: Under what conditions are they equivalent?," Journal of Health Economics, Elsevier, vol. 14(1), pages 17-37, May.
    12. Propper, Carol, 1990. "Contingent Valuation of Time Spent on NHS Waiting Lists," Economic Journal, Royal Economic Society, vol. 100(400), pages 193-199, Supplemen.
    13. Daniel McFadden & Kenneth Train, 2000. "Mixed MNL models for discrete response," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 15(5), pages 447-470.
    14. Adamowicz W. & Louviere J. & Williams M., 1994. "Combining Revealed and Stated Preference Methods for Valuing Environmental Amenities," Journal of Environmental Economics and Management, Elsevier, vol. 26(3), pages 271-292, May.
    15. Emily Lancsar, 2002. "Deriving welfare measures from stated preference discrete choice modelling experiments, CHERE Discussion Paper No 48," Discussion Papers 48, CHERE, University of Technology, Sydney.
    16. Andrew J Lloyd, 2003. "Threats to the estimation of benefit: are preference elicitation methods accurate?," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 393-402, May.
    17. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521766555.
    18. 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.
    19. Daniel Kahneman & Amos Tversky, 2013. "Prospect Theory: An Analysis of Decision Under Risk," World Scientific Book Chapters, in: Leonard C MacLean & William T Ziemba (ed.), HANDBOOK OF THE FUNDAMENTALS OF FINANCIAL DECISION MAKING Part I, chapter 6, pages 99-127, World Scientific Publishing Co. Pte. Ltd..
    20. Mandy Ryan & Fernando San Miguel, 2003. "Revisiting the axiom of completeness in health care," Health Economics, John Wiley & Sons, Ltd., vol. 12(4), pages 295-307, April.
    21. Kelvin J. Lancaster, 1966. "A New Approach to Consumer Theory," Journal of Political Economy, University of Chicago Press, vol. 74(2), pages 132-132.
    22. Madeleine T. King & Jane Hall & Emily Lancsar & Denzil Fiebig & Ishrat Hossain & Jordan Louviere & Helen K. Reddel & Christine R. Jenkins, 2007. "Patient preferences for managing asthma: results from a discrete choice experiment," Health Economics, John Wiley & Sons, Ltd., vol. 16(7), pages 703-717, July.
    23. Hall, Jane & Fiebig, Denzil G. & King, Madeleine T. & Hossain, Ishrat & Louviere, Jordan J., 2006. "What influences participation in genetic carrier testing?: Results from a discrete choice experiment," Journal of Health Economics, Elsevier, vol. 25(3), pages 520-537, May.
    24. Hanley, Nick & Adamowicz, Wiktor & Wright, Robert E., 2005. "Price vector effects in choice experiments: an empirical test," Resource and Energy Economics, Elsevier, vol. 27(3), pages 227-234, October.
    25. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
    26. Lancsar, Emily & Louviere, Jordan & Flynn, Terry, 2007. "Several methods to investigate relative attribute impact in stated preference experiments," Social Science & Medicine, Elsevier, vol. 64(8), pages 1738-1753, April.
    27. Emma McIntosh, 2006. "Using Discrete Choice Experiments within a Cost-Benefit Analysis Framework," PharmacoEconomics, Springer, vol. 24(9), pages 855-868, September.
    28. Mandy Ryan & Angela Bate, 2001. "Testing the assumptions of rationality, continuity and symmetry when applying discrete choice experiments in health care," Applied Economics Letters, Taylor & Francis Journals, vol. 8(1), pages 59-63.
    29. Swait, Joffre & Adamowicz, Wiktor, 2001. "Choice Environment, Market Complexity, and Consumer Behavior: A Theoretical and Empirical Approach for Incorporating Decision Complexity into Models of Consumer Choice," Organizational Behavior and Human Decision Processes, Elsevier, vol. 86(2), pages 141-167, November.
    30. Ryan, Mandy, 1999. "Using conjoint analysis to take account of patient preferences and go beyond health outcomes: an application to in vitro fertilisation," Social Science & Medicine, Elsevier, vol. 48(4), pages 535-546, February.
    31. 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.
    32. Mandy Ryan & Diane Skåtun, 2004. "Modelling non‐demanders in choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 397-402, April.
    33. DeShazo, J. R. & Fermo, German, 2002. "Designing Choice Sets for Stated Preference Methods: The Effects of Complexity on Choice Consistency," Journal of Environmental Economics and Management, Elsevier, vol. 44(1), pages 123-143, July.
    34. Nick Hanley & Susana Mourato & Robert E. Wright, 2001. "Choice Modelling Approaches: A Superior Alternative for Environmental Valuatioin?," Journal of Economic Surveys, Wiley Blackwell, vol. 15(3), pages 435-462, July.
    35. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D. With contributions by-Name:Adamowicz,Wiktor, 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304.
    36. Emily Lancsar & Cam Donaldson, 2005. "Discrete choice experiments in health economics: Distinguishing between the method and its application," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(4), pages 314-316, December.
    37. Kjaer, Trine & Gyrd-Hansen, Dorte, 2008. "Preference heterogeneity and choice of cardiac rehabilitation program: Results from a discrete choice experiment," Health Policy, Elsevier, vol. 85(1), pages 124-132, January.
    38. Swait, Joffre, 2001. "A non-compensatory choice model incorporating attribute cutoffs," Transportation Research Part B: Methodological, Elsevier, vol. 35(10), pages 903-928, November.
    39. Scott, Anthony, 2001. "Eliciting GPs' preferences for pecuniary and non-pecuniary job characteristics," Journal of Health Economics, Elsevier, vol. 20(3), pages 329-347, May.
    40. Zafar Hakim & Dev S. Pathak, 1999. "Modelling the EuroQol data: a comparison of discrete choice conjoint and conditional preference modelling," Health Economics, John Wiley & Sons, Ltd., vol. 8(2), pages 103-116, March.
    41. Stirling Bryan & Paul Dolan, 2004. "Discrete choice experiments in health economics," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(3), pages 199-202, September.
    42. McIntosh, E. & Ryan, M., 2002. "Using discrete choice experiments to derive welfare estimates for the provision of elective surgery: Implications of discontinuous preferences," Journal of Economic Psychology, Elsevier, vol. 23(3), pages 367-382, June.
    43. Ryan, Mandy & Netten, Ann & Skatun, Diane & Smith, Paul, 2006. "Using discrete choice experiments to estimate a preference-based measure of outcome--An application to social care for older people," Journal of Health Economics, Elsevier, vol. 25(5), pages 927-944, September.
    44. Tara Maddala & Kathryn A. Phillips & F. Reed Johnson, 2003. "An experiment on simplifying conjoint analysis designs for measuring preferences," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 1035-1047, December.
    45. Jordan J. Louviere & Towhidul Islam & Nada Wasi & Deborah Street & Leonie Burgess, 2008. "Designing Discrete Choice Experiments: Do Optimal Designs Come at a Price?," Journal of Consumer Research, Journal of Consumer Research Inc., vol. 35(2), pages 360-375, March.
    46. Jane Hall & Patricia Kenny & Madeleine King & Jordan Louviere & Rosalie Viney & Angela Yeoh, 2002. "Using stated preference discrete choice modelling to evaluate the introduction of varicella vaccination," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 457-465, July.
    47. Rosalie Viney & Elizabeth Savage & Jordan Louviere, 2005. "Empirical investigation of experimental design properties of discrete choice experiments in health care," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 349-362, April.
    48. Jayson L. Lusk & F. Bailey Norwood, 2005. "Effect of Experimental Design on Choice-Based Conjoint Valuation Estimates," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 87(3), pages 771-785.
    49. Emily Lancsar & Elizabeth Savage, 2004. "Deriving welfare measures from discrete choice experiments: inconsistency between current methods and random utility and welfare theory," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 901-907, September.
    50. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    2. Robert J. Johnston & Kevin J. Boyle & Wiktor (Vic) Adamowicz & Jeff Bennett & Roy Brouwer & Trudy Ann Cameron & W. Michael Hanemann & Nick Hanley & Mandy Ryan & Riccardo Scarpa & Roger Tourangeau & Ch, 2017. "Contemporary Guidance for Stated Preference Studies," Journal of the Association of Environmental and Resource Economists, University of Chicago Press, vol. 4(2), pages 319-405.
    3. Emily Lancsar & Peter Burge, 2014. "Choice modelling research in health economics," Chapters, in: Stephane Hess & Andrew Daly (ed.), Handbook of Choice Modelling, chapter 28, pages 675-687, Edward Elgar Publishing.
    4. Haghani, Milad & Bliemer, Michiel C.J. & Hensher, David A., 2021. "The landscape of econometric discrete choice modelling research," Journal of choice modelling, Elsevier, vol. 40(C).
    5. Hoyos, David, 2010. "The state of the art of environmental valuation with discrete choice experiments," Ecological Economics, Elsevier, vol. 69(8), pages 1595-1603, June.
    6. Hoyos Ramos, David, 2010. "Using discrete choice experiments for environmental valuation," BILTOKI 1134-8984, Universidad del País Vasco - Departamento de Economía Aplicada III (Econometría y Estadística).
    7. Lancsar, Emily & Louviere, Jordan & Flynn, Terry, 2007. "Several methods to investigate relative attribute impact in stated preference experiments," Social Science & Medicine, Elsevier, vol. 64(8), pages 1738-1753, April.
    8. Rulleau, Bénédicte & Dachary-Bernard, Jeanne, 2012. "Preferences, rational choices and economic valuation: Some empirical tests," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 41(2), pages 198-206.
    9. Emily Lancsar & Jordan Louviere, 2006. "Deleting ‘irrational’ responses from discrete choice experiments: a case of investigating or imposing preferences?," Health Economics, John Wiley & Sons, Ltd., vol. 15(8), pages 797-811, August.
    10. Esther W. de Bekker‐Grob & Mandy Ryan & Karen Gerard, 2012. "Discrete choice experiments in health economics: a review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 145-172, February.
    11. Emily Lancsar & Denzil G. Fiebig & Arne Risa Hole, 2017. "Discrete Choice Experiments: A Guide to Model Specification, Estimation and Software," PharmacoEconomics, Springer, vol. 35(7), pages 697-716, July.
    12. Emily Lancsar & Elizabeth Savage, 2004. "Deriving welfare measures from discrete choice experiments: inconsistency between current methods and random utility and welfare theory," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 901-907, September.
    13. Campbell, Danny & Hutchinson, W. George & Scarpa, Riccardo, 2006. "Lexicographic Preferences in Discrete Choice Experiments: Consequences on Individual-Specific Willingness to Pay Estimates," Sustainability Indicators and Environmental Valuation Working Papers 12224, Fondazione Eni Enrico Mattei (FEEM).
    14. Regier, Dean A. & Watson, Verity & Burnett, Heather & Ungar, Wendy J., 2014. "Task complexity and response certainty in discrete choice experiments: An application to drug treatments for juvenile idiopathic arthritis," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 50(C), pages 40-49.
    15. Chiara Seghieri & Alessandro Mengoni & Sabina Nuti, 2014. "Applying discrete choice modelling in a priority setting: an investigation of public preferences for primary care models," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(7), pages 773-785, September.
    16. Nicolas Krucien & Verity Watson & Mandy Ryan, 2017. "Is Best–Worst Scaling Suitable for Health State Valuation? A Comparison with Discrete Choice Experiments," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1-16, December.
    17. Paul Scuffham & Jennifer Whitty & Matthew Taylor & Ruth Saxby, 2010. "Health system choice," Applied Health Economics and Health Policy, Springer, vol. 8(2), pages 89-97, March.
    18. Lieke Boonen & Frederik Schut & Bas Donkers & Xander Koolman, 2009. "Which preferred providers are really preferred? Effectiveness of insurers’ channeling incentives on pharmacy choice," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 347-366, December.
    19. Joachim Marti, 2012. "Assessing preferences for improved smoking cessation medications: a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 533-548, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:26:y:2008:i:8:p:661-677. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.