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Australian Preferences for Prenatal Screening: A Discrete Choice Experiment Comparing Metropolitan and Rural/Regional Areas

Author

Listed:
  • Amber Salisbury

    (University of Sydney
    University of Sydney, A Joint Venture with Cancer Council NSW)

  • Sarah Norris

    (University of Sydney)

  • Alison Pearce

    (University of Sydney, A Joint Venture with Cancer Council NSW
    University of Sydney)

  • Kirsten Howard

    (University of Sydney)

Abstract

Background Non-invasive prenatal testing has the potential to be a useful genetic screening tool in Australia. However, concerns have been raised about its cost, commercial provision, the psychological impacts of the screening process, and disparities in access experienced by rural and regional communities. Aims The aims of this study are (1) to estimate Australian preferences for features of prenatal screening; (2) to explore potential variations in preferences between metropolitan and rural/regional communities; (3) to estimate the extent to which respondents are willing to trade-off between attributes, using willingness to pay (WTP) and willingness to wait estimates. Methods A discrete choice experiment (DCE) was conducted with 12 choice tasks. The DCE recruited participants from metropolitan (n = 160) and rural/regional (n = 168) locations across Australia. Mixed logit and latent class analyses were conducted and WTP and willingness to wait were calculated. Results Both metropolitan and rural/regional preferences were significantly impacted by the false-positive rate, false-negative rate, and cost. In addition, rural preferences were significantly impacted by the scope of the conditions covered, the inconclusive rate, and wait times. The number of screening tests and revealing the sex of the foetus were not significant within either group. Willingness to pay estimates ranged from AU$13 to avoid a test with a 1% increase in the false-positive rate to AU$323 to screen for a wide range of conditions. Conclusions This study highlights the importance of considering differing preferences between rural and metropolitan populations when delivering prenatal screening. Further, this study provides Australian-specific WTP estimates to be incorporated into economic evaluations.

Suggested Citation

  • Amber Salisbury & Sarah Norris & Alison Pearce & Kirsten Howard, 2025. "Australian Preferences for Prenatal Screening: A Discrete Choice Experiment Comparing Metropolitan and Rural/Regional Areas," Applied Health Economics and Health Policy, Springer, vol. 23(3), pages 493-506, May.
    • Handle: RePEc:spr:aphecp:v:23:y:2025:i:3:d:10.1007_s40258-024-00938-5
    DOI: 10.1007/s40258-024-00938-5
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    References listed on IDEAS

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    1. McFadden, Daniel, 1980. "Econometric Models for Probabilistic Choice among Products," The Journal of Business, University of Chicago Press, vol. 53(3), pages 13-29, July.
    2. Bliemer, Michiel C.J. & Rose, John M. & Hensher, David A., 2009. "Efficient stated choice experiments for estimating nested logit models," Transportation Research Part B: Methodological, Elsevier, vol. 43(1), pages 19-35, January.
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    1. James Buchanan & Ilias Goranitis & Deirdre Weymann, 2025. "The Health Economics of Genomic Technologies: A Growing Evidence Base on Value," Applied Health Economics and Health Policy, Springer, vol. 23(3), pages 331-335, May.

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