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Exploring the social value of health-care interventions: a stated preference discrete choice experiment


  • Colin Green

    (Institute of Health Service Research, Peninsula Medical School, Universities of Exeter and Plymouth, UK)

  • Karen Gerard

    (School of Nursing and Midwifery, University of Southampton, UK)


Much of the literature on distributive preferences covers specific considerations in isolation, and recent reviews have suggested that research is required to inform on the relative importance of various key considerations. Responding to this research recommendation, we explore the distributive preferences of the general public using a set of generic social value judgments. We report on a discrete choice experiment (DCE) survey, using face-to-face interviews, in a sample of the general population (n=259). The context for the survey was resource allocation decisions in the UK National Health Service, using the process of health technology appraisal as an example. The attributes used covered health improvement, value for money, severity of health, and availability of other treatments, and it is the first such survey to use cost-effectiveness in scenarios described to the general public. Results support the feasibility and acceptability of the DCE approach for the elicitation of public preferences. Choice data are used to consider the relative importance of changes across attribute levels, and to model utility scores and relative probabilities for the full set of combinations of attributes and levels in the experimental design used (n=64). Results allow the relative social value of health technology scenarios to be explored. Findings add to a sparse literature on 'social' preferences, and show that DCE data can be used to consider the strength of preference over alternative scenarios in a priority-setting context. Copyright © 2008 John Wiley & Sons, Ltd.

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  • Colin Green & Karen Gerard, 2009. "Exploring the social value of health-care interventions: a stated preference discrete choice experiment," Health Economics, John Wiley & Sons, Ltd., vol. 18(8), pages 951-976.
  • Handle: RePEc:wly:hlthec:v:18:y:2009:i:8:p:951-976 DOI: 10.1002/hec.1414

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    2. Shah, Koonal K. & Tsuchiya, Aki & Wailoo, Allan J., 2015. "Valuing health at the end of life: A stated preference discrete choice experiment," Social Science & Medicine, Elsevier, vol. 124(C), pages 48-56.
    3. 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.
    4. Jennifer Whitty & Emily Lancsar & Kylie Rixon & Xanthe Golenko & Julie Ratcliffe, 2014. "A Systematic Review of Stated Preference Studies Reporting Public Preferences for Healthcare Priority Setting," The Patient: Patient-Centered Outcomes Research, Springer;Johns Hopkins Bloomberg School of Public Health, vol. 7(4), pages 365-386, December.
    5. Martin Buxton & James Chambers, 2011. "What values do the public want their health care systems to use in evaluating technologies?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(4), pages 285-288, August.
    6. Nord, Erik & Johansen, Rune, 2014. "Concerns for severity in priority setting in health care: A review of trade-off data in preference studies and implications for societal willingness to pay for a QALY," Health Policy, Elsevier, vol. 116(2), pages 281-288.
    7. Gu, Yuanyuan & Lancsar, Emily & Ghijben, Peter & Butler, James RG & Donaldson, Cam, 2015. "Attributes and weights in health care priority setting: A systematic review of what counts and to what extent," Social Science & Medicine, Elsevier, vol. 146(C), pages 41-52.
    8. Pavel, Md Sadik & Chakrabarty, Sayan & Gow, Jeff, 2014. "Assessing willingness to pay for health care quality improvements," MPRA Paper 68591, University Library of Munich, Germany.
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    10. Apostolidis, Chrysostomos & McLeay, Fraser, 2016. "Should we stop meating like this? Reducing meat consumption through substitution," Food Policy, Elsevier, vol. 65(C), pages 74-89.
    11. Lakdawalla, Darius & Malani, Anup & Reif, Julian, 2017. "The insurance value of medical innovation," Journal of Public Economics, Elsevier, vol. 145(C), pages 94-102.
    12. Liesbet Wetering & Job Exel & Ana Bobinac & Werner Brouwer, 2015. "Valuing QALYs in Relation to Equity Considerations Using a Discrete Choice Experiment," PharmacoEconomics, Springer, vol. 33(12), pages 1289-1300, December.
    13. Erik Nord & Rune Johansen, 2015. "Transforming EQ-5D utilities for use in cost–value analysis of health programs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 313-328, April.
    14. Carlsen, Benedicte & Hole, Arne Risa & Kolstad, Julie Riise & Norheim, Ole Frithjof, 2012. "When you can’t have the cake and eat it too," Social Science & Medicine, Elsevier, vol. 75(11), pages 1964-1973.
    15. Michael Clark & Domino Determann & Stavros Petrou & Domenico Moro & Esther Bekker-Grob, 2014. "Discrete Choice Experiments in Health Economics: A Review of the Literature," PharmacoEconomics, Springer, vol. 32(9), pages 883-902, September.
    16. Erdem, Seda & Campbell, Danny & Thompson, Carl, 2014. "Elimination and selection by aspects in health choice experiments: Prioritising health service innovations," Journal of Health Economics, Elsevier, vol. 38(C), pages 10-22.
    17. Axel C. Mühlbacher & John F. P. Bridges & Susanne Bethge & Ch.-Markos Dintsios & Anja Schwalm & Andreas Gerber-Grote & Matthias Nübling, 2017. "Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(2), pages 155-165, March.
    18. Petra Baji & Manuel García-Goñi & László Gulácsi & Emmanouil Mentzakis & Francesco Paolucci, 2016. "Comparative analysis of decision maker preferences for equity/efficiency attributes in reimbursement decisions in three European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(7), pages 791-799, September.
    19. Erdem, Seda & Campbell, Danny & Thompson, Carl, 2014. "Addressing elimination and selection by aspects decision rules in discrete choice experiments: does it matter?," 2014 Annual Meeting, July 27-29, 2014, Minneapolis, Minnesota 169839, Agricultural and Applied Economics Association.
    20. 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.

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