The Evolving Landscape of Discrete Choice Experiments in Health Economics: A Systematic Review

Sven Petrus Henricus Nouwens (), Stella Maria Marceta, Michael Bui, Daisy Maria Alberta Hendrika Dijk, Catharina Gerarda Maria Groothuis-Oudshoorn, Jorien Veldwijk, Janine Astrid Til and Esther Wilhelmina Bekker-Grob
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Sven Petrus Henricus Nouwens: Erasmus University Rotterdam
Stella Maria Marceta: Erasmus University Rotterdam
Michael Bui: University of Twente
Daisy Maria Alberta Hendrika Dijk: Erasmus University Rotterdam
Catharina Gerarda Maria Groothuis-Oudshoorn: University of Twente
Jorien Veldwijk: Erasmus University Rotterdam
Janine Astrid Til: University of Twente
Esther Wilhelmina Bekker-Grob: Erasmus University Rotterdam

PharmacoEconomics, 2025, vol. 43, issue 8, No 4, 879-936

Abstract: Abstract Introduction Stakeholder preference evaluations are increasingly emphasized in healthcare policy and health technology assessment. Discrete choice experiments (DCEs) are the most common method for quantifying preferences among patients, the public, and healthcare professionals. While prior reviews (1990–2017) have examined DCE trends, no comprehensive synthesis exists for studies published since 2018. This updated review (2018–2023) provides critical insights into evolving methodologies and global trends in health-related DCEs. Methods A systematic search (2018–2023) of Medline, Embase, and Web of Science identified relevant studies. Studies were screened for inclusion and data were extracted, including details on DCE design and analysis. To enable trend comparisons, the search strategy and extraction items aligned with previous reviews. Results Of 2663 identified papers, 1279 met the inclusion criteria, reflecting a significant rise in published DCEs over time. DCEs were conducted globally, with a remarkable increase in publications from Asia and Africa compared with previous reviews. Experimental designs and econometric models have advanced, continuing prior trends. Notably, most recent DCEs were administered online. Discussion The rapid growth of DCE applications underscores their importance in health research. While the methodology is advancing rapidly, it is crucial that researchers provide full transparency in reporting their methods, particularly in detailing experimental designs and validity tests, which are too often overlooked. Key recommendations include improving reporting of experimental designs, applying validity tests, following good practices for presenting benefit–risk attributes, and adopting open science practices. Ensuring methodological rigor will maximize the impact and reproducibility of DCE research in health economics.

Date: 2025
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DOI: 10.1007/s40273-025-01495-y

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