Measuring Public Preferences for Health Outcomes and Expenditures in a Context of Healthcare Resource Re-Allocation

Nicolas Krucien (), Nathalie Pelletier-Fleury () and Amiram Gafni ()
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Nicolas Krucien: Institute of Applied Health Sciences, University of Aberdeen
Nathalie Pelletier-Fleury: Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay
Amiram Gafni: McMaster University

PharmacoEconomics, 2019, vol. 37, issue 3, No 7, 407-417

Abstract: Abstract Background The final outcome of any resource allocation decision in healthcare cannot be determined in advance. Thus, decision makers, in deciding which new program to implement (or not), need to accommodate the uncertainty of different potential outcomes (i.e., change in both health and costs) that can occur, the size and nature (i.e., ‘bad’ or ‘good’) of these outcomes, and how they are being valued. Using the decision-making plane, which explicitly incorporates opportunity costs and relaxes the assumptions of perfect divisibility and constant returns to scale of the cost-effectiveness plane, all the potential outcomes of each resource allocation decision can be described. Objective In this study, we describe the development and testing of an instrument, using a discrete choice experiment methodology, allowing the measurement of public preferences for potential outcomes falling in different quadrants of the decision-making plane. Method In a sample of 200 participants providing 4200 observations, we compared four versions of the preference-elicitation instrument using a range of indicators. Results We identified one version that was well accepted by the participants and with good measurement properties. Conclusion This validated instrument can now be used in a larger representative sample to study the preferences of the public for potential outcomes stemming from re-allocation of healthcare resources.

Date: 2019
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DOI: 10.1007/s40273-018-0751-1

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