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What, who and when? Incorporating a discrete choice experiment into an economic evaluation

BACKGROUND: Economic evaluation focuses on Quality-Adjusted-Life-Years (QALYs) as the main valuation method. However, it is well known that factors beyond health related quality of life are important to patients and the public. Whilst discrete-choice-experiments (DCE) have been extensively used to v...

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Autores principales: Tinelli, Michela, Ryan, Mandy, Bond, Christine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967060/
https://www.ncbi.nlm.nih.gov/pubmed/27472943
http://dx.doi.org/10.1186/s13561-016-0108-4
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author Tinelli, Michela
Ryan, Mandy
Bond, Christine
author_facet Tinelli, Michela
Ryan, Mandy
Bond, Christine
author_sort Tinelli, Michela
collection PubMed
description BACKGROUND: Economic evaluation focuses on Quality-Adjusted-Life-Years (QALYs) as the main valuation method. However, it is well known that factors beyond health related quality of life are important to patients and the public. Whilst discrete-choice-experiments (DCE) have been extensively used to value such factors, their incorporation within an economic evaluation framework is limited. This study is the first to incorporate patient preferences for factors beyond QALYs into an economic evaluation and compare results with the standard cost-per-QALY approach, using randomised-controlled-trial (RCT) participants. METHODS: Costings, clinical-effectiveness (appropriateness-of-treatment), QALYs and patient satisfaction data were collected at baseline and 12-month follow-up for a new pharmacy-service within a randomised-controlled-trial. Trial participants who replied to the follow-up survey and had not subsequently withdrawn from the study were mailed a DCE questionnaire at 24-months. WTP for the standard and new service was derived from the DCE. Results from QALYs and the DCE were compared. RESULTS: At 12 months, costs, clinical-effectiveness and QALYs did not differ between the intervention and control; however there was a significant increase in satisfaction in the intervention. The DCE valued this increased satisfaction in the intervention (positive net-benefit). The longer the time patients experienced the new service the greater the reported net-benefit. CONCLUSION: When incorporating a DCE into an economic evaluation a number of questions are raised: what factors should be valued, whose values (trial-groups vs. all–trial-population) and when should they be elicited (still-receiving-the-intervention or afterwards). Consideration should also be given to status quo bias. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13561-016-0108-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-49670602016-08-11 What, who and when? Incorporating a discrete choice experiment into an economic evaluation Tinelli, Michela Ryan, Mandy Bond, Christine Health Econ Rev Research BACKGROUND: Economic evaluation focuses on Quality-Adjusted-Life-Years (QALYs) as the main valuation method. However, it is well known that factors beyond health related quality of life are important to patients and the public. Whilst discrete-choice-experiments (DCE) have been extensively used to value such factors, their incorporation within an economic evaluation framework is limited. This study is the first to incorporate patient preferences for factors beyond QALYs into an economic evaluation and compare results with the standard cost-per-QALY approach, using randomised-controlled-trial (RCT) participants. METHODS: Costings, clinical-effectiveness (appropriateness-of-treatment), QALYs and patient satisfaction data were collected at baseline and 12-month follow-up for a new pharmacy-service within a randomised-controlled-trial. Trial participants who replied to the follow-up survey and had not subsequently withdrawn from the study were mailed a DCE questionnaire at 24-months. WTP for the standard and new service was derived from the DCE. Results from QALYs and the DCE were compared. RESULTS: At 12 months, costs, clinical-effectiveness and QALYs did not differ between the intervention and control; however there was a significant increase in satisfaction in the intervention. The DCE valued this increased satisfaction in the intervention (positive net-benefit). The longer the time patients experienced the new service the greater the reported net-benefit. CONCLUSION: When incorporating a DCE into an economic evaluation a number of questions are raised: what factors should be valued, whose values (trial-groups vs. all–trial-population) and when should they be elicited (still-receiving-the-intervention or afterwards). Consideration should also be given to status quo bias. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13561-016-0108-4) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2016-07-29 /pmc/articles/PMC4967060/ /pubmed/27472943 http://dx.doi.org/10.1186/s13561-016-0108-4 Text en © Tinelli et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Tinelli, Michela
Ryan, Mandy
Bond, Christine
What, who and when? Incorporating a discrete choice experiment into an economic evaluation
title What, who and when? Incorporating a discrete choice experiment into an economic evaluation
title_full What, who and when? Incorporating a discrete choice experiment into an economic evaluation
title_fullStr What, who and when? Incorporating a discrete choice experiment into an economic evaluation
title_full_unstemmed What, who and when? Incorporating a discrete choice experiment into an economic evaluation
title_short What, who and when? Incorporating a discrete choice experiment into an economic evaluation
title_sort what, who and when? incorporating a discrete choice experiment into an economic evaluation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967060/
https://www.ncbi.nlm.nih.gov/pubmed/27472943
http://dx.doi.org/10.1186/s13561-016-0108-4
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