Patient Preferences for Diagnostic Tests Aimed at Managing Antimicrobial Resistance

Article by: David Mott

Antimicrobial resistance (AMR) in infectious diseases is a global health crisis. AMR is highly problematic, because it limits the ability to treat common infections, ultimately leading to prolonged illnesses, increased costs, and higher rates of mortality. It has been estimated that by 2050, annual deaths from drug-resistant infections could reach 10 million globally unless effective action is taken.

Funded by the UK’s cross-council initiative on tackling AMR, OHE and the University of Sussex Business School have researched patients’ preferences for the different characteristics of diagnostic tests used in the primary care setting with the aim of managing AMR. This research involved survey participants from the United Kingdom (UK), Germany, Spain, France, the Netherlands, Greece, and Italy who had used antibiotics in the previous two years. This is the first preference study in this context (to our knowledge), and the survey results have now been published in the peer-reviewed journal Applied Health Economics & Health Policy.

Discrete choice experiment (DCE) methodology was used to identify the relative importance of different diagnostic test characteristics: the convenience of taking the test, confidence in the test results, and the speed that results would become available. In the DCE, participants had to make choices between two hypothetical diagnostic tests, indicating their preference for one test over another.

The results illustrated that preferences differ both within and between different European countries. The convenience of taking the test was the most important characteristic on average for participants living in the UK, France, Spain and Italy, whereas for Germany and the Netherlands it was the confidence in the test results. In Greece, these characteristics were equally important. In all countries apart from the UK, the speed that results would become available was the least important characteristic. These results suggest that a ‘one size fits all’ strategy for the provision of diagnostic tests across Europe is unlikely to be the most efficient approach.

Given that patients can have a direct impact on the uptake of diagnostic tests, as well as the severity of the threat of AMR, it is important that patients’ preferences are considered when decisions are made about the design and provision of diagnostic tests. Ultimately, the use of diagnostic tests in the primary care setting has the potential to substantially reduce the overuse and misuse of antibiotics, which is fundamental to tackling AMR.

The full article, which has been published with an open access licence making it free to read, can be accessed on the Applied Health Economics & Health Policy website.

An additional component of this research aimed at identifying the views of European health care professionals working in both primary care and hospital settings for the characteristics of diagnostic tests. This research is ongoing and will be published in the near future.

This work was funded by ‘Tackling AMR – A Cross Council Initiative’ (grant ref: MR/N014316/1).



Mott, D.J., Hampson, G., Llewelyn, M.J., Mestre-Ferrandiz, J. and Hopkins, M.M., 2019. A Multinational European Study of Patient Preferences for Novel Diagnostics to Tackle Antimicrobial Resistance. Applied Health Economics & Health Policy. DOI.

Related research

Neri, M., Hampson, G., Henshall, C. and Towse, A., 2019. HTA and Payment Mechanisms for New Drugs to Tackle AMR. OHE Research Paper. Office of Health Economics: London. RePEc.

Neri, M. and Towse, A., 2017. Antimicrobials Resistance: A Call for Multi-disciplinary Action. How Can HTA Help? OHE Briefing. Office of Health Economics: London. RePEc.

Karlsberg Schaffer, S., West, P., Towse, A., Henshall, C., Mestre-Ferrandiz, J., Masterson, R., and Fischer, A., 2017. Assessing the Value of New Antibiotics: Additional Elements of Value for Health Technology Assessment Decisions. OHE Briefing. Office of Health Economics: London. RePEc.

Ferraro, J., Towse, A., and Mestre-Ferrandiz, J., 2017. Incentives for New Drugs to Tackle Anti-Microbial Resistance. OHE Briefing. Office of Health Economics: London. RePEc.

Towse, A., Hoyle, C., Goodall J., Hirsch M., Mestre-Ferrandiz, J. and Rex, J., 2017. Time for a Change in How New Antibiotics are Reimbursed: Development of an Insurance Framework for Funding New Antibiotics based on a Policy of Risk Mitigation. Health Policy. DOI. RePEc.

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