Public Preferences for Health Gains and Cures: A Discrete Choice Experiment

Whether or not society values curative therapies and those with large health gains over and above more incremental gains has been highlighted as an important area for research. In a new OHE Consulting Report, we explore society’s preferences across curative and non-curative therapies and large and small health gains.

A discrete choice experiment (DCE) was undertaken as part of an online stated preferences survey (n=1,000). Five attributes were included to describe the alternatives: life expectancy with current care, quality of life with current care, increase in life expectancy with new treatment, increase in quality of life with new treatment, and number of patients treated. A treatment was flagged to respondents as “a cure” if the combination of attributes restored patients to normal life expectancy and full quality of life.

The results revealed that respondents:

  • preferred larger health gains in terms of both quality of life and length of life, but evidence of diminishing marginal utility in health was identified. These gains were the strongest in driving choices, with a combined relative importance of 66%;
  • were less likely to choose to treat groups with worse outlook under current care;
  • preferred to treat greater numbers of patients;
  • were not influenced by whether or not a treatment was a cure above and beyond the influence of the health gains themselves.

In summary, we find that respondents value health gains highly but do not appear to place special value on the treatment being a “cure” per se.

However, we used a very specific definition of a cure and therefore suggest our results are interpreted with caution. Treatments that offer sizeable health gains, but do not necessarily restore health to that of a healthy individual, would no doubt be of significant social value given the preferences of our respondents for larger health gains. This reflects the benefits offered by some advanced therapy medicinal products, which have the potential to result in substantial health benefits but may not quite restore patients to the health of a disease-free individual.

Download the full report here.

For more information, please contact Grace Hampson.

Citation

Hampson, G., Mott, D., Shah, K., and Devlin, N., 2018. Public Preferences for Health Gains and Cures: A Discrete Choice Experiment. OHE Consulting Report, London: Office of Health Economics

Related research

Karlsberg-Schaffer, S., Messner, D., Mestre-Ferrandiz, J., Tambor, E. and Towse, A., 2018. Paying for Cures: Perspectives on Solutions to the “Affordability Issue”. Value in Health, 21(3), pp.76-279. DOI.

Shah, K., Tsuchiya, A., and Wailoo, A., 2015. Valuing health at the end of life: A stated preference discrete choice experiment. Social Science & Medicine, 124(C), pp. 48-56. DOI. RePEc.

Posted in Health Technology Assessment, OHE Consulting | Tagged Consulting Reports