Discrete Choice Experiments

Abstract

Discrete choice experiments (DCEs) were introduced into health economics in the early 1990s to ensure a person-centred approach to economic evaluation. While economic evaluation had focused on clinical outcomes, using measures such as quality-adjusted life years (QALYs), DCEs valued broader aspects of care, including how the care is delivered and non-health outcomes. DCEs are an attribute-based measure of value. They can be used to address a range of questions faced by decision-makers, including valuing patient experiences alongside clinical outcomes, valuing health states and predicting uptake/acceptability of new services. DCEs provide potentially useful information within a health technology assessment (HTA) decision-making context—what characteristics (attributes) are important, how important these are, trade-offs between characteristics, monetary measures of value and predictions of take-up rates and acceptability of interventions/medicines/services. This chapter provides an introduction to DCEs, summarising the method and discussing how they can inform the HTA process. The method is illustrated using a DCE within a HTA looking at surveillance of ocular hypertension. We discuss methodological challenges within a HTA context and areas for future research.