The Impact Of Patient Preference Studies In The German Healthcare System

Abstract

Patients commonly have to deal with healthcare-related decisions based on their personal preferences. Preference studies could help informing on relevance of patient-related outcomes which are of paramount importance in the regulatory AMNOG process. IQWIG also already performed preference studies on the impact of adverse events of pharmaceuticals for the AMNOG process. Aim of this study was to assess the current impact of preference studies in the German healthcare context. A systematic literature search was performed in PubMed and Scopus. Search terms comprised the different preference elicitation methods. The search included all studies conducted in/for Germany up to March 2017 with respect to the applied approach, year of publication, and indication. The search yielded n=511 hits (n=122 in PubMed, n=389 in Scopus, respectively) with n=94 publications being included and stratified by approach, publication year, and indication. Six categories of preference methods were determined: Analytic Hierarchy Process (AHP), Best-Worst-Scaling (BWS), Conjoint Analysis (CA), Contingent Valuation/Willingness to pay (WTP), Discrete Choice Experiment (DCE), and others. Most publications (64.9%) used DCEs, followed by AHP (11.7%) and CA (9.6%) with the first study dating back to 2001. Since 2011, numbers significantly increased with a peak in 2016 (24.5%). 80.9% of the preference studies were conducted for specific disease areas being led by psychological disorders (16.0%), metabolic disorders (10.6%), and infections (9.6%). Patient preference studies have become an important research area when considering the increasing number of patient preference studies in Germany over recent years. Out of the identified methods of preference elicitation, the DCE is the most commonly applied method in Germany. Patient preference studies were adapted over a wide range of diseases suggesting that an inclusion of such evidence in many cases might constitute a feasible option of identifying patient-relevant outcomes offering a separate component of value also during the regulatory AMNOG process.