Choice Experiment Research Articles

Exploring Co-labeling Strategies in Local Food Markets: Insights from a Choice Experiment on Southern Buyers’ Preferences for Cherry Tomatoes

Labeling strategies are often discussed in the context of local food purchase. Substantial research has been undertaken to discern buyers’ preferences for different labeling strategies associated with a production practice or a geographic location. Some studies have also emphasized the substitution or complementarity effects that may occur across these different labels. Using a large choice experiment with 1820 respondents across six US southern states, this research evaluates buyers’ preferences for co-labeling strategies, focusing on the association of a production practice and certifications (USDA Organic and Certified Naturally Grown) alongside six different production locations, ranging from local to imported sources. We focus on pint baskets of cherry tomatoes, chosen due to their popularity among purchasers of fresh produce. Based on the results provided by a Bayesian Mixed Logit model, we derived the respondent-specific posterior distribution of the partworths associated with each production location and regressed each of those against demographic indicators. Our findings highlight that most buyers substitute between USDA Organic and Certified Naturally Grown (CNG), and a minority consistently opt for the same production practice option. In addition, we underscore that price, or an indication of origin predominantly guides nearly half of buyers’ choices. We find that the premium for CNG is slightly superior to the organic one. Last, older respondents and respondents with a higher degree of education value produce grown within their state over neighboring states and more distant origins.

Consumer preference and willingness to pay for 3D-printed chocolates: A discrete choice experiment

This study explores the emerging field of 3D food printing, specifically examining consumer preferences for 3D-printed chocolate bars. While 3D printing has revolutionized various industries, the consumer acceptance of 3D-printed food remains a relatively underexplored topic. A discrete choice experiment was conducted to investigate consumer preferences and willingness to pay for 3D-printed chocolate bars in the UK. Key attributes included in the study were price, chocolate type, and the use of 3D printing technology. Using a mixed logit model, preference heterogeneity was assessed, revealing a general inclination towards 3D-printed chocolates, with an estimated increase in willingness to pay of £0.21 per 100g. Furthermore, the influence of individual (participants’) characteristics, such as age, gender, prior knowledge of 3D food printing, and food technology neophobia, on perceived benefits associated with this technology and willingness to pay was also explored, using a structural equation modeling analysis. The results indicated that only perceived hedonic benefits, such as improved texture, positively impacted the willingness to pay, while food technology neophobia acted as a significant barrier. The results of this study therefore contribute valuable insights into the consumer acceptance of 3D-printed foods, specifically chocolates, highlighting potential avenues for market adoption and emphasizing the importance of effective communication in shaping consumer attitudes toward novel food processing technologies.

Older adults preferences for long-term caregivers in China: a discrete choice experiment

ObjectiveUnderstanding the preferences of old-age adults for their long-term caregivers can improve person-centred health care and the quality of long-term care (LTC). This study examines Chinese older adults’ preferences for long-term caregivers. Study designThis is a cross-sectional study. MethodsA national representative discrete choice experiment (DCE) surveyed 2031 adults aged 50–70 across 12 provinces in China. Each DCE scenario described five attributes: type of caregivers, place of LTC, contents of LTC, out-of-pocket payments, and quality of life (QoL). Preferences and the marginal willingness to pay (WTP) were derived using mixed-logit and latent class models. ResultsOlder adults displayed higher preferences for long-term caregivers who improve their QoL, incur lower out-of-pocket payments, and provide medical LTC services at home, with the maximum WTP of $22.832 per month. QoL was rated as the most important LTC factor, followed by the place of LTC and the type of caregivers. When the level of QoL improved from poor to good, respondents would be willing to pay $18.375 per month more (95% confidence interval: 16.858 to 20.137), and the uptake rate increased by 76.47%. There was preference heterogeneity among older people with different sex, education, family size, and knowledge of LTC insurance. ConclusionQoL was the most important factor in older Chinese adults' preference for caregivers. Home care and medical care from formal caregivers was preferred by older adults. We recommend training family caregivers, raising older people's awareness of LTC insurance, and guiding policymakers in developing people-oriented LTC and a multi-level LTC system.

Valuing flexible resources in the Korean electricity market based on stated preference methods

This study quantifies the value of lost load (VoLL) for the manufacturing sector in South Korea using stated preference methods. VoLL represents the cost of a stable electricity supply, which serves as a public good without a market price to compensate for flexible resources in the electricity market. The contingent valuation and choice experiment showed VoLL ranges from 0.35 to 0.80 USD per kWh unserved, below the industrial VoLL estimates in the existing literature. This finding suggests that outages may have lower costs for electricity consumers than investing in flexible resources. Using the correct estimate of outage costs is required to ensure capacity adequacy.

Public preferences for coastal adaptation: Economic evidence from a discrete choice experiment for hard structures and nature-based solutions in Miami, Florida

Coastal communities are under pressure to adapt to the increasing impacts of climate change and environmental degradation. One strategy to achieve adaptation goals is to deploy hard structures and nature-based solutions that can help reduce damages from flooding, storm surge, and sea level rise in coastal areas. Understanding how local communities perceive and value these measures helps local authorities follow strategies that not only increase efficiency, but also garner public support. In this paper, we used Miami-Dade County as a case study to establish public preferences and trade-offs across hard structures and nature-based solutions and their physical characteristics to address coastal risk reduction: specifically, seawalls and mangroves. By applying a discrete choice experiment, we showed that respondents are generally in favor of deploying any coastal measures, with a higher willingness-to-pay for nature-based solutions over hard structures. We also found that the same respondents identify the length of protected coastline as a valuable feature of these coastal measures. Our findings inform ongoing plans and policies for coastal adaptation, particularly the deployment of nature-based solutions, and also illustrate the importance of including public input in the decision-making process of coastal management policy.

Youth not engaged in education, employment, or training: a discrete choice experiment of service preferences in Canada

BackgroundPrior research has showed the importance of providing integrated support services to prevent and reduce youth not in education, employment, or training (NEET) related challenges. There is limited evidence on NEET youth’s perspectives and preferences for employment, education, and training services. The objective of this study was to identify employment, education and training service preferences of NEET youth. We acknowledge the deficit-based lens associated with the term NEET and use ‘upcoming youth’ to refer to this population group.MethodsCanadian youth (14–29 years) who reported Upcoming status or at-risk of Upcoming status were recruited to the study. We used a discrete choice experiment (DCE) survey, which included ten attributes with three levels each indicating service characteristics. Sawtooth software was used to design and administer the DCE. Participants also provided demographic information and completed the Global Appraisal of Individual Needs–Short Screener. We analyzed the data using hierarchical Bayesian methods to determine service attribute importance and latent class analyses to identify groups of participants with similar service preferences.ResultsA total of n=503 youth participated in the study. 51% of participants were 24–29 years of age; 18.7% identified as having Upcoming status; 41.1% were from rural areas; and 36.0% of youth stated that they met basic needs with a little left. Participants strongly preferred services that promoted life skills, mentorship, basic income, and securing a work or educational placement. Three latent classes were identified and included: (i) job and educational services (38.9%), or services that include career counseling and securing a work or educational placement; (ii) mental health and wellness services (34.9%), or services that offer support for mental health and wellness in the workplace and free mental health and substance use services; and (iii) holistic skills building services (26.1%), or services that endorsed skills for school and job success, and life skills.ConclusionsThis study identified employment, education, and training service preferences among Upcoming youth. The findings indicate a need to create a service model that supports holistic skills building, mental health and wellness, and long-term school and job opportunities.

Comparing Two Deep-Learning Models in Discrete Choice Analysis of Customers’ Mobile Plan Preferences

A discrete choice experiment (DCE) was used to investigate students’ preferences for mobile phone plans at a South African university. Upon obtaining the data, this study compares the predictive performance of two machine-learning models for discrete choice analysis and makes recommendations for model selection. Using concepts from blocked fractional factorial designs, a locally optimal DCE was created for the choice sets. This contrasts with alternative ways that, in practice, could be more difficult, especially when there is a large number of attributes. The call rate, data speed, customer service, premiums, and network coverage were the features considered. A total of 180 respondents were chosen from the student population using a two-stage sample approach, and data were gathered through face-to-face interviews. In this study, two deep-learning models are examined to analyze the data, which are the artificial neural network (ANN) and the extreme gradient boosting (XGBoost) models. Root mean square error (RMSE) and mean absolute error (MAE) are used to assess the model fitness, while accuracy, precision, recall and F1 score were used to compare the models’ performance. The results showed that XGBoost performs better compared to ANN in model fitness and prediction. Thus, the use of the XGBoost deep-learning model in choice preference modeling is therefore encouraged.

Examining the Effect of Depicting a Patient Affected by a Negative Reimbursement Decision in Healthcare on Public Disagreement with the Decision.

The availability of increasingly advanced and expensive new health technologies puts considerable pressure on publicly financed healthcare systems. Decisions to not-or no longer-reimburse a health technology from public funding may become inevitable. Nonetheless, policymakers are often pressured to amend or revoke negative reimbursement decisions due to the public disagreement that typically follows such decisions. Public disagreement may be reinforced by the publication of pictures of individual patients in the media. Our aim was to assess the effect of depicting a patient affected by a negative reimbursement decision on public disagreement with the decision. We conducted a discrete choice experiment in a representative sample of the public (n = 1008) in the Netherlands and assessed the likelihood of respondents' disagreement with policymakers' decision to not reimburse a new pharmaceutical for one of two patient groups. We presented a picture of one of the patients affected by the decision for one patient group and "no picture available" for the other group. The groups were described on the basis of patients' age, health-related quality of life (HRQOL) and life expectancy (LE) before treatment, and HRQOL and LE gains from treatment. We applied random-intercept logit regression models to analyze the data. Our results indicate that respondents were more likely to disagree with the negative reimbursement decision when a picture of an affected patient was presented. Consistent with findings from other empirical studies, respondents were also more likely to disagree with the decision when patients were relatively young, had high levels of HRQOL and LE before treatment, and large LE gains from treatment. This study provides evidence for the effect of depicting individual, affected patients on public disagreement with negative reimbursement decisions in healthcare. Policymakers would do well to be aware of this effect so that they can anticipate it and implement policies to mitigate associated risks.

The impacts of packaging on preferences for cannabis edibles: A discrete choice experiment

BackgroundsCannabis edibles recently gained considerable market share in the United States. The tobacco and food literatures consistently suggest that product packaging regulations are crucial to substance control, but little is known about how product packaging may impact cannabis edible use. This study aims to estimate the impacts of packaging on individual preferences for cannabis edibles and explore heterogeneities in preferences by cannabis use status and use purposes. Methods1578 adults were recruited, who lived in 18 states and Washington D.C. in the United States that legalized recreational cannabis by the time of data collection in August and September of 2022. An online discrete choice experiment was conducted to elicit individual choices between cannabis edibles with variations in five packaging attributes: package style, health claim, potency indicator, warning label position, and warning label text. Mixed logit regressions were used to assess associations between package attributes and package choices. Subsample analysis was conducted by cannabis use status (users vs. nonusers) and use purposes (medical-only, recreational-only, and dual-purpose) to detect heterogeneities. ResultsAlmost all subsamples prefer branded packages to plain packages, any health claim to no health claim, and any potency indicator to no potency indicator. Cannabis users, particularly recreational-only users and dual-purpose users, also prefer youth-appealing packages to branded packages. Warning label position and text have limited impacts on choices. Overall, package style is perceived to be the most important attribute among the five (relative importance 33.2–50.8%), followed by health claim (relative importance 22.6–30.5%). ConclusionIn the United States, adults’ preferences for cannabis edibles are associated with packaging features. Policies requiring plain package and prohibiting youth-appealing package and unsubstantiated health claims may be effective methods of cannabis control.

Synthetic natural gas in the private heating sector in Germany: match or mismatch between production costs and consumer willingness to pay?

BackgroundThe residential heating sector in many European countries requires a fundamental transformation if it is to become climate neutral. Besides the introduction of efficiency measures and updating heating systems, scholars and practitioners consider replacing fossil fuels in existing heating systems a viable approach. Drop-in renewable gases such as biomethane and synthetic natural gas (SNG) cause considerably fewer carbon dioxide (CO2) emissions than natural gas and can be used in natural gas boilers, the dominant heating system in many European countries. To move the ongoing debate around e-fuels forward, this study reports on a Discrete Choice Experiment with 512 respondents in Germany that analyzed consumer preferences and willingness to pay (WTP) for SNG. I build on these insights by comparing WTP to the production costs, making evidence-based decision-making possible.ResultsThe results show that consumers prefer renewable gases over natural gas. Comparing the two types of renewable gases, SNG and biomethane, reveals that consumers clearly favor the latter despite the criticism it has come under in the last 10–15 years. Consumers show a surprisingly high WTP for increasing shares of SNG, with premia of 40 to almost 70% over a natural gas-based tariff. Comparing production costs to the WTP reveals that only tariffs with small shares of SNG (5% and 10%) can be offered at cost-covering prices.ConclusionsGiven the urgent need for a fundamental transition of the residential heating sector, marketers and policymakers should consider carefully whether it is worth channeling a rather unknown and expensive product like SNG into the voluntary market for heating gas, especially as biomethane is already established in the market and clearly a cheaper and more popular alternative.

Plant growth-promoting rhizobacteria modulate induced corn defense against Spodoptera litura (Lepidoptera: Noctuidae).

Common cutworm, Spodoptera litura is an important pest of corn causing significant crop yield loss. Synthetic insecticides have mostly been used to combat this pest, raising human and environmental health concerns. Plant-growth promoting rhizobacteria (PGPR) could compensate for or augment the harmful effects of agrochemicals. Herein, we aimed to assess whether PGPR-induced defenses in corn plants impact the host-plant selection behavior of S. litura. Headspace volatile organic compounds (VOCs) were analyzed using Gas chromatography-mass spectrometry (GC-MS). Larvae fed inoculated corn exhibited lower weights and RGR than non-inoculated plants. Under choice experiments, PGPR-treated plants significantly reduced percentage leaf damage area and oviposition rate compared to untreated plants. VOC ratio emission varied significantly between control and PGPR treatments, which, in part, explains feeding and oviposition deterrence in PGPR-treated plants. The results demonstrate that PGPR inoculation can enhance corn resistance to S. litura, making it a promising candidate for crop protection strategies.

Information scripts and the incentive compatibility of discrete choice experiments

Information scripts and the incentive compatibility of discrete choice experiments

Multi-Method Formative Evaluation of a Digital Online Grocery Shopping Assistant Among Special Supplemental Nutrition Program for Women, Infants, and Children Participants

ObjectiveAssess the acceptability of a digital grocery shopping assistant among rural women with low income. DesignSimulated shopping experience, semistructured interviews, and a choice experiment. SettingRural central North Carolina Special Supplemental Nutrition Program for Women, Infants, and Children clinic. ParticipantsThirty adults (aged ≥18 years) recruited from a Special Supplemental Nutrition Program for Women, Infants, and Children clinic. Phenomenon of InterestA simulated grocery shopping experience with the Retail Online Shopping Assistant (ROSA) and mixed-methods feedback on the experience. AnalysisDeductive and inductive qualitative content analysis to independently code and identify themes and patterns among interview responses and quantitative analysis of simulated shopping experience and choice experiment. ResultsMost participants liked ROSA (28/30, 93%) and found it helpful and likely to change their purchase across various food categories and at checkout. Retail Online Shopping Assistant's reminders and suggestions could reduce less healthy shopping habits and diversify food options. Participants desired dynamic suggestions and help with various health conditions. Participants preferred a racially inclusive, approachable, cartoon-like, and clinically dressed character. Conclusions and ImplicationsThis formative study suggests ROSA could be a beneficial tool for facilitating healthy online grocery shopping among rural shoppers. Future research should investigate the impact of ROSA on dietary behaviors further.

Physician preferences for nonmetastatic castration-resistant prostate cancer treatment in China

IntroductionThe treatment preferences of Chinese physicians who treat nonmetastatic castration-resistant prostate cancer (nmCRPC) and how they weigh the benefits and risks of nmCRPC treatment are still unknown. This study aimed to evaluate Chinese physicians’ benefit–risk treatment preferences for nmCRPC and assist in setting nmCRPC treatment goals.MethodsA paper-based discrete choice experiment (DCE) survey was administered to 80 nmCRPC-treating physicians. DCE responses were analyzed to produce the preference weight and the relative importance score for each attribute level. The marginal rate of substitution (MRS) was used to quantify the amount of overall survival (OS) physicians were willing to trade for a reduction in treatment-related adverse events (AEs). We further conducted the exploratory analysis, stratifying physicians from 5 perspectives into different subgroups and examining the treatment preferences and OS trade-off in each subgroup.ResultsIn terms of efficacy attributes, physicians placed greater emphasis on OS than time to pain progression. With regard to safety attributes, serious fracture was perceived as the most important AE by physicians, followed by serious fall, cognitive problems, skin rash, and fatigue. In the exploratory analysis, we found generally that physicians with less clinical practice experience and those from more economically developed regions placed more emphasis on AEs and were willing to give up more of their patients’ OS to reduce the risk of AEs.ConclusionPhysicians from mainland China value the importance of minimizing treatment-related AEs when considering different treatment options for patients with nmCRPC, and they are willing to trade a substantial amount of OS to avoid AEs.

Rapid respiratory microbiological point-of-care-testing and antibiotic prescribing in primary care: Protocol for the RAPID-TEST randomised controlled trial.

Antibiotics are prescribed for over 50% of respiratory tract infections in primary care, despite good evidence of there being no benefit to the patient, and evidence of over prescribing driving microbial resistance. The high treatment rates are attributed to uncertainty regarding microbiological cause and clinical prognosis. Point-of-care-tests have been proposed as potential antibiotic stewardship tools, with some providing microbiological results in 15 minutes. However, there is little research on their impact on antibiotic use and clinical outcomes in primary care. This is a multi-centre, individually randomised controlled trial with mixed-methods investigation of microbial, behavioural and antibiotic mechanisms on outcomes in patients aged 12 months and over presenting to primary care in the UK with a suspected respiratory tract infection, where the clinician and/or patient thinks antibiotic treatment may be, or is, necessary. Once consented, all participants are asked to provide a combined nose and throat swab sample and randomised to have a rapid microbiological point-of-care-test or no point-of-care-test. For intervention patients, clinicians review the result of the test, before contacting the patient to finalise treatment. Treatment decisions are made as per usual care in control group patients. The primary outcome is whether an antibiotic is prescribed at this point. All swab samples are sent to the central laboratory for further testing. Patients are asked to complete a diary to record the severity and duration of symptoms until resolution or day 28, and questionnaires at 2 months about their beliefs and intention to consult for similar future illnesses. Primary care medical records are also reviewed at 6-months to collect further infection consultations, antibiotic prescribing and hospital admissions. The trial aims to recruit 514 patients to achieve 90% power with 5% significance to detect a 15% absolute reduction in antibiotic prescribing. Qualitative interviews are being conducted with approximately 20 clinicians and 30 participants to understand any changes in beliefs and behaviour resulting from the point-of-care-test and generate attributes for clinician and patient discrete choice experiments. This trial will provide evidence of efficacy, acceptability and mechanisms of action of a rapid microbiological point-of-care test on antibiotic prescribing and patient symptoms in primary care. ISRCTN16039192, prospectively registered on 08/11/2022.

Healthcare Providers' and Pregnant People's Preferences for a Preventive to Protect Infants from Serious Illness Due to Respiratory Syncytial Virus.

We assessed the impact of respiratory syncytial virus (RSV) preventive characteristics on the intentions of pregnant people and healthcare providers (HCPs) to protect infants with a maternal vaccine or monoclonal antibodies (mAbs). Pregnant people and HCPs who treated pregnant people and/or infants were recruited via convenience sample from a general research panel to complete a cross-sectional, web-based survey, including a discrete choice experiment (DCE) wherein respondents chose between hypothetical RSV preventive profiles varying on five attributes (effectiveness, preventive type [maternal vaccine vs. mAb], injection recipient/timing, type of medical visit required to receive the injection, and duration of protection during RSV season) and a no-preventive option. A best-worst scaling (BWS) exercise was included to explore the impact of additional attributes on preventive preferences. Data were collected between October and November 2022. Attribute-level preference weights and relative importance (RI) were estimated. Overall, 992 pregnant people and 310 HCPs participated. A preventive (vs. none) was chosen 89.2% (pregnant people) and 96.0% (HCPs) of the time (DCE). Effectiveness was most important to preventive choice for pregnant people (RI = 48.0%) and HCPs (RI = 41.7%); all else equal, pregnant people (RI = 5.5%) and HCPs (RI = 7.2%) preferred the maternal vaccine over mAbs, although preventive type had limited influence on choice. Longer protection, protection starting at birth or the beginning of RSV season, and use for both pre-term and full-term babies were ranked highest in importance (BWS). Pregnant people and HCPs strongly preferred a preventive to protect infants against RSV (vs. none), underscoring the need to incorporate RSV preventives into routine care.

Differences in health utilities between cancer patients and the general population: The case of Quebec using the SF-6Dv2

A considerable debate persists in the literature about whose preferences should be considered in the calculation of quality-adjusted life-years. Some suggest considering only the preferences of the general population, while others advocate for the consideration of those of patients or a combination of both. This study aims to inform and measure the differences in health preferences between cancer patients and the general population in Quebec. A total of 60,976 observations representing the preferences of the general population for various health states were collected and used to develop a new value set using the SF-6Dv2. This value set was generated by combining 34,299 observations with time trade-off (TTO) and 26,677 observations with discrete choice experiment (DCE). Utility scores derived from this value set were compared to those of patients' preferences from a new value set in breast and colorectal patients for the SF-6Dv2. For both patients and the general population, the ‘Pain’ dimension was the highest contributor to the utility score. However, noticeable differences were observed in the estimates. Estimates of levels 2 and 3 were generally lower for cancer patients, while they were more likely to have greater estimates in severe levels. Significant differences in utility scores were also noticed with the general population showing higher mean utility scores for the same health states. These differences increased as the health states worsened. This study sheds light on the existing differences in preferences between cancer patients and the general population of Quebec for a better consideration in healthcare decision-making.

Turmeric trends: analyzing consumer preferences and willingness to pay

This Research determines the factors influencing American consumers’ willingness to purchase turmeric products, amidst the spice’s rising popularity for its potential health benefits, particularly those linked to its bioactive component, curcumin. Through a comprehensive analysis of a Qualtrics online survey with 1,020 national respondents in the U.S., we employed advanced choice experiment mixed logit models to elucidate consumer preferences regarding product form, origin, sustainability certification, curcumin content, and price. Contrary to the initial hypothesis that curcumin potency would be a primary driver, our results indicate that the place of origin and price significantly shape purchasing decisions, with a clear preference for inland domestically grown, organically certified turmeric products. These insights offer valuable guidance for producers, manufacturers, and marketers in the natural products industry, suggesting a focus on emphasizing local, sustainable sourcing and clear communication of organic credentials to align with consumer expectations. Our findings not only provide a detailed understanding of current consumer attitudes toward turmeric but also highlight potential markets for turmeric–based product development and effective marketing to cater to the evolving demand for health-beneficial natural products.

The Global Impact of Diversifying PrEP Options: Results of an International Discrete Choice Experiment of Existing and Potential PrEP Strategies with Gay and Bisexual Men and Physicians.

To improve current and future use of existing (oral, injectable) and potential future (implants, douches) pre-exposure prophylaxis (PrEP) products, we must understand product preferences relative to one another, among gay and bisexual men (GBM), and physicians who prescribe PrEP. We completed an online discrete choice experiment (DCE) with separate groups of GBM and/or physicians from the United States, South Africa, Spain, and Thailand. Participants were presented information on PrEP products, including daily pills, event-driven pills (2-1-1 regimen), injections, subdermal implants (dissolvable, removable), and rectal douches. Next, they completed a choice exercise in which they were shown 10 screens, each presenting 3 of the aforementioned products at a time with 11 attributes for physicians and 10 attributes for GBM. For the attributes that were not constant, one level was shown per screen for each product. Participants selected the product they preferred most and rated their likelihood to select (GBM) or recommend (physicians) that product. Data were modeled using hierarchical Bayes estimation; resulting model coefficients were used to develop attribute importance measures and product preferences. For GBM across all countries, if all aforementioned PrEP products were on the market at the same time, over 90% of GBM would use some form of PrEP; 100% of physicians would recommend at least one of the PrEP products. There were variations in product preference by country. GBM in the United States and Thailand preferred the injection (21.7%, 22.9%, respectively), while the dissolvable implant was preferred in South Africa and Spain (19.9%, 19.8%, respectively). In the United States, South Africa, and Spain (where physician data were available), physicians were most likely to recommend the dissolvable implant (37.2%, 40.6%, 38.3%, respectively).

Patients' Preferences for Sphingosine-1-Phosphate Receptor Modulators in Multiple Sclerosis Based on Clinical Management Considerations: A Choice Experiment.

Several sphingosine-1-phosphate receptor (S1PR) modulators are available in the US for treating relapsing forms of multiple sclerosis (RMS). Given that these S1PR modulators have similar efficacy and safety, patients may consider the clinical management characteristics of the S1PR modulators when deciding among treatments. However, none of the S1PR modulators is clearly superior in every aspect of clinical management, and for some treatments, clinical management varies based on a patient's comorbid health conditions (e.g., heart conditions [HC]). This study aimed to determine which S1PR modulator patients with relapsing-remitting multiple sclerosis (RRMS) would prefer based on clinical management considerations, and to estimate how different clinical management considerations might drive these preferences. Preferences were explored separately for patients with and without comorbid HC. A multicriteria decision analysis was conducted on S1PR modulators approved to treat RMS: fingolimod, ozanimod, siponimod, and ponesimod. Clinical management preferences of patients with RRMS were elicited in a discrete choice experiment (DCE) in which participants repeatedly chose between hypothetical S1PR modulator profiles based on their clinical management attributes. Attributes included first-dose observations, genotyping, liver function tests, eye examinations, drug-drug interactions, interactions with antidepressants, interactions with foods high in tyramine, and immune system recovery time. Preferences were estimated separately for patients with HC and without HC (noHC). Marginal utilities were calculated from the DCE data for each attribute and level using a mixed logit model. In the multicriteria decision analysis, partial value scores were created by applying the marginal utilities for each attribute and level to the real-world profiles of S1PR modulators. Partial value scores were summed to determine an overall clinical management value score for each S1PR modulator. Four hundred patients with RRMS completed the DCE. Ponesimod had the highest overall value score for patients both without (n=341) and with (n=59) HC (noHC: 5.1; HC: 4.0), followed by siponimod (noHC: 4.9; HC: 3.3), fingolimod (noHC: 3.4; HC: 2.8), and ozanimod (noHC: 0.9; HC: 0.8). Overall, immune system recovery time contributed the highest partial value scores (noHC: up to 1.9 points; HC: up to 1.2 points), followed by the number of drug-drug interactions (noHC: up to 1.2 points; HC: up to 1.7 points). When considering the clinical management of S1PR modulators, the average patient with RRMS is expected to choose a treatment with shorter immune system recovery time and fewer interactions with other drugs. Patients both with and without heart conditions are likely to prefer the clinical management profile of ponesimod over those of siponimod, fingolimod, and ozanimod. This information can help inform recommendations for treating RRMS and facilitate shared decision making between patients and their doctors.