Societal Preferences for Interventions with the Same Efficiency: Assessment and Application to Decision Making.

Area of Science:

• Health Economics
• Decision Analysis
• Public Health Policy

Background:

• Quality-adjusted life-years (QALYs) are standard but may not fully capture healthcare technology value.
• Adjusting cost-per-QALY thresholds based on public preferences remains challenging.

Purpose of the Study:

• Compare two survey methods for measuring public preferences in healthcare.
• Investigate how to integrate public preferences into healthcare decision-making thresholds.

Main Methods:

• Conducted single-attribute (budget allocation) and multi-attribute (discrete-choice) experiments with ~1000 respondents each.
• Assessed preferences based on age, objective of care, disease severity, prior care, cause, and frequency, with equal costs and cost-effectiveness ratios (ICERs).
• Calculated a preference-adjusted threshold (PAT) to quantify public preferences.

Main Results:

• Both experiments showed strong preferences for interventions benefiting younger patients, for treatment over prevention, and for severe conditions, despite equal ICERs.
• The single-attribute experiment indicated a preference for equal resource allocation between two interventions.
• Calculated marginal PATs for key attributes like age and disease severity.

Conclusions:

• Single- and multi-attribute experiments yielded consistent public preference data.
• The preference-adjusted threshold (PAT) offers a numerical method to integrate public preferences into decision-maker thresholds.