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Choi SH, Templin T. College students' preferences for tobacco treatment: a discrete choice experiment. HEALTH EDUCATION RESEARCH 2023; 38:563-574. [PMID: 37639385 DOI: 10.1093/her/cyad035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
The purpose of this study was to elicit preferences for the 'format' and 'content' of tobacco treatment among college student smokers, using an online discrete choice experiment (DCE) survey. A DCE survey, supplemented with a think-aloud method, was conducted among 54 college students who smoked combustible cigarettes and/or e-cigarettes. Conditional logistic regression models were constructed to determine optimal profiles of treatment. Cutting down nicotine rather than quitting 'cold turkey' (P < 0.001) and two-way communication (P < 0.001) were viewed as the most critical attributes for the intervention 'format'; changing behaviors rather than social groups/peers (P < 0.001) and autonomy (P < 0.001) were viewed as the most critical attributes for the intervention 'content'. Some preferences varied based on smoking subgroups. Combustible cigarette users preferred interventions with a longer time commitment (P < 0.05) and without nicotine replacement therapies (NRTs) (P < 0.001). Think-aloud data supported the DCE findings and further revealed a strong desire for cutting down nicotine and keeping social groups/peers and misconceptions regarding NRTs. Our study findings can guide tobacco treatment tailored to college students. These treatments should be tailored to specific smoker subgroups.
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Affiliation(s)
- S H Choi
- College of Nursing - Wayne State University, 5557 Cass Ave #350, Detroit, MI 48202, USA
| | - T Templin
- College of Nursing - Wayne State University, 5557 Cass Ave #350, Detroit, MI 48202, USA
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Lund M, Kvaavik E. Methods Used in Smoking Cessation and Reduction Attempts: Findings from Help-Seeking Smokers. J Smok Cessat 2021; 2021:6670628. [PMID: 34306230 PMCID: PMC8279185 DOI: 10.1155/2021/6670628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 11/17/2022] Open
Abstract
In addition to traditional smoking cessation methods like nicotine replacement therapy (NRT), new methods such as mobile applications and e-cigarettes have been added to the toolbox. The purpose of this study was to examine which methods smokers currently use in quit or reduction attempts and map characteristics of users of the various methods. In this study, participants were smokers who visited a website or called a quit line for smoking cessation and who were currently in quit or reduction attempts (N = 740). Data were collected in Norway in 2013-2017 through a web survey. Most smokers were currently trying to quit, and the most frequently used methods were a smoking cessation app for mobile phones, nicotine replacement therapies (NRTs), and e-cigarettes. Logistic regression analyses identified older daily smokers with high cigarette consumption as NRT users, while the users of a cessation app were younger females. The use of e-cigarettes was associated with older, low educated smokers with low cigarette consumption. The use of the mobile phone app was associated with having made several recent quit attempts. The study provides insight into help-seeking smokers' preferences for smoking cessation methods and user characteristics. This knowledge is relevant for further work in smoking cessation planning and policies.
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Leone FT, Zhang Y, Evers-Casey S, Evins AE, Eakin MN, Fathi J, Fennig K, Folan P, Galiatsatos P, Gogineni H, Kantrow S, Kathuria H, Lamphere T, Neptune E, Pacheco MC, Pakhale S, Prezant D, Sachs DPL, Toll B, Upson D, Xiao D, Cruz-Lopes L, Fulone I, Murray RL, O’Brien KK, Pavalagantharajah S, Ross S, Zhang Y, Zhu M. Initiating Pharmacologic Treatment in Tobacco-Dependent Adults. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2020; 202:e5-e31. [PMID: 32663106 PMCID: PMC7365361 DOI: 10.1164/rccm.202005-1982st] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: Current tobacco treatment guidelines have established the efficacy of available interventions, but they do not provide detailed guidance for common implementation questions frequently faced in the clinic. An evidence-based guideline was created that addresses several pharmacotherapy-initiation questions that routinely confront treatment teams. Methods: Individuals with diverse expertise related to smoking cessation were empaneled to prioritize questions and outcomes important to clinicians. An evidence-synthesis team conducted systematic reviews, which informed recommendations to answer the questions. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was used to rate the certainty in the estimated effects and the strength of recommendations. Results: The guideline panel formulated five strong recommendations and two conditional recommendations regarding pharmacotherapy choices. Strong recommendations include using varenicline rather than a nicotine patch, using varenicline rather than bupropion, using varenicline rather than a nicotine patch in adults with a comorbid psychiatric condition, initiating varenicline in adults even if they are unready to quit, and using controller therapy for an extended treatment duration greater than 12 weeks. Conditional recommendations include combining a nicotine patch with varenicline rather than using varenicline alone and using varenicline rather than electronic cigarettes. Conclusions: Seven recommendations are provided, which represent simple practice changes that are likely to increase the effectiveness of tobacco-dependence pharmacotherapy.
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Katz DA, Hamlin C, Vander Weg MW, Grant KM, Stewart Steffensmeier KR, Paez M, Hawley ST, Gaeth G. Veterans' preferences for tobacco treatment in primary care: A discrete choice experiment. PATIENT EDUCATION AND COUNSELING 2020; 103:652-660. [PMID: 31629558 DOI: 10.1016/j.pec.2019.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 09/25/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To evaluate US veterans' preferences for smoking cessation counseling and pharmacotherapy. METHODS A discrete choice experiment (DCE) was conducted in 123 Veterans Health Administration primary care outpatients who planned to quit smoking within 6 months. Key attributes of tobacco cessation treatment were based on literature review and expert opinion. We used a hierarchical Bayesian approach with a logit model to estimate the part-worth utility of each attribute level and used latent class logit models to explore preference heterogeneity. RESULTS In the aggregate, participants valued counseling options with the following attributes: higher quit rate at 1 year, emphasis on autonomy, familiarity of the counselor, counselor's communication skills, and inclusion of printed materials on smoking cessation. Participants valued pharmacotherapy options with the following attributes: higher quit rate at 1 year, lower risk of physical side effects, zero copayment, monthly check-in calls, and less weight gain. Latent class analysis revealed distinct clusters of patients with a unique preference "phenotype." CONCLUSIONS Veterans have distinct preferences for attributes of cessation counseling and pharmacotherapy. PRACTICE IMPLICATIONS Identifying patients' preferences provides an opportunity for clinicians to offer tailored treatment options that better engage veterans in their own care and boost adherence to guideline-recommended counseling and pharmacotherapy.
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Affiliation(s)
- David A Katz
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, VA Iowa City Health Care System (152), Iowa City, IA 52246-2208, USA; Department of Medicine, University of Iowa, Iowa City, IA, USA; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
| | - Christine Hamlin
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, VA Iowa City Health Care System (152), Iowa City, IA 52246-2208, USA
| | - Mark W Vander Weg
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, VA Iowa City Health Care System (152), Iowa City, IA 52246-2208, USA; Department of Medicine, University of Iowa, Iowa City, IA, USA; Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Kathleen M Grant
- VA Nebraska-Western Iowa Health Care System and the Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kenda R Stewart Steffensmeier
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, VA Iowa City Health Care System (152), Iowa City, IA 52246-2208, USA
| | - Monica Paez
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, VA Iowa City Health Care System (152), Iowa City, IA 52246-2208, USA
| | - Sarah T Hawley
- Ann Arbor Veterans Administration (VA) Healthcare System, University of Michigan, Ann Arbor, MI, USA; Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
| | - Gary Gaeth
- Tippie School of Business, University of Iowa, Iowa City, IA, USA
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Katz DA, Stewart KR, Paez M, Vander Weg MW, Grant KM, Hamlin C, Gaeth G. Development of a Discrete Choice Experiment (DCE) Questionnaire to Understand Veterans' Preferences for Tobacco Treatment in Primary Care. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 11:649-663. [PMID: 29855976 DOI: 10.1007/s40271-018-0316-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Providers often prescribe counseling and/or medications for tobacco cessation without considering patients' treatment preferences. OBJECTIVE The primary aims of this study are to describe (1) the development of a discrete choice experiment (DCE) questionnaire designed to identify the attributes and levels of tobacco treatment that are most important to veterans; and (2) the decision-making process in choosing between hypothetical tobacco treatments. METHODS We recruited current smokers who were already scheduled for a primary care appointment within a single Veterans Affairs (VA) healthcare system. Subjects were asked to rate the importance of selected treatment attributes and were interviewed during two rounds of pilot testing of initial DCE instruments. Key attributes and levels of the initial instruments were identified by targeted literature review; the instruments were iteratively revised after each round of pilot testing. Using a 'think aloud' approach, subjects were interviewed while completing DCE choice tasks. Constant comparison techniques were used to characterize the issues raised by subjects. Findings from the cognitive interviews were used to revise the initial DCE instruments. RESULTS Most subjects completed the DCE questionnaire without difficulty and considered two or more attributes in choosing between treatments. Two common patterns of decision-making emerged during the cognitive interviews: (1) counting 'pros' and 'cons' of each treatment alternative; and (2) using a 'rule-out' strategy to eliminate a given treatment choice if it included an undesirable attribute. Subjects routinely discounted the importance of certain attributes and, in a few cases, focused primarily on a single 'must-have' attribute. CONCLUSION Cognitive interviews provide valuable insights into the comprehension and interpretation of DCE attributes, the decision processes used by veterans during completion of choice tasks, and underlying reasons for non'-compensatory decision-making.
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Affiliation(s)
- David A Katz
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System (152), Iowa City, IA, 52246-2208, USA. .,Department of Medicine, University of Iowa, Iowa City, IA, USA. .,Department of Epidemiology, University of Iowa, Iowa City, IA, USA.
| | - Kenda R Stewart
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System (152), Iowa City, IA, 52246-2208, USA
| | - Monica Paez
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System (152), Iowa City, IA, 52246-2208, USA
| | - Mark W Vander Weg
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System (152), Iowa City, IA, 52246-2208, USA.,Department of Medicine, University of Iowa, Iowa City, IA, USA.,Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Kathleen M Grant
- VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA.,Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Christine Hamlin
- Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System (152), Iowa City, IA, 52246-2208, USA
| | - Gary Gaeth
- Tippie School of Business, University of Iowa, Iowa City, IA, USA
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Regmi K, Kaphle D, Timilsina S, Tuha NAA. Application of Discrete-Choice Experiment Methods in Tobacco Control: A Systematic Review. PHARMACOECONOMICS - OPEN 2018; 2:5-17. [PMID: 29464666 PMCID: PMC5820233 DOI: 10.1007/s41669-017-0025-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Economic evidence relating to tobacco control is generally derived from the cost effectiveness of smoking-cessation programs or the economic impact of tobacco-induced disease, based on revealed-preference data. However, empirical estimates from stated-preference data on tobacco users' preferences, smoking behaviour and smoking cessation aids using analytical techniques such as discrete-choice experiments (DCEs) could be important for policy decision making in tobacco control. OBJECTIVES Our objective was to review the practice and utility of DCE methodology across nicotine- and tobacco-related issues, particularly smoking and smoking-cessation behaviour, anti-smoking policies and preferences for smoking-cessation aids. METHODS We searched the PubMed, MEDLINE and ECONLIT databases for full-text original research articles on tobacco-related issues published between January 2000 and April 2016 that used a DCE method. We summarised the evidence and methodological characteristics of DCEs according to Lancsar and Louviere, 2008. RESULTS Our review of the 12 eligible studies showed that DCE methodology was used to elicit smoker preferences and to evaluate tobacco-control policies. The majority of the studies were published in the last 5 years. The areas of application were smoking cessation, smoking behaviour, electronic cigarette use, water-pipe smoking and tobacco packaging. Monetary attributes were the most influential attributes in all studies. The design of the DCEs varied. CONCLUSION DCE studies of tobacco-related issues were methodologically consistent with guidelines proposed for conducting health-related DCEs.
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Affiliation(s)
- Kabindra Regmi
- Faculty of Health Science, PAPRSB Institute of Health Science, University Brunei Darussalam, Gadong, BE1410 Brunei Darussalam
- Centre for Innovative Research in Public Health, Pokhara, Nepal
| | - Dinesh Kaphle
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sabina Timilsina
- Centre for Innovative Research in Public Health, Pokhara, Nepal
- Faculty of Medicine, Center for Tropical Medicine, Gadjah Mada University, Gedung PAU UGM, Yogyakarta, 55281 Indonesia
| | - Nik Annie Afiqah Tuha
- Faculty of Health Science, PAPRSB Institute of Health Science, University Brunei Darussalam, Gadong, BE1410 Brunei Darussalam
- Department of Primary Care and Public Health, Faculty of Public Health, Imperial College London, London, UK
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A Cross-sectional Examination of What Smokers Perceive to be Important and Their Willingness to Pay for Tobacco Cessation Medications. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 22:48-56. [PMID: 26594936 DOI: 10.1097/phh.0000000000000338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Tobacco smoking is the leading cause of preventable morbidity and mortality in the United States, and smoking cessation has multiple health benefits. OBJECTIVE The purpose of this study was to assess cigarette smokers' perceived importance toward characteristics of tobacco cessation medications using a willingness-to-pay approach. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional analysis of data from the 2008 HealthStyles survey, a mail-based probability sample of 5399 adults aged 18 years and older.Point estimates and 95% confidence intervals were calculated overall and by sociodemographic and smoking behavior characteristics. Multivariate Probit regression analysis was used to evaluate smokers' willingness to pay in relation to perceived importance of 3 cessation medication characteristics: convenience of use, over-the-counter availability, and efficiency to help quit. All models controlled for sociodemographic characteristics, smoking behavior characteristics, and US regional fixed effects. A total of 914 current cigarette smokers. MAIN OUTCOME MEASURES Interest in quitting, interest in using cessation medications, and willingness to pay for 6 types of cessation medications. RESULTS Approximately 68.4% of current cigarette smokers were interested in quitting. Among these individuals, 45.6% indicated that they were interested in using cessation medications, and of these, 47.3% indicated that they were willing to pay $150 or more out-of-pocket for these medications. Convenience of use and the effectiveness of these medications to help quit were positively associated with current smokers' willingness to pay for $300 or more (P < .05); however, no association was observed for over-the-counter availability. Self-reported exposure to telephone quitline advertisements was also positively associated with the willingness to pay. CONCLUSIONS Approximately 68% of current smokers are interested in quitting, and about half of those smokers interested in quitting are also interested in using cessation medications. Convenience of use and the medication's effectiveness are important characteristics of cessation medication for smokers with quit intentions. Understanding preferences for these cessation medication characteristics may help inform smoking cessation efforts.
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Nesson E. Heterogeneity in Smokers' Responses to Tobacco Control Policies. HEALTH ECONOMICS 2017; 26:206-225. [PMID: 26620261 DOI: 10.1002/hec.3289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 09/06/2015] [Accepted: 10/17/2015] [Indexed: 06/05/2023]
Abstract
This paper uses unconditional quantile regression to estimate whether smokers' responses to tobacco control policies change across the distribution of smoking levels. I measure smoking behavior with the number of cigarettes smoked per day and also with serum cotinine levels, a continuous biomarker of nicotine exposure, using individual-level repeated cross-section data from the National Health and Nutrition Examination Surveys. I find that the cigarette taxes lead to reductions in both the number of cigarettes smoked per day and in smokers' cotinine levels. These reductions are most pronounced in the middle quantiles of both distributions in terms of marginal effects, but most pronounced in the lower quantiles in terms of tax elasticities. I do not find that higher cigarette taxes lead to statistically significant changes in the amount of nicotine smokers ingest from each cigarette. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Erik Nesson
- Department of Economics, Miller College of Business, Ball State University, Muncie, IN, USA
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Cutler DM, Jessup AI, Kenkel DS, Starr MA. Economic Approaches to Estimating Benefits of Regulations Affecting Addictive Goods. Am J Prev Med 2016; 50:S20-S26. [PMID: 27102854 DOI: 10.1016/j.amepre.2015.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/01/2015] [Accepted: 12/02/2015] [Indexed: 10/21/2022]
Abstract
The question of how to evaluate lost consumer surplus in benefit-cost analyses has been contentious. There are clear health benefits of regulations that curb consumption of goods with health risks, such as tobacco products and foods high in fats, calories, sugar, and sodium. Yet, if regulations cause consumers to give up goods they like, the health benefits they experience may be offset by some utility loss, which benefit-cost analyses of regulations need to take into account. This paper lays out the complications of measuring benefits of regulations aiming to curb consumption of addictive and habitual goods, rooted in the fact that consumers' observed demand for such goods may not be in line with their true preferences. Focusing on the important case of tobacco products, the paper describes four possible approaches for estimating benefits when consumers' preferences may not be aligned with their behavior, and identifies one as having the best feasibility for use in applied benefit-cost analyses in the near term.
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Affiliation(s)
- David M Cutler
- Department of Economics, Harvard University, Cambridge, Massachusetts
| | - Amber I Jessup
- U.S. DHHS Office of the Assistant Secretary for Planning and Evaluation, Washington, District of Columbia.
| | - Donald S Kenkel
- Department of Policy Analysis and Management, College of Human Ecology, Cornell University, Ithaca, New York
| | - Martha A Starr
- Office of the Deputy Commissioner of Planning, Policy, and Legislation, U.S. Food and Drug Administration, Silver Spring, Maryland
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Marti J, Sindelar J. Smaller Cigarette Pack as a Commitment to Smoke Less? Insights from Behavioral Economics. PLoS One 2015; 10:e0137520. [PMID: 26356844 PMCID: PMC4565702 DOI: 10.1371/journal.pone.0137520] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 08/18/2015] [Indexed: 11/24/2022] Open
Abstract
Cigarettes are commonly sold in packs of 20 units and therefore little is known about the potential impact of pack size on consumption. Using insights from behavioral economics, we suggest that cigarette packs smaller than the standard size may help some smokers cut back and/or quit, consistent with their long-term goals. Results from an online hypothetical purchase experiment conducted in a sample of US smokers reveal that over a third of smokers are willing to pay a price premium to purchase in smaller quantities. Further, a desire to quit smoking and high self-control is associated with preference for a smaller pack. While we provide some preliminary evidence that smaller packs may be beneficial to certain types of smokers, further research should be conducted to assess whether the smaller pack size should be considered in the arsenal of tobacco control policies to help current smokers quit (JEL: I18; I12; D12)
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Affiliation(s)
- Joachim Marti
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
- * E-mail:
| | - Jody Sindelar
- Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, United States of America
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Torbica A, Fattore G, Ayala F. Eliciting preferences to inform patient-centred policies: the case of psoriasis. PHARMACOECONOMICS 2014; 32:209-223. [PMID: 24446282 DOI: 10.1007/s40273-013-0126-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess patient preferences for psoriasis treatment features and to investigate the heterogeneity of preferences among patients with different socio-demographic and disease-related characteristics. METHODOLOGY A discrete choice experiment was conducted on adult patients with moderate to severe plaque-type psoriasis during a routine visit to their physician at 15 centres in Italy. We investigated the preferences of patients with respect to five treatment attributes: (1) mode and frequency of administration; (2) time to improvement; (3) time free of symptoms; (4) unintended life expectancy reduction resulting from treatment; and (5) monthly treatment cost. The heterogeneity of preferences was investigated in a mixed logit model with normally distributed random coefficients. RESULTS Overall, patients preferred the subcutaneous or intravenous route of administration (versus oral administration) and treatments that took less time to show improvement, ensured a longer time free of symptoms, involved a lesser reduction in life expectancy and had lower costs. There was significant preference heterogeneity for all attributes. The cost attribute was found to be significantly more important to females and to older patients (above 60 years of age). Older patients placed significantly greater emphasis on reduced life expectancy, whereas the time free of symptoms was significantly less important to them than to patients under 60 years of age. Patients with higher scores on the Dermatology Life Quality Index (DLQI) placed higher value on the time free of symptoms than those with lower DLQI scores. For the overall sample, the marginal willingness to pay (WTP) for a month's reduction in the time to improvement was <euro>32.4, whereas the WTP for one additional month without symptoms was significantly higher (<euro>68.2). CONCLUSION Patient-centred policies should consider the heterogeneity of patients' expectations to identify individualized treatments that would aid in optimizing patient satisfaction and wellbeing, as well as overall treatment effectiveness.
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Affiliation(s)
- Aleksandra Torbica
- Department of Policy Analysis and Public Management, Università Commerciale Luigi Bocconi, Via Roentgen 1, 20136, Milan, Italy
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Marti J. Assessing preferences for improved smoking cessation medications: a discrete choice experiment. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2012; 13:533-48. [PMID: 21706307 DOI: 10.1007/s10198-011-0333-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Accepted: 06/07/2011] [Indexed: 05/15/2023]
Abstract
BACKGROUND The use of smoking cessation medications can considerably enhance the long-term abstinence rate at a reasonable cost, but only a small proportion of quitters seek medical assistance. The objective of this study was to evaluate the factors that influence the decision to use such treatments and the willingness-to-pay of smokers for improved cessation drugs. METHOD A discrete choice experiment was conducted amongst smokers in the French-speaking part of Switzerland. Choice sets consisted of two hypothetical medications described via five attributes (price, efficacy, possibility of minor side effects, attenuation of weight gain and availability) and an opt-out option. Various discrete choice models were estimated to analyse both the factors that influence treatment choice and those that influence the overall propensity to use a smoking cessation medication. RESULTS Our results indicate that smokers are willing to pay for higher efficacy, less-frequent side effects and prevention of weight gain. Whether the drug is available over-the-counter or on medical prescription is of secondary importance. In addition, we show that there are several individual-specific factors influencing the decision to use such medications, including education level. Results also indicate substantial preference heterogeneity. CONCLUSION This study shows that there is a potential demand for improved cessation medications. Broader usage could be reached through lower out-of-pocket price and greater efficacy. Secondary aspects such as side effects and weight gain should also be taken into consideration.
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Affiliation(s)
- Joachim Marti
- Faculty of Economics, Institute for Research in Economics, University of Neuchâtel, 2000, Neuchâtel, Switzerland.
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Gerking S, Khaddaria R. Perceptions of health risk and smoking decisions of young people. HEALTH ECONOMICS 2012; 21:865-877. [PMID: 21796724 DOI: 10.1002/hec.1760] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 03/28/2011] [Accepted: 04/27/2011] [Indexed: 05/31/2023]
Abstract
Using the Annenberg Perception of Tobacco Risk Survey 2, this paper finds that perceived risk deters smoking among persons aged 14-22 years who think that it is relatively difficult to quit smoking and that onset of deleterious health effects occurs relatively quickly. Perceived health risk, however, does not affect the smoking status of young people who hold the opposite beliefs. These results are consistent with predictions of rational addiction models and suggest that young people, who view smoking as more addictive and health effects as more immediate, may have greater incentive to consider long-term health effects in their decision to smoke.
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Affiliation(s)
- Shelby Gerking
- Department of Economics, University of Central Florida, Orlando, FL, USA.
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Ida T, Goto R, Takahashi Y, Nishimura S. Can economic-psychological parameters predict successful smoking cessation? ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.socec.2011.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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