Public and decision-maker stated preferences for pharmaceutical subsidy decisions in Iran: an application of the discrete choice experiment

Pregnant women's and policymakers' preferences for the expansion of noninvasive prenatal screening: A discrete choice experiment approach study

Background and Aims

Quantitative approaches for eliciting preferences for new interventions are mostly conducted by patients and rarely by policymakers. This study aimed to quantify the preferences of pregnant women and policymakers regarding the addition of a new test to prenatal screening programs for detecting chromosomal abnormalities.

Methods

A discrete choice experiment was conducted to measure the respondents' preferences for a new prenatal test. A seven-attribute instrument was built based on interviews with pregnant women and policymakers. The data were analyzed using robust conditional logistic regression and nested logit models.

Results

In total, 272 pregnant women and 24 policymakers completed the questionnaire (response rates of 48% and 55%, respectively). Overall, all attributes were statistically significant in the pregnant women group, whereas only three attributes (test performance, degree of test result certainty, and cost) were statistically significant in the policymakers group. Statistically significant differences in test performance and information were observed between the two groups.

Conclusion

Policymakers differed from pregnant women in their appraisal of attributes related to their preference for a new prenatal screening intervention. The low response rates observed in both groups suggest that further investigation of the relevance of this approach must be conducted.

Development of a discrete choice experiment questionnaire to elicit preferences by pregnant women and policymakers for the expansion of non-invasive prenatal screening

OBJECTIVE

An instrument for measuring intervention preferences applicable to both patients and policymakers would make it possible to better confront the needs of the supply and demand sides of the health care system. This study aimed to develop a discrete choice experiments (DCE) questionnaire to elicit the preferences of patients and policymakers. The instrument was specifically developed to estimate preferences for new conditions to be added to a screening program for fetal chromosomal anomalies.

METHODS

A DCE development study was conducted. The methods employed included a literature review, a qualitative study (based on individual semi-structured interviews, consultations, and a focus group discussion) with pregnant women and policymakers, and a pilot project with 33 pregnant women to validate the first version of the instrument and test the feasibility of its administration.

RESULTS

An initial list of 10 attributes was built based on a literature review and the qualitative research components of the study. Five attributes were built based on the responses provided by the participants from both groups. Eight attributes were consensually retained. A pilot project performed on 33 pregnant women led to a final instrument containing seven attributes: 'conditions to be screened', 'test performance', 'moment at gestational age to obtain the test result', 'degree of test result certainty to the severity of the disability', 'test sufficiency', 'information provided from test result', and 'cost related to the test'.

CONCLUSION

It is possible to reach a consensus on the construction of a DCE instrument intended to be administered to pregnant women and policymakers. However, complete validation of the consensual instrument is limited because there are too few voting members of health technology assessment agencies committees to statistically ascertain the relevance of the attributes and their levels.

The main decision-making competence for willingness-to-pay towards COVID-19 vaccination: a family-based study in Taizhou, China

PURPOSE

This research aimed to explore individuals' willingness to pay (WTP) and studied the role of family decision makers in WTP for COVID-19 vaccines.

METHODS

A self-administered online questionnaire evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China. The logistic regression model was performed to identify the factors associated with WTP for the COVID-19 vaccines, and all data were analysed by R software, version 4.1.0.

RESULTS

44.2% and 43.7% of 824 community residents were willing to pay for the first two doses and the booster dose of the COVID-19 vaccine, respectively. Decision-makers were more willing to pay for both the first two doses and the boost dose of the COVID-19 vaccines, with OR (95%CI) being 1.75 (1.25-2.47) and 1.89 (1.34-2.67), respectively. Besides, participants' WTP for COVID-19 vaccines were also associated with their occupation and monthly household income.

CONCLUSION

This study found that family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines in Taizhou, China. To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision makers in vaccination.Key MessagesA study evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China.Family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines.To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision-makers in vaccination.