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Choice experiments in health: the good, the bad, the ugly and toward a brighter future


Compared to many applied areas of economics, health economics has a strong tradition in eliciting and using stated preferences (SP) in policy analysis. Discrete choice experiments (DCEs) are one SP method increasingly used in this area. Literature on DCEs in health and more generally has grown rapidly since the mid-1990s. Applications of DCEs in health have come a long way, but to date few have been ‘best practice’, in part because ‘best practice’ has been somewhat of a moving target. The purpose of this paper is to briefly survey the history of DCEs and the state of current knowledge, identify and discuss knowledge gaps, and suggest potentially fruitful areas for future research to fill such gaps with the aim of moving the application of DCEs in health economics closer to best practice.

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*Corresponding author: Jordan J. Louviere, Professor of Marketing, Executive Director, Centre for the Study of Choice, University of Technology, Sydney, PO BOX 123, Broadway, NSW 2007, Australia. Email:
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W. Adamowicz , D. Bunch , T. Cameron , B. Dellaert , M. Hanneman , M. Keane , J. Louviere , R. Meyer , T. Steenburgh and J. Swait (2008), ‘Behavioural frontiers in choice modelling’, Marketing Letters, 19: 215228.

G. M. Allenby and P. E. Rossi (1998), ‘Marketing models of consumer heterogeneity’, Journal of Econometrics, 89(1–2): 5778.

D. A. Anderson and J. Wiley (1992), ‘Efficient choice set designs for estimating cross effects models’, Marketing Letters, 3(4): 357370.

N. H. Anderson (1981), Foundations of Information Integration Theory, New York: Academic Press.

M. Bech (2003), ‘Politicians’ and hospital managers’ trade-offs in the choice of reimbursement scheme: a discrete choice experiment’, Health Policy, 66(3): 261275.

M. Bliemer , J. Rose and S. Hess (2008), ‘Approximation of Bayesian efficiency in experimental choice designs’, Journal of Choice Modelling, 1(1): 98127.

R. A. Bradley and M. E. Terry (1952), ‘Rank analysis of incomplete block designs: I. The method of paired comparisons’, Biometrika, 39: 324345.

E. Brunswick (1955), ‘Representative design and probabilistic theory in a functional psychology’, Psychological Review, 62: 193217.

L. Burgess and A. Street (2005), ‘Optimal designs for choice experiments with asymmetric attributes’, Journal of Statistical Planning and Inference, 134(1): 288301.

L. Burgess , D. Street , R. Viney and J. J. Louviere (2006), ‘Design of Choice Experiments in Health Economics’, in A. M. Jones (ed.), The Elgar Companion to Health Economics, Cheltenham, UK: Edward Elgar: 415–426.

J. Cairns and M. van der Pol (2004), ‘Repeated follow-up as a method for reducing non-trading behaviour in discrete choice experiments’, Social Science and Medicine, 58(11): 22112218.

F. Carlsson and P. Martinsson (2003), ‘Design techniques for stated preference methods in health economics’, Health Economics, 12: 281294.

J. Coast and S. Horrocks (2007), ‘Developing attributes and levels for discrete choice experiments using qualitative methods’, Journal of Health Services and Research Policy, 12(1): 2530.

J. R. DeShazo and G. Fermo (2002), ‘Designing choice sets for stated preference methods: the effects of complexity on choice consistency’, Journal of Environmental Economics and Management, 44: 123143.

T. Erdem and M. Keane (1996), ‘Decision-making under uncertainty: capturing dynamic brand choice processes in turbulent consumer goods markets’, Marking Science, 15(1): 120.

T. Flynn , J. Louviere , T. Peters and J. Coast (2007), ‘Best–worst scaling: what it can do for health care and how to do it’, Journal of Health Economics, 26: 171189.

P. Green and V. Rao (1971), ‘Conjoint measurement for quantifying judgement data’, Journal of Marketing Research, 8: 355363.

W. H. Greene , D. A. Hensher and J. Rose (2006), ‘Accounting for heterogeneity in the variance of unobserved effects in mixed logit models’, Transportation Research Part B: Methodological, 40(1): 7592.

D. Gyrd-Hansen (2004), ‘Investigating the social value of health changes’, Journal of Health Economics, 23(6): 11011116.

Z. Hakim and D. S. Pathak (1999), ‘Modelling the EuroQol data: a comparison of discrete choice conjoint and conditional preference modelling', Health Economics, 8(2): 103116.

J. Hall , D. G. Fiebig , M. T. King , I. Hossain and J. J. Louviere (2006), ‘What influences participation in genetic carrier testing? Results from a discrete choice experiment’, Journal of Health Economics, 25(3): 520537.

J. Hall , P. Kenny , M. King , J. Louviere , R. Viney and A. Yeoh (2002), ‘Using stated preference discrete choice modelling to evaluate the introduction of Varicella vaccination’, Health Economics, 11: 457465.

A. R. Hole (2008), ‘Modelling heterogeneity in patients’ preferences for the attributes of a general practitioner appointment’, Health Economics, 27: 10781094.

J. Huber and K. Zwerina (1996), ‘The importance of utility balance in efficient choice designs’, Journal of Marketing Research, 33: 307317.

T. Islam , J. J. Louviere and P. F. Burke (2007), ‘Modeling the effects of including/excluding attributes in choice experiment on systematic and random components’, International Journal of Research in Marketing, 24: 289300.

S. Jan , G. Mooney , M. Ryan , K. Bruggemann and K. Alexander (2000), ‘The use of conjoint analysis to elicit community preferences in public health research: a case study of hospital services in South Australia’, Australian and New Zealand Journal of Public Health, 24: 6470.

F. R. Johnson , M. R. Banzhaf and W. H. Desvousges (2000), ‘Willingness to pay for improved respiratory and cardiovascular health: a multiple-format stated preference approach’, Health Economics, 9(4): 295317.

W. A. Kamakura and G. R. Russell (1989), ‘A probabilistic choice model for market segmentation and elasticity structure’, Journal of Marketing Research, 26(4): 379390.

B. Kanninen (2002), ‘Optimal designs for multinomial choice experiments’, Journal of Marketing Research, 39: 214227.

M. P. Keane and K. I. Wolpin (1994), ‘The solution and estimation of discrete choice dynamic programming models by simulation and interpolation: Monte Carlo evidence’, The Review of Economics Statistics, 76(4): 648672.

M. G. Kendall and B. B. Smith (1940), ‘On the method of paired comparisons’, Biometrika, 31: 324345.

M. T. King , J. Hall , E. Lancsar , D. Fiebig , I. Hossain , J. Louviere , H. K. Reddel and C. R. Jenkins (2007), ‘Patient preferences for managing asthma: results from a discrete choice experiment’, Health Economics, 16(7): 703717.

T. Kjaer and D. Gyrd-Hansen (2008), ‘Preference heterogeneity and choice of cardiac rehabilitation program: results from a discrete choice experiment’, Health Policy, 85: 124132.

E. Lancsar and J. Louviere (2006), ‘Deleting “irrational” responses from discrete choice experiments: a case of investigating or imposing preferences?’, Health Economics, 15(8): 797811.

E. Lancsar and J. Louviere (2008a), ‘Conducting discrete choice experiments to inform healthcare decision making: a user’s guide’, Pharmacoeconomics, 26(8): 661677.

E. Lancsar , J. Louviere and T. Flynn (2007a), ‘Several methods to investigate relative attribute impact in stated preference experiments’, Social Science and Medicine, 64(8): 17381753.

E. Lancsar and E. Savage (2004a), ‘Deriving welfare measures from discrete choice experiments: inconsistency between current methods and random utility and welfare theory, Health Economics, 13(9): 901907.

E. Lancsar and E. Savage (2004b), ‘Deriving welfare measures from discrete choice experiments: a response to Ryan and Santos Silva’, Health Economics Letters, 13(9): 919924.

E. J. Lancsar , J. P. Hall , M. King , P. Kenny , J. J. Louviere , D. G. Fiebig , I. Hossain , F. C. Thien , H. K. Reddel and C. R. Jenkins (2007b), ‘Using discrete choice experiments to investigate subject preferences for preventive asthma medication’, Respirology, 12(1): 127136.

A. J. Lloyd (2003), ‘Threats to the estimation of benefit: are preference elicitation methods accurate?’, Health Economics, 12: 393402.

J. Louviere , T. Islam , N. Wasi , D. Street and L. Burgess (2008), ‘Designing discrete choice experiments: do optimal designs come at a price?’ Journal of Consumer Research, 35: 360376.

J. Louviere , A. Street , L. Burgess , N. Wasi , T. Islam and A. A. J. Marley (2008b), ‘Modeling the choices of individual decision-makers by combining efficient choice experiment designs with extra preference information’, The Journal of Choice Modelling, 1(1): 128163.

J. Louviere and G. Woodworth (1983), ‘Design and analysis of simulated consumer choice or allocation experiments: an approach based on aggregated data’, Journal of Marketing Research, 20: 350367.

T. Maddala , K. Phillips and F. R. Johnson (2003), ‘An experiment on simplifying conjoint analysis designs for measuring preferences’, Health Economics, 12: 10351047.

T. Mark and J. Swait (2004), ‘Using stated preference and revealed preference modelling to evaluate prescribing decisions’, Health Economics, 13(6): 563573.

A. Marley and J. Louviere (2005), ‘Some probabilistic models of best, worst, and best–worst choices’, Journal of Mathematical Psychology, 49(6): 464480.

A. A. J. Marley , T. Flynn and J. J. Louviere (2008), ‘Probabilistic models of set-dependent and attribute-level best–worst choice’, Journal of Mathematical Psychology, 52: 281296.

E. McIntosh (2006), ‘Using discrete choice experiments within a cost–benefit analysis framework: some considerations’, Pharmacoeconomics, 24(9): 855868.

C. Propper (1990), ‘Contingent valuation of time spent on NHS waiting lists’, Economic Journal, 100: 193199.

D. Revelt and K. Train (1998), ‘Mixed logit with repeated choices of appliance efficiency levels’, Review of Economic Statistics, 80(4): 647657.

D. Ruta , C. Mitton , A. Bate and C. Donaldson (2005), ‘Programme budgetting and marginal analysis (PBMA): bridging the divide between doctors and managers’, British Medical Journal, 330: 15011503.

M. Ryan (1999), ‘Using conjoint analysis to take account of patient preferences and go beyond health outcomes: an application to in vitro fertilisation’, Social Science and Medicine, 48(4): 535546.

M. Ryan , K. Gerard and M. Amaya-Amaya (2008), Using Discrete Choice Experiments to Value Helath and Health Care, Dordrecht: Springer.

M. Ryan and J. Hughes (1997), ‘Using conjoint analysis to assess women’s preferences for miscarriage management’, Health Economics, 6(3): 261273.

M. Ryan , A. Netten , D. Skatun and P. Smith (2006), ‘Using discrete choice experiments to estimate a preference-based measure of outcome: an application to social care for older people’, Journal of Health Economics, 25(5): 927944.

M. Ryan and D. Skatun (2004), ‘Modelling non-demanders in choice experiments’, Health Economics, 13(4): 397402.

A. Scott (2001), ‘Eliciting GPs’ preferences for pecuniary and non-pecuniary job characteristics’, Journal of Health Economics, 20: 329347.

D. A. Street and L. Burgess (2004), ‘Optimal and near-optimal pairs for the estimation of effects in 2-level choice experiments’, Journal of Statistical Planning and Inference, 118: 185199.

D. A. Street and L. Burgess (2007), The Construction of Optimal Stated Choice Experiments: Theory and Methods, Hoboken, NJ: Wiley.

D. A. Street , L. Burgess and J. J. Louviere (2005), ‘Quick and easy choice sets: constructing optimal and nearly optimal stated choice experiments’, International Journal of Research in Marketing, 22(4): 459470.

D. J. Street , L. Burgess , R. Viney and J. J. Louviere (2008), ‘Designing Discrete Choice Experiments for Health Care’, in M. Ryan , K. Gerard and M. Amaya-Amaya (eds), Using Discrete Choice Experiments to Value Health and Health Care, Dordrecht, The Netherlands: Springer: 47–72.

J. Swait (2001), ‘A non-compensatory choice model incorporating attribute cutoffs’, Transportation Research. Part B: Methodological, 35(10): 903928.

J. Swait and W. Adamowicz (2001), ‘Choice environment, market complexity, and consumer behavior: a theoretical and empirical approach for incorporating decision complexity into models of consumer choice’, Organizational Behavior and Human Decision Processes, 86(2): 141167.

L. Thurstone (1927), ‘A law of comparative judgement’, Psychological Review, 34: 273286.

M. van der Pol and J. Cairns (2001), ‘Estimating time preference for health using discrete choice experiments’, Social Science and Medicine, 52: 14591470.

R. Viney , E. Lancsar and J. Louviere (2002), ‘Discrete choice experiments to measure consumer preferences for health and healthcare’, Expert Review of Pharmacoeconomics and Outcomes Research, 2(4): 319326.

R. Viney , E. Savage and J. Louviere (2005), ‘Empirical investigation of experimental design properties of discrete choice experiments in health care’, Health Economics, 14(4): 349362.

A. J. Wells (1991), ‘Optimal presentation orders for the method of paired comparisons’, British Journal of Mathematical and Statistical Psychology, 44(1): 181193.

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Health Economics, Policy and Law
  • ISSN: 1744-1331
  • EISSN: 1744-134X
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