Measuring the Loss of Consumer Choice in Mandatory Health Programmes Using Discrete Choice Experiments
MetadataShow full item record
Background - Economic evaluation of mandatory health programmes generally do not consider the utility impact of a loss of consumer choice upon implementation, despite evidence suggesting that consumers do value having the ability to choose. Objectives - The primary aim of this study was to explore whether the utility impact of a loss of consumer choice from implementing mandatory health programmes can be measured using discrete choice experiments (DCEs). Methods - Three case studies were used to test the methodology: fortification of bread-making flour with folate, mandatory influenza vaccination of children, and the banning of trans-fats. Attributes and levels were developed from a review of the literature. An orthogonal, fractional factorial design was used to select the profiles presented to respondents to allow estimation of main effects. Overall, each DCE consisted of 64 profiles which were allocated to four versions of 16 profiles. Each choice task compared two profiles, one being voluntary and the other being mandatory, plus a ‘no policy’ option, thus each respondent was presented with eight choice tasks. For each choice task, respondents were asked which health policy they most preferred and least preferred. Data was analysed using a mixed logit model with correlated coefficients (200 Halton draws). The compensating variation required for introducing a programme on a mandatory basis (versus achieving the same health impacts with a voluntary programme) that holds utility constant was estimated. Results - Responses were provided by 535 participants (a response rate of 83 %). For the influenza vaccination and folate fortification programmes, the results suggested that some level of compensation may be required for introducing the programme on a mandatory basis. Introducing a mandatory influenza vaccination programme required the highest compensation (Australian dollars [A$] 112.75, 95 % CI −60.89 to 286.39) compared with folate fortification (A$18.05, 95 % CI −3.71 to 39.80). No compensation was required for introducing the trans-fats programme (−A$0.22, 95 % CI −6.24 to 5.80) [year 2010 values]. In addition to the type of mandatory health programme, the compensation required was also found to be dependent on a number of other factors. In particular, the study found an association between the compensation required and stronger libertarian preferences. Conclusions - DCEs can be used to measure the utility impact of a loss of consumer choice. Excluding the utility impact of a loss of consumer choice from an economic evaluation taking a societal perspective may result in a sub-optimal, or incorrect, funding decision.
Showing items related by title, author, creator and subject.
Norman, Richard; Cronin, P.; Viney, R. (2013)Background. The EQ-5D-5L has recently been developed to improve the sensitivity of the widely used three-level version. Valuation studies are required before the use of this new instrument can be adopted. The use of ...
Beatty, Shelley Ellen (2003)The long-term regular use of tobacco and hazardous alcohol use are responsible for significant mortality and morbidity as well as social and economic harm in Australia each year. There is necessary the more cost-efficient ...
Evidence-based evaluation of programme interventions to achieve positive community integration outcomes for adults with acquired brain injuryParvaneh, Shahriar (2010)Background. The growing population of people with acquired brain injury (ABI) requires a strong focus on clients to be integrated into the community in order to use their productive skills in society, to help them live ...