The application of discrete choice experiments in health economics: a systematic review of the literature

Objectives. In recent years, there has been a growing interest in the development and application of discrete choice experiments (DCEs) within health economics. Even though the literature include several reviews of the methodology associated with conducting DCEs and analysing the resultant choice data, a detailed classification of the areas covered by DCEs is lacking. The aim of this paper is to provide, after a brief description of the most important phases of a DCE, a comprehensive categorization of the various areas in which DCEs in health care have been performed. Methods. A systematic literature review was conducted to identify published studies using stated preferences DCEs within a health context between January 1990 and May 2011. Results. 256 DCEs were included in the review. Compared to the 1990-2000 period, the number of DCEs has increased quickly, with experiments carried out in 30 different countries. A growing number of studies primarily investigated patients’ preferences during the years, collecting a greater number of responses in comparison to the baseline period. A significant proportion of publications estimated the benefits of health care services, like specialistic surgical and medical services, generic medical services, services for chronics and elderly people, maternity and childbirth services and diagnostic facilities. Nevertheless, DCEs has also been used to value health outcomes, examine preferences for pharmaceutical products, investigate labour-market choices as well as healthcare systems characteristics and health policies. Conclusions. This paper adds to the body of literature reviewing the growing stock of published DCEs in health economics, providing a new detailed taxonomy of the various areas in which such experiments have been applied. Together with the methodological refinements, future research should continue to explore new contexts of analysis.