Discrete choice experiments in health care

NICE should consider using them for patient centred evaluations of technologies

In many publicly provided healthcare systems, limited resources coupled with unlimited demand result in decisions having to be made about the efficient allocation of scarce resources. This raises questions of how services should be provided (for example, how should patients with cancer be treated? should central clinics, which reduce waiting time but increase travel time for patients, be introduced?) through to the optimal provision and the financing of health care (for example, how should we pay doctors to encourage them to work in remote and rural areas? what would encourage nurses to return to the labour market?). Given the lack of a market for health care, economics techniques inform such decisions.1 One approach adopted by and further developed in health economics over the past decade is discrete choice experiments.2 3 In this issue Sculpher et al use this approach to consider patients' preferences in the treatment of prostate cancer (p 382).4 …