Joffre Swait | PubMed Health

PubMed2004

Using stated preference and revealed preference modeling to evaluate prescribing decisions.

The use of stated preference analyses to evaluate choice of health care products has been growing in recent years. This paper shows how revealed preference data can be enriched with stated preference data and highlights the relative advantages of revealed and stated preference data. The techniques were applied to a study of determinants of physicians' prescriptions of alcoholism medications. Analyses were conducted on the relationship between physicians' perceptions of existing alcoholism medication attributes and their prescribing rates of those medications. Analyses were also conducted on physicians' decisions to prescribe hypothetical alcoholism medications with varying attributes such as efficacy, side effects, compliance, mode of action, and price. Finally, analyses were conducted on the combined stated and revealed preference data. Joint estimation suggests that parameters from the revealed and stated preference data are equal, up to scale. Joint analyses highlight how stated preference data can be used to estimate parameters for attributes that are not observed in the marketplace, that do not vary in the marketplace, or that are highly collinear with other attributes in actual markets.

Alcoholism↗

PubMedDate not supplied

Using stated preference modeling to forecast the effect of medication attributes on prescriptions of alcoholism medications.

OBJECTIVE: The objective of this study was to forecast physicians' preferred rate of prescriptions of alcoholism medications given different medications attributes (i.e., efficacy, side effects, compliance, price, mode of administration, method of action). METHODS: Stated preference modeling was used. Data came from a survey of 1388 physicians specializing in addiction medication (65% response rate). Physicians were given four hypothetical scenarios, each in which they were asked to choose between prescribing one of two hypothetical alcoholism medications with given attributes or prescribing no medication. RESULTS: Prescribing decisions were elastic with respect to the efficacy of the medication (1.35 and 1.65 using two efficacy measures). A 10% increase in the percentage of patients who would remain abstinent on the medication would lead to a 13.5% increase in the percentage of patients prescribed the medication. Prescribing decisions were inelastic with respect of nonserious side effects (-0.24), compliance (0.80), and price (-0.25). The market share of alcoholism medications with extremely favorable characteristics (i.e., 80% abstinence rate, a 95% no heavy drinking rate, a 10% side effect rate, a 80% compliance rate, and a price of US dollars 0.25) was predicted to be 53%, and 47% of the population would not be prescribed a medication to prevent alcoholism. CONCLUSIONS: The market share of new medications to treat alcoholism among addiction specialists could surpass the low usage rates of existing medications if those medications have better attributes. However, prescription levels may not reach that expected for treatment of other diseases.

Alcohol Deterrents↗