Discrete choice experiments (DCEs) are regularly used in health economics to elicit preferences for healthcare products and programmes. There is growing recognition that DCEs can provide more than information on preferences and, in particular, they have the potential to contribute more directly to outcome measurement for use in economic evaluation. Almost uniquely, DCEs could potentially contribute to outcome measurement for use in both cost-benefit and cost-utility analysis. Within this expanding remit, our intention is to provide a resource for current practitioners as well as those considering undertaking a DCE, using DCE results in a policy/commercial context, or reviewing a DCE. We present the fundamental principles and theory underlying DCEs. To aid in undertaking and assessing the quality of DCEs, we discuss the process of carrying out a choice study and have developed a checklist covering conceptualizing the choice process, selecting attributes and levels, experimental design, questionnaire design, pilot testing, sampling and sample size, data collection, coding of data, econometric analysis, validity, interpretation and welfare and policy analysis. In this fast-moving area, a number of issues remain on the research frontier. We therefore outline potentially fruitful areas for future research associated both with DCEs in general, and with health applications specifically, paying attention to how the results of DCEs can be used in economic evaluation. We also discuss emerging research trends. We conclude that if appropriately designed, implemented, analysed and interpreted, DCEs offer several advantages in the health sector, the most important of which is that they provide rich data sources for economic evaluation and decision making, allowing investigation of many types of questions, some of which otherwise would be intractable analytically. Thus, they offer viable alternatives and complements to existing methods of valuation and preference elicitation.

AcknowledgementsMany individuals have contributed intellectually to this book. The literature on discrete choice analysis, combining sources of preference data and experimental design, is vast, with a history spanning at least sixty years. This book is a contribution to that literature, inspired by a need at the end of the twentieth century for a single source accessible to both practitioners and researchers who need some assistance in`travelling' through the essential components of the extant literature in order to undertake an appropriate systematic study of consumer choice behaviour.To Daniel McFadden, Norman Anderson and Moshe Ben-Akiva we owe a special debt for their contribution to the literature and for their inspiration to all authors. Wiktor Adamowicz and graduate students and sta in the Faculty of Economics and Business at the University of Sydney read earlier versions of the book and guided us in revisions. The in¯uence of a number of other colleagues has been substantial in our appreciation of the topic. We especially thank

The mixed or heterogeneous multinomial logit (MIXL) model has become popular in a number of fields, especially marketing, health economics, and industrial organization. In most applications of the model, the vector of consumer utility weights on product attributes is assumed to have a multivariate normal (MVN) distribution in the population. Thus, some consumers care more about some attributes than others, and the IIA property of multinomial logit (MNL) is avoided (i.e., segments of consumers will tend to switch among the subset of brands that possess their most valued attributes). The MIXL model is also appealing because it is relatively easy to estimate. Recently, however, some researchers have argued that the MVN is a poor choice for modelling taste heterogeneity. They argue that much of the heterogeneity in attribute weights is accounted for by a pure scale effect (i.e., across consumers, all attribute weights are scaled up or down in tandem). This implies that choice behaviour is simply more random for some consumers than others (i.e., holding attribute coefficients fixed, the scale of their error term is greater). This leads to a “scale heterogeneity” MNL model (S-MNL). Here, we develop a generalized multinomial logit model (G-MNL) that nests S-MNL and MIXL. By estimating the S-MNL, MIXL, and G-MNL models on 10 data sets, we provide evidence on their relative performance. We find that models that account for scale heterogeneity (i.e., G-MNL or S-MNL) are preferred to MIXL by the Bayes and consistent Akaike information criteria in all 10 data sets. Accounting for scale heterogeneity enables one to account for “extreme” consumers who exhibit nearly lexicographic preferences, as well as consumers who exhibit very “random” behaviour (in a sense we formalize below).choice models, mixture models, consumer heterogeneity, choice experiments

The measurement of passive use values has become an important issue in environmental economics. In this paper we examine an extension or variant of contingent valuation, the choice experiment, which employs a series of questions with more than two alternatives that are designed to elicit responses that allow the estimation of preferences over attributes of an environmental state. We also combine the information from choice experiments and contingent valuation to test for differences in preferences and error variances arising from the two methods. Our results show that choice experiments have considerable merit in measuring passive use values. Copyright 1998, Oxford University Press.

The purpose of the Rural Economy "Staff Paper" series is to provide a forum to accelerate the presentation of issues, concepts, ideas and research results within the academic and professional community. Staff Papers are published without peer review. .

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This paper reports the first application of the capabilities approach to the development and valuation of an instrument for use in the economic evaluation of health and social care interventions. The ICECAP index of capability for older people focuses on quality of life rather than health or other influences on quality of life, and is intended to be used in decision making across health and social care in the UK. The measure draws on previous qualitative work in which five conceptual attributes were developed: attachment, security, role, enjoyment and control. This paper details the innovative use within health economics of further iterative qualitative work in the UK among 19 informants to refine lay terminology for each of the attributes and levels of attributes used in the eventual index. For the first time within quality of life measurement for economic evaluation, a best-worst scaling exercise has been used to estimate general population values (albeit for the population of those aged 65+ years) for the levels of attributes, with values anchored at one for full capability and zero for no capability. Death was assumed to be a state in which there is no capability. The values obtained indicate that attachment is the attribute with greatest impact but all attributes contribute to the total estimation of capability. Values that were estimated are feasible for use in practical applications of the index to measure the impact of health and social care interventions.

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