Séminaire du LEDi - Nicolas Krucien

Nicolas Krucien (University of Aberdeen, UK) animera un séminaire le 5 mars 2019 à partir de 14h en salle des Conseils de la MSH.

Full title

Using public preferences to help deal with the uncertainty associated with the allocation of healthcare resources

Abstract

When deciding which new programme to implement (or not), the decision makers need to accommodate the uncertainty of different potential outcomes that can occur (i.e., change in population health and medical expenditures).

They also need to determine the value of these potential outcomes. The objective of this study is to identify how the public values changes in population health and medical expenditures when healthcare resources are re-allocated. We report the results of a choice experiment conducted in a large representative sample of the population living in England (N=1,021). The main results indicate that on average people are 2.06 to 3.66 more sensitive to changes in population health than medical expenditures. There is a non-linear valuation of these changes with evidence of loss aversion (The public gives 1.15 times more weight to losses in population health than gains) and non-constant marginal sensitivity (The public becomes less sensitive to marginal changes in population health as the level of changes increases). In a simulated illustrative study, we show that a more realistic representation of public preferences allowing for non-linear valuation of changes can lead to significantly different recommendations in terms of healthcare resources allocation.

Keywords

Stated preferences; Choice experiment; Choices modelling; Resources allocation

Authors:

Nicolas KRUCIEN

Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen (AB25 2QN), United Kingdom

Sebastian HEIDENREICH

Evidera Ltd, London, United Kingdom

Amiram GAFNI

Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada

Nathalie PELLETIER-FLEURY

Centre de Recherche en Epidemiologie et Santé des Populations, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France