title: Eliciting preferences for prioritizing treatment of rare diseases: the role of opportunity costs and framing effects.
abstract: BACKGROUND
  Understanding societal preferences regarding resource allocation in the health sector has gained importance as countries increasingly base reimbursement decisions on economic evaluations. Preference elicitation using surveys, a common practice in the health sector, is subject to a range of framing effects.
  
  
  OBJECTIVE
  This research investigates the importance of (theoretically relevant) opportunity costs and (theoretically irrelevant) framing effects on stated preferences for prioritizing treatment of rare (orphan) diseases.
  
  
  METHODS
  We elicited preferences from Norwegians, aged 40-67, using simple trade-off exercises. Respondents were randomised to different opportunity costs of the rare disease or to different framings of the trade-off exercises.
  
  
  RESULTS
  Respondents were quite sensitive to the visual presentation of the choice problem, and, to a lesser extent, to focusing and labelling effects. Elicited preferences varied little in response to large changes in opportunity costs, suggesting scope-insensitivity among respondents.
  
  
  CONCLUSIONS
  Preferences for prioritizing treatment of rare diseases elicited using trade-off exercises are insensitive to (theoretically relevant) opportunity costs, but sensitive to (theoretically irrelevant) framing effects.
authors.affiliation: Department of Health Management and Health Economics, University of Oslo, PO Box 1089, Blindern, 0317, Oslo, Norway, arna.desser@gmail.com.
authors.forename: Arna S
authors.initials: AS
authors.lastname: Desser
authors.forename: Jan Abel
authors.initials: JA
authors.lastname: Olsen
authors.forename: Sverre
authors.initials: S
authors.lastname: Grepperud
mesh_terms: D000328:Adult; D000368:Aged; D002755:Choice Behavior; D003625:Data Collection; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006292:Health Priorities / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D011639:Public Opinion; D035583:Rare Diseases / Q000191:economics / Q000628:therapy*; D040841:Resource Allocation / Q000191:economics*