title: Whose preferences should be elicited for use in health-care decision-making? A case study using anticoagulant therapy.
abstract: The question of whose preferences to elicit in health-state valuation has been widely discussed in the literature. The importance of this debate lies in the fact that health-state utility values are used in health technology assessment (HTA); therefore, an individual's preferences can influence decision-making. If preferences differ across groups, making decisions based on one group's preferences may be suboptimal for the other. Preferences for benefits, risks, experiences and health states associated with anticoagulant therapies have been elicited by researchers due to the underutilization of warfarin and the introduction of non-vitamin K antagonist oral anticoagulants. The majority of existing studies elicit preferences from patient populations as opposed to other stakeholders such as the general public. This paper extends the preference debate by using this clinical area as a case study, with a particular focus on HTA guidelines and the recent advocacy of the use of preference information in benefit-risk assessments.
authors.affiliation: a Health Economics Group, Institute of Health & Society , Newcastle University , Newcastle upon Tyne , UK.
authors.forename: David John
authors.initials: DJ
authors.lastname: Mott
authors.affiliation: b Division of Pharmacoepidemiology and Pharmacoeconomics , Brigham & Women's Hospital, Harvard Medical School , Boston , MA , USA.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Najafzadeh
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003657:Decision Making; D017408:Guidelines as Topic; D006304:Health Status; D006801:Humans; D057240:Patient Preference; D018570:Risk Assessment / Q000379:methods; D013673:Technology Assessment, Biomedical / Q000379:methods*
chemical_list: D000925:Anticoagulants
keywords: Anticoagulant therapy; benefit–risk assessment; cost–effectiveness analysis; preference elicitation; utility assessment