Health Preference Research in Europe: A Review of Its Use in Marketing Authorization, Reimbursement, and Pricing Decisions-Report of the ISPOR Stated Preference Research Special Interest Group

K. Marsh*, J.A. van Til, E. Molsen-David, C. Juhnke, N. Hawken, E.M. Oehrlein, Y.C. Choi, A. Duenas, W. Greiner, K. Haas, M. Hiligsmann, K.S. Hockley, I. Ivlev, F. Liu, J. Ostermann, T. Poder, J.L. Poon, A. Muehlbacher

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Objective: This study examines European decision makers' consideration and use of quantitative preference data.Methods: The study reviewed quantitative preference data usage in 31 European countries to support marketing authorization, reimbursement, or pricing decisions. Use was defined as: agency guidance on preference data use, sponsor submission of preference data, or decision-maker collection of preference data. The data could be collected from any stakeholder using any method that generated quantitative estimates of preferences. Data were collected through: (1) documentary evidence identified through a literature and regulatory websites review, and via key opinion leader outreach; and (2) a survey of staff working for agencies that support or make healthcare technology decisions.Results: Preference data utilization was identified in 22 countries and at a European level. The most prevalent use (19 countries) was citizen preferences, collected using time-trade off or standard gamble methods to inform health state utility estimation. Preference data was also used to: (1) value other impact on patients, (2) incorporate non-health factors into reimbursement decisions, and (3) estimate opportunity cost. Pilot projects were identified (6 countries and at a European level), with a focus on multi-criteria decision analysis methods and choice-based methods to elicit patient preferences.Conclusion: While quantitative preference data support reimbursement and pricing decisions in most European countries, there was no utilization evidence in European-level marketing authorization decisions. While there are commonalities, a diversity of usage was identified between jurisdictions. Pilots suggest the potential for greater use of preference data, and for alignment between decision makers.
Original languageEnglish
Pages (from-to)831-841
Number of pages11
JournalValue in Health
Issue number7
Publication statusPublished - 1 Jul 2020


  • benefit-risk assessment
  • criteria
  • discrete-choice experiments
  • economics
  • elicitation methods
  • european regulatory
  • health preferences
  • health technology assessment
  • interventions
  • marketing authorization
  • patient preferences
  • preference research
  • pricing
  • quantitative preference data
  • reimbursement
  • stakeholder preferences
  • technology-assessment
  • European regulatory

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