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To pay or not to pay: Investigating the validity of monetary preferences in health choice experiments

Project Description

Preferences-elicitation methods are frequently used in health economics to obtain monetary values for health and health care e.g., willingness to pay to improve treatment effectiveness by 1% or to reduce waiting time by one month. Recent years have seen choice experiments (CE) become the preferred method to measure individuals’ preferences in monetary terms. Rather than ask individuals directly what they are willing to pay, CEs elicit monetary values indirectly. Individuals are presented with a number of choice tasks that vary with respect to a number of defined attributes. For each task respondents are asked what option they would choose. If cost/price is one of attributes, then monetary measures of value can be estimated indirectly. It has been argued that this indirect valuation approach helps attenuate problematic behavioural responses such as protest responses (objecting to paying for health care and therefore refusing to answer) and strategic choices (e.g., systematically choosing the cheapest choice option). However, the inclusion of a monetary attribute may still be problematic in health care systems where individuals do not pay at the point of consumption. Further, moral/ethical values may influence the acceptability of the monetary dimension.

The objective of this PhD is to investigate the validity of cost preferences in health choice experiments.

A possible way of tackling this research question would be to run the same choice experiment in different health contexts where both relevance and morality of cost dimension differ. Additional questions about individuals’ attitudes and experiences of having to pay for medical services may also be explored.

This is an important research objective as results from CEs are increasingly being used to inform the economic evaluation of health and healthcare services. It is therefore important to ensure that monetary valuations obtained from CEs are valid. A better understanding of the determinants of cost acceptability in health will also help to improve the design of CEs.

This PhD project offers an exciting opportunity to work with leaders in the field of applying CE in health economics. The Health Economics Research Unit (HERU) is internationally recognised for the quality of its stated preferences research in health.

During the 3-year study period the candidate will acquire and improve skills in econometrics modelling (especially discrete choices modelling), running a choice experiment, writing scientific articles, and developing multi-disciplinary work. The PhD candidate will be based at HERU. HERU offers a thriving work environment to develop research projects and collaborate with leading researchers in many areas.

This project is advertised in relation to the research areas of APPLIED HEALTH SCIENCE. Formal applications can be completed online: You should apply for Degree of Doctor of Philosophy in Applied Health Science, to ensure that your application is passed to the correct person for processing.


Candidates should contact the lead supervisor to discuss the project in advance of submitting an application, as supervisors will be expected to provide a letter of support for suitable applicants. Candidates will be informed after the application deadline if they have been shortlisted for interview.

Funding Notes

This project is part of a competition funded by the Institute of Applied Health Sciences. Full funding is available to UK/EU candidates only. Overseas candidates can apply for this studentship but will have to find additional funding to cover the difference between overseas and home fees (approximately £15,680 per annum).

Candidates should have (or expect to achieve) a minimum of a First Class Honours degree in a relevant subject. Applicants with a minimum of a 2:1 Honours degree may be considered provided they have a Distinction at Masters level.

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