If you were a policymaker, which treatment would you disinvest? A participatory value evaluation on public preferences for active disinvestment of health care interventions in the Netherlands

A. H. Rotteveel*, M. S. Lambooij, E. A.B. Over, J. I. Hernández, A. W.M. Suijkerbuijk, A. T. de Blaeij, G. A. de Wit, N. Mouter

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)
17 Downloads (Pure)

Abstract

INTRODUCTION: Currently, it is not known what attributes of health care interventions citizens consider important in disinvestment decision-making (i.e. decisions to discontinue reimbursement). Therefore, this study aims to investigate the preferences of citizens of the Netherlands toward the relative importance of attributes of health care interventions in the context of disinvestment. METHODS: A participatory value evaluation (PVE) was conducted in April and May 2020. In this PVE, 1143 Dutch citizens were asked to save at least €100 million by selecting health care interventions for disinvestment from a list of eight unlabeled health care interventions, described solely with attributes. A portfolio choice model was used to analyze participants' choices. RESULTS: Participants preferred to disinvest health care interventions resulting in smaller gains in quality of life and life expectancy that are provided to older patient groups. Portfolios (i.e. combinations of health care interventions) resulting in smaller savings were preferred for disinvestment over portfolios with larger savings. CONCLUSION: The disinvestment of health care interventions resulting in smaller health gains and that are targeted at older patient groups is likely to receive most public support. By incorporating this information in the selection of candidate interventions for disinvestment and the communication on disinvestment decisions, policymakers may increase public support for disinvestment.

Original languageEnglish
Pages (from-to)428-443
Number of pages16
JournalHealth economics, policy, and law
Volume17
Issue number4
DOIs
Publication statusPublished - 1 Oct 2022

Bibliographical note

Funding Information:
This research was funded by the strategic research program RIVM (S/133005), a research fund from the National Institute of Public Health and the Environment, the Netherlands. Funders had no role in the design of the study, its conduct or the analysis of the results and were not involved in manuscript preparation or submission.

Publisher Copyright:
Copyright © The Author(s), 2022.

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