Attributes Development for Pharmaceutical Subsidization: A Qualitative Study

Document Type: Research article


Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.


Discrete choice experiments (DCES) as a stated preference method have used increasingly to
determine preferences attached to some attributes associated to health. Although, the validity of
this type of studies comprehensively depends on the appropriate determination of attributes and
attribute-levels for DCES, there is little rigorous evidence regarding which factors or attributes and
attribute- levels should be counted for eliciting public preferences in health resource allocation.
This paper responds to such question by carefully doing a qualitative study. A qualitative study
used semi-structured interviews, which were audio recorded, transcribed and subject to thematic
analysis. Sixteen participants had been key informants and decision makers of pharmaceutical and
health system. Initially, by conducting a meticulous literature review, an inclusive list of attributes
associated with intended policy was identified. Qualitative data for the development of attributes
and their levels were collected using 16 key informant interviews and were analyzed by software
MAXQDA followed by a focus group discussion (FGD) with 7 people, well-familiar with the
notion pharmaceutical policy and Pharmacoeconomics. The 311 codes in four main dimensions
were initially identified by conducting interviews. However, for being manageable within a
DCE, they were classified and limited to four attributes, including severity of disease without
treatment, health gain after treatment, frequency of patients, and cost of treatment per patient.
This qualitative study provides enough evidence for designing and doing a precise discrete choice
experiment answering the question about public preferences in pharmaceutical subsidization and
contributes empirical evidence to the limited methodological literature on attributes development
for DCE, specifically within low and middle-income countries.

Graphical Abstract

Attributes Development for Pharmaceutical Subsidization: A Qualitative Study


Main Subjects