Axel C. Mühlbacher

• Dipl.-Kaufmann, Dr. rer. oec., Professor of Health Economics and Health Care Management
• Professor (Full) at Neubrandenburg University of Applied Sciences

In health preference research (HPR) studies, data are generated by participants’/subjects’ decisions. When developing an HPR study, it is therefore important to have a clear understanding of the components of a decision and how those components stimulate participant behavior. To obtain valid and reliable results, study designers must sufficiently d...

Background Stroke is a common, serious, and disabling healthcare problem with increasing incidence and prevalence. Following a stroke, identifying the factors associated with decisions about rehabilitation interventions is important to assess rehabilitation after stroke. The aim is to guide clinical staff to make patient-centered decisions. Fundame...

To measure preference heterogeneity for monitoring systems among patients with a chronic heart failure. A best–worst scaling experiment (BWS case 3) was conducted among patients with chronic heart failure to assess preferences for hypothetical monitoring care scenarios. These were characterized by the attributes mobility, risk of death, risk of hos...

We aimed to investigate whether individuals’ trade-offs between vaccine effectiveness and vaccine safety vary if they are asked to consider the perspective of a policymaker making decisions for others compared with the decisions they would make for themselves. A web-enabled discrete choice experiment survey was administered between 1 April and 1 Ma...

Background: Strokes pose a particular challenge to the health care system. Although stroke-related mortality has declined in recent decades, the absolute number of new strokes (incidence), stroke deaths, and survivors of stroke has increased. With the increasing need of neurorehabilitation and the decreasing number of professionals, innovations ar...

Introduction: Discrete choice experiments (DCE) are increasingly being conducted using online panels. However, the comparability of such DCE-based preferences to traditional modes of data collection (e.g., in-person) is not well established. In this study, supervised, face-to-face DCE was compared with its unsupervised, online facsimile on face va...

BACKGROUND Strokes pose a particular challenge to the health care system. Although stroke-related mortality has declined in recent decades, the absolute number of new strokes (incidence), stroke deaths, and survivors of stroke has increased. With the increasing need of neurorehabilitation and the decreasing number of professionals, innovations are...

Chronic heart failure (CHF) patients are facing trade-offs when deciding on the use of medical devices to monitor hemodynamics/changes in pulmonary artery pressure, indicating a worsening. This study assessed individual level patients’ preferences for benefits and risks of CHF monitoring. A systematic literature search and pre-test interviews wer...

Background: There has been a persistent organ shortage, which forces priority setting in organ allocation to potential recipients. Because organ allocation is a highly normative decision task, it can be only legitimate if the general public is also involved in the decision making. Therefore, the aim was to assess public preferences for the allocati...

To achieve the UNAIDS target of diagnosing 95% of all persons living with HIV, enhanced HIV testing services with greater attractional value need to be developed and implemented. We conducted a discrete choice experiment (DCE) to quantify preferences for enhanced HIV testing features across two high-risk populations in the Kilimanjaro Region in nor...

Objectives Discrete choice experiments (DCEs) are increasingly used to elicit preferences for health and healthcare. Although many applications assume preferences are homogenous, there is a growing portfolio of methods to understand both explained (because of observed factors) and unexplained (latent) heterogeneity. Nevertheless, the selection of a...

Background South Africa (SA) has the world’s highest burden of HIV infection, with an estimated 13.7% of the population living with HIV (PLWH/Persons Living With HIV). The early identification of PLWH and rapid engagement of them in HIV treatment are indispensable tools in the fight against HIV transmission. Understanding client preferences for HIV...

Background In childhood autism spectrum disorder (ASD), the Childhood Autism Rating Scale–2nd edition (CARS2) instrument is used for diagnosis and assessment of severity and change. Following a feasibility study, we conducted 2 discrete choice experiments (DCEs), each of which used caregivers and clinicians as proxies for autistic children, to asse...

Problem Policymakers must decide on interventions to control the pandemic. These decisions are driven by weighing the risks and benefits of various non-pharmaceutical intervention alternatives. Due to the nature of the pandemic, these decisions are not based on sufficient evidence regarding the effects, nor are decision-makers informed about the wi...

Background In childhood autism spectrum disorder (ASD), the Childhood Autism Rating Scale–2nd edition (CARS2) is a condition-specific instrument to be filled out by clinicians, resulting in a score for diagnosis and severity. Our aim is to estimate a preference-based scoring of CARS2 to better understand the value of changes in the CARS2 score. Usi...

Background: The gastrointestinal symptom score (GIS) is used in a standardized form to ascertain dyspeptic symptoms in patients with functional dyspepsia in clinical practice. As a criterion for evaluating the effectiveness of a treatment, the change in the summed total point value is used. The total score ranges from 0 to 40 points, in which a hi...

This study aimed to assess public preferences for the allocation of donor organs in Germany with the focus on ethical principles of distributive justice. We performed a discrete choice experiment (DCE) using a self-completed online questionnaire. Based on a systematic review and focus group discussions, six attributes, each with 2–4 levels, were se...

Objective To examine subgroup-specific treatment preferences and characteristics of patients with hemophilia A. Methods Best–Worst Scaling (BWS) Case 3 (four attributes: application type; bleeding frequencies/year; inhibitor development risk; thromboembolic events of hemophilia A treatment risk) conducted via online survey. Respondents chose the b...

Efforts to eliminate the HIV epidemic will require increased HIV testing rates among high-risk populations. To inform the design of HIV testing interventions, a discrete choice experiment (DCE) with six policy-relevant attributes of HIV testing options elicited the testing preferences of 300 female barworkers and 440 male Kilimanjaro mountain porte...

Objective The aim of this study was to compare online, unsupervised and face-to-face (F2F), supervised valuation of EQ-5D-5L health states using composite time trade-off (cTTO) tasks. Methods The official EuroQol experimental design and valuation protocol for the EQ-5D-5L of 86 health states were implemented in interviewer-assisted, F2F and unsupe...

Background There are unresolved procedural and medical problems in the care of diabetes, which cause high costs for health systems. These include the inadequate glycemic adjustment, care gaps, therapeutic inertia, and a lack of motivation. Personalized diabetes management can be seen as a kind of “standard process” that provides both physicians and...

Background Web-based surveys are increasingly utilized for health valuation studies but may be more prone to lack of engagement and, therefore, poor data validity. The objective of this study was to evaluate the effect of imposed engagement (i.e., at least three trade-offs) in the composite time trade-off (cTTO) task.Methods The EQ-5D-5L valuation...

Introduction Approximately one million undiagnosed persons living with HIV in Southern and Eastern Africa need to test for HIV. Novel approaches are necessary to identify HIV testing options that match the heterogeneous testing preferences of high-risk populations. This pragmatic randomised controlled trial (PRCT) will evaluate the efficacy of a pr...

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...

Objective Limited data describe patient preferences for the growing number of antiretroviral therapies (ARTs). We quantified preferences for key characteristics of modern ART deemed relevant to shared decision making. Methods A discrete choice experiment survey elicited preferences for ART characteristics, including dosing (frequency and number of...

Objective To assess patient preferences for benefits and risks in hemophilia A treatment. Methods A systematic literature search and pretest interviews were conducted to determine the most patient-relevant endpoints in terms of effects, risks, and administration of hemophilia A treatments. A Best–Worst Scaling (BWS; Case 3 or multiprofile case) ap...

The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.jval.2020.05.007. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal

Background Deceased donor organs are scarce resources because of a large supply‐and‐demand mismatch. This scarcity leads to an ethical dilemma, forcing priority‐setting of how these organs should be allocated and whom to leave behind. Objective To explore public preferences for the allocation of donor organs in regard to ethical aspects of distrib...

Zusammenfassung Hintergrund und Zielsetzung Kostenberechnungen sind ein wesentlicher Bestandteil gesundheitsökonomischer Evaluationen, weisen jedoch für den deutschen Versorgungskontext teilweise große Unterschiede im methodischen Vorgehen auf. Zielsetzung der vorliegenden Artikelserie ist es, einen konsentierten Vorschlag zu den Vorgehensweisen de...

Schon heute ist jede zweite Person in Deutschland älter als 45 Jahre und jede fünfte Person älter als 66 Jahre. Durch die steigende Lebenserwartung bei sinkender Geburtenrate wird es zunehmend ältere und multimorbide Patienten geben. Der Altenquotient steigt, sodass das Gesundheitssystem vor finanziellen und organisatorischen Herausforderungen steh...

Zusammenfassung Discrete Choice Experimente (DCE) sind eine wichtige Methode zur Erfassung von Patientenpräferenzen. Neuroendokrine Tumore (NET) sind eine seltene Krankheit und daher ist es schwierig, eine ausreichende Anzahl von Studienteilnehmern für Präferenzstudien zu gewinnen. Darüber hinaus gibt es kaum internationale Standards für die Bestim...

OBJECTIVES: The aim of this study was to examine subgroup-specific treatment preferences and characteristics of patients with hemophilia A. METHODS: A Best-Worst Scaling Case 3 with four attributes was conducted as online survey. Attributes represented type of application, bleeding frequencies/year, risk of inhibitor development and risk of thrombo...

Introduction: Deceased donor organs are a scarce resource because of a large mismatch between supply and demand. This scarcity leads to an ethical dilemma, forcing priority setting of how these organs should be allocated and who should be considered to receive a suitable organ. A systematic review and focus groups were performed to determine public...

Diabetes mellitus ist eine Volkskrankheit mit hohen Ausgaben für das Gesundheitssystem. Bis heute gibt es in der Diabetesversorgung ungelöste verfahrenstechnische und medizinische Probleme. Dazu gehören die unzureichende glykämische Anpassung, Versorgungslücken und mangelnde Motivation. Aufgrund der gewaltigen sozioökonomischen Bedeutung von Innova...

Introduction Health Technology Assessment (HTA) and regulatory decisions involve value judgements. As patient groups, industry, and regulatory agencies conduct more preference studies to quantify these judgements, a better understanding of the methods and practices is needed. Currently, there is no systematic mapping of the use of preference data i...

Objectives Neuroendocrine tumors (NETs) are rare, slow-growing malignant tumors. So far, there are no data on patient preferences regarding its therapy. This empirical study aimed to elicit patient preferences in the drug treatment of NET. Methods Based on qualitative patient interviews and an analytic hierarchy process, six patient-relevant attri...

Background Solid organ transplantation is the treatment of choice for organ failure, but donor organs are a scarce resource because of a large mismatch between supply and demand. This scarcity leads to an ethical dilemma, forcing priority setting in organ allocation to individual patients. Little is known about public preferences regarding priority...

Background The effects of health interventions are often complex, and it is argued that they comprise more than pure changes in clinical parameters. Aspects of the treatment process, so-called ‘benefits beyond health’, are often overlooked in the evaluation of health interventions but can be of value to the patients. Objectives The aim of this stu...

Der Klassiker der Wirtschaftsliteratur: Wie ehedem einzigartig - sowohl in der Tiefe seiner Begriffserklärungen als auch in der Breite der Darstellungen - informiert das Gabler Wirtschaftslexikon kompetent und zuverlässig über alle wichtigen Begriffe aus der Welt der Wirtschaft. Dafür sorgen die mehr als 200 renommierten Experten aus Wissenschaft u...

Background: To assess patients’ preferences for HIV testing in Colombia. Methods: A discrete-choice experiment was used to assess preferences of patients diagnosed with HIV, for HIV testing in two HIV clinics in Bogotá, Colombia. Patients were asked to choose repeatedly between two hypothetical HIV testing options that varied with respect to five a...

Objectives Severe hypercholesterolemia is a major cause of death in coronary heart disease. New adjunctive drug therapies have passed authorization processes and been launched recently. So far it is not known which properties of the new treatment options generate the highest benefit for patients. The aim was to evaluate patient priorities in the fi...

Objective. To examine whether personality traits, particularly conscientiousness and agreeableness, were associated with systematic differences in health outcome preferences in cancer treatment scenarios among second-year Doctor of Pharmacy students. Methods. An online survey that quantified outcome preferences using profile best-worst scaling task...

Background: Demographic trends affect size and age structure of populations. One of the consequences will be an increasing need for blood products to treat age-related diseases. Donation services rely on voluntariness and charitable motivation. It might be questioned whether there will be sufficient blood supply with voluntary donation. The present...

Aim: To elicit patients’ preferences for HIV/AIDS treatment characteristics in Colombia. Material and methods: A best-worst scaling case 1 was used to provide a ranking of 26 HIV/AIDS treatment characteristics that were similar to a previous study conducted in Germany. In each choice task, participants were asked to choose the most important and th...

Background: Severe hypercholesterolemia is a major risk factor of death in patients with coronary heart disease. New adjunctive drug therapies (proprotein convertase subtilisin/kexin type 9 [PCSK9] inhibitors) have gained approval in Europe and the USA. Objective: In this empirical study, we documented preferences regarding adjuvant drug therapy...

Introduction Integrated care systems as well as accountable care organisations (ACOs) in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality met...

Introduction Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The risk structure of the providers plays a vital role in Pay for Performance. A prerequisite for optimal incentive-based service models is a (partial) dependence of the agent...

Introduction Integrated care systems are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. Little is known about the contractual design and the main challenges of delegating “accountab...

Zusammenfassung Verfahren der multikriteriellen Entscheidungsanalyse erlauben die Bewertung und Saldierung von Nutzen und Schaden unter der Berücksichtigung von Präferenzen. Im Gesundheitswesen können beispielsweise die Patienten- oder Expertenpräferenzen in Bezug auf verschiedene Nutzen-, Schaden- oder Anwendungsaspekte einer Gesundheitstechnologi...

The lately inured § 137 h SGB V aims to assess the benefit of new examination and treatment methods with medical devices of class IIb and III. In the future, the decision on the reimbursement eligibility will be marked by high requirements in terms of documentation of benefits and harm. The objective of benefit assessment is the operationalization...

Integrated care (IC) suits patient needs better than fragmented health services. It is needed to organize care around the patient (Davis et al. 2005) and is seen as a critical factor in a high-performance healthcare system (McAllister et al. 2007). Care coordination is a process that addresses the health needs and wants of patients, including a ran...