WILLINGNESS TO TRADE EFFECTIVENESS FOR OTHER CONTRACEPTIVE FEATURES: A DISCRETE CHOICE EXPERIMENT
Author(s)
Vanessa P. Patel, PhD, MS1, Ashley Holub, PhD2, Keith A. Betts, PhD2, Lorraine Liu, BA2, Kevin Collins, MD1, Kara Rood, MD3, Stephanie Teal, MD, MPH4;
1Organon, Jersey City, NJ, USA, 2Analysis Group, Boston, MA, USA, 3The Ohio State University, Columbus, OH, USA, 4University Hospitals, Cleveland, OH, USA
1Organon, Jersey City, NJ, USA, 2Analysis Group, Boston, MA, USA, 3The Ohio State University, Columbus, OH, USA, 4University Hospitals, Cleveland, OH, USA
OBJECTIVES: Understanding tradeoffs when choosing contraception is fundamental to understanding the values of women and healthcare providers (HCPs). This discrete choice experiment (DCE) quantified the tradeoffs willing to be made between contraceptive attributes.
METHODS: DCEs were conducted separately for women and HCPs. Seven attributes were assessed: effectiveness, mode of administration, return to fertility, cardiovascular risk, immediate postpartum use, breastfeeding, and amenorrhea. Participants completed 12 choice cards per DCE; each choice card displayed hypothetical yet realistic contraceptive methods with varying levels. HCPs completed DCEs for distinct patient profiles: 1) a young, nulliparous woman; 2) an older woman, family planning complete; and 3) a woman with higher body weight. Tradeoffs were estimated using marginal utilities (continuous) or preference weights (categorical) for an attribute divided by the marginal utility for effectiveness; utilities derived from conditional logistic regression models. A negative (positive) beta coefficient for willingness to tradeoff [WTT] indicated that a method would need to be more (less) effective to accept a given attribute. Good research practice guidelines were followed.
RESULTS: A total of 612 participants were included. Women (n=307) were 29.9 years, on average. HCPs (n=305) practiced for 16.3 years, on average; 65.6% specialized in obstetrics/gynecology. Women required more effectiveness for a given method if it delayed fertility once stopping (WTT= -2.05) and would accept a less effective method if it had a daily mode of administration (WTT=3.04). When considering long-acting reversible methods, women required more effectiveness to accept intrauterine devices over the etonogestrel implant (WTT=-0.51). Across profiles, HCPs consistently indicated a dislike for oral pills and injections and required greater effectiveness to use these methods over their preferred contraceptive methods (i.e., etonogestrel implant, intrauterine devices).
CONCLUSIONS: Notable tradeoffs are willing to be made when considering various contraceptive attributes. These findings are central to educational efforts, contraceptive counseling, benefit-risk, and resource allocation.
METHODS: DCEs were conducted separately for women and HCPs. Seven attributes were assessed: effectiveness, mode of administration, return to fertility, cardiovascular risk, immediate postpartum use, breastfeeding, and amenorrhea. Participants completed 12 choice cards per DCE; each choice card displayed hypothetical yet realistic contraceptive methods with varying levels. HCPs completed DCEs for distinct patient profiles: 1) a young, nulliparous woman; 2) an older woman, family planning complete; and 3) a woman with higher body weight. Tradeoffs were estimated using marginal utilities (continuous) or preference weights (categorical) for an attribute divided by the marginal utility for effectiveness; utilities derived from conditional logistic regression models. A negative (positive) beta coefficient for willingness to tradeoff [WTT] indicated that a method would need to be more (less) effective to accept a given attribute. Good research practice guidelines were followed.
RESULTS: A total of 612 participants were included. Women (n=307) were 29.9 years, on average. HCPs (n=305) practiced for 16.3 years, on average; 65.6% specialized in obstetrics/gynecology. Women required more effectiveness for a given method if it delayed fertility once stopping (WTT= -2.05) and would accept a less effective method if it had a daily mode of administration (WTT=3.04). When considering long-acting reversible methods, women required more effectiveness to accept intrauterine devices over the etonogestrel implant (WTT=-0.51). Across profiles, HCPs consistently indicated a dislike for oral pills and injections and required greater effectiveness to use these methods over their preferred contraceptive methods (i.e., etonogestrel implant, intrauterine devices).
CONCLUSIONS: Notable tradeoffs are willing to be made when considering various contraceptive attributes. These findings are central to educational efforts, contraceptive counseling, benefit-risk, and resource allocation.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH120
Topic
Epidemiology & Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Reproductive & Sexual Health, STA: Personalized & Precision Medicine