WHAT MAKES DIGITAL HEALTH VALUABLE? A MULTIDIMENSIONAL PREFERENCE STUDY FOR HTA AND REIMBURSEMENT DECISIONS
Author(s)
Ann-Kathrin Fischer, MSc1, Andrew Sadler, MSc2, Axel Christian Mühlbacher, PhD3.
1M.Sc., Hochschule Neubrandenburg, Neubrandenburg, Germany, 2Gesellschaft für empirische Beratung mbH, Berlin, Germany, 3Hochschule Neubrandenburg, Neubrandenburg, Germany.
1M.Sc., Hochschule Neubrandenburg, Neubrandenburg, Germany, 2Gesellschaft für empirische Beratung mbH, Berlin, Germany, 3Hochschule Neubrandenburg, Neubrandenburg, Germany.
OBJECTIVES: Digital health interventions (DHIs) are increasingly embedded in healthcare systems, yet their assessment often remains fragmented across clinical, technical, economic, and societal criteria. This study quantified stakeholder preferences for DHIs using a multidimensional preference study design and identified value drivers relevant for innovation, implementation, and HTA decision-making.
METHODS: A Discrete Choice Experiment was conducted in Germany (general population, N=5,170) using four independently randomized modules reflecting user-related value (Subject), interaction quality, system integration, and societal impact of DHIs. Each module included dimension-specific attributes and two shared continuous attributes: out-of-pocket costs per month and individual time investment per day. Mixed logit models were estimated for each module. Relative importance was calculated based on utility coefficients. The shared continuous attributes enabled cross-dimensional interpretation through willingness to pay and willingness to trade time.
RESULTS: In the subject-related model (N=1,282), clinical benefit was the dominant driver. In the interaction-related model (N=1,309), out-of-pocket costs were most important, followed by task support and comprehensibility. In the system-related model (N=1,287), out-of-pocket costs dominated, followed by scalability. In the society-related model (N=1,292), out-of-pocket costs were strongest, followed by public health, environmental protection and sustainability, and social equity and justice. Significant standard deviations across most attributes indicated substantial preference heterogeneity.
CONCLUSIONS: Out-of-pocket costs were a key preference driver, but preferences extended beyond financial trade-offs. Across dimensions, respondents assigned substantial relative importance to clinical benefit, task support, scalability, interoperability, public health, sustainability, and equity, often exceeding the relative importance of individual time investment. By combining DCE modules with shared cost and time attributes, this study provides a transferable approach for comparing value components that are usually assessed separately. This enables researchers to quantify how respondents trade off individual, interactional, system-level, and societal benefits and supports more comprehensive preference-based evidence for HTA, reimbursement, and digital health innovation decisions
METHODS: A Discrete Choice Experiment was conducted in Germany (general population, N=5,170) using four independently randomized modules reflecting user-related value (Subject), interaction quality, system integration, and societal impact of DHIs. Each module included dimension-specific attributes and two shared continuous attributes: out-of-pocket costs per month and individual time investment per day. Mixed logit models were estimated for each module. Relative importance was calculated based on utility coefficients. The shared continuous attributes enabled cross-dimensional interpretation through willingness to pay and willingness to trade time.
RESULTS: In the subject-related model (N=1,282), clinical benefit was the dominant driver. In the interaction-related model (N=1,309), out-of-pocket costs were most important, followed by task support and comprehensibility. In the system-related model (N=1,287), out-of-pocket costs dominated, followed by scalability. In the society-related model (N=1,292), out-of-pocket costs were strongest, followed by public health, environmental protection and sustainability, and social equity and justice. Significant standard deviations across most attributes indicated substantial preference heterogeneity.
CONCLUSIONS: Out-of-pocket costs were a key preference driver, but preferences extended beyond financial trade-offs. Across dimensions, respondents assigned substantial relative importance to clinical benefit, task support, scalability, interoperability, public health, sustainability, and equity, often exceeding the relative importance of individual time investment. By combining DCE modules with shared cost and time attributes, this study provides a transferable approach for comparing value components that are usually assessed separately. This enables researchers to quantify how respondents trade off individual, interactional, system-level, and societal benefits and supports more comprehensive preference-based evidence for HTA, reimbursement, and digital health innovation decisions
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA291
Topic
Health Technology Assessment, Methodological & Statistical Research, Patient-Centered Research
Topic Subcategory
Decision & Deliberative Processes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas