PATIENT-PHYSICIAN DIFFERENCES IN PREFERENCES FOR FINANCIAL INCENTIVES TO IMPROVE MEDICATION ADHERENCE: EVIDENCE FROM A BEST-WORST SCALING STUDY IN CHINA
Author(s)
Xiaoyu Ou, BS1, Yi Cao, BS1, Luying Wang, PhD2, Tiantian Tao, PhD3, Pingyu Chen, PhD4.
1China Pharmaceutical University, Nanjing, China, 2post doctoral researcher, China Pharmaceutical University, Nanjing, China, 3Nanjing Medical University, Nanjing, China, 4China Pharmaceutical University, Nanjing, China.
1China Pharmaceutical University, Nanjing, China, 2post doctoral researcher, China Pharmaceutical University, Nanjing, China, 3Nanjing Medical University, Nanjing, China, 4China Pharmaceutical University, Nanjing, China.
OBJECTIVES: Medication non-adherence remains a major challenge in the management of chronic diseases. Although financial incentives have been proposed to improve adherence, evidence is limited regarding whether patients and physicians value program attributes differently. This study compared preferences for medication adherence incentive programs among patients and physicians from a community healthcare perspective in China.
METHODS: A profile-case best-worst scaling (BWS-2) survey was conducted among patients with chronic diseases receiving long-term medication and physicians. Five attributes were evaluated: participation condition, reward qualification criteria, reward type, reward value, and reward timing. Respondents completed experimentally designed choice tasks and selected the most and least preferred attribute levels. Preferences were estimated using conditional logit and mixed logit models. Relative importance (RI) was derived from mixed logit estimates. Preference heterogeneity was assessed by testing significance of random-parameter standard deviations.
RESULTS: A total of 536 patients and 313 physicians were included. Among patients, participation condition was the most important attribute (RI=45.2%), followed by reward timing (RI=21.9%) and reward value (RI=15.3%). Patients showed strong preferences for programs that require no participation fee (β=2.74, P<0.001) and provide immediate rewards (β=1.39, P<0.001). In contrast, physicians prioritized reward value (RI=34.1%) and reward type (RI=26.6%), with greater reward values and cash-based incentives associated with higher estimated utility. Significant differences were observed between patients and physicians in the importance of attributes. Significant preference heterogeneity was identified in both groups, although the attributes exhibiting heterogeneity differed between patients and physicians.
CONCLUSIONS: Patients place greater value on reduced participation burden and immediate rewards, whereas physicians emphasize reward magnitude and incentive type. These findings may inform the development of patient-centered financial incentives to improve medication adherence.
METHODS: A profile-case best-worst scaling (BWS-2) survey was conducted among patients with chronic diseases receiving long-term medication and physicians. Five attributes were evaluated: participation condition, reward qualification criteria, reward type, reward value, and reward timing. Respondents completed experimentally designed choice tasks and selected the most and least preferred attribute levels. Preferences were estimated using conditional logit and mixed logit models. Relative importance (RI) was derived from mixed logit estimates. Preference heterogeneity was assessed by testing significance of random-parameter standard deviations.
RESULTS: A total of 536 patients and 313 physicians were included. Among patients, participation condition was the most important attribute (RI=45.2%), followed by reward timing (RI=21.9%) and reward value (RI=15.3%). Patients showed strong preferences for programs that require no participation fee (β=2.74, P<0.001) and provide immediate rewards (β=1.39, P<0.001). In contrast, physicians prioritized reward value (RI=34.1%) and reward type (RI=26.6%), with greater reward values and cash-based incentives associated with higher estimated utility. Significant differences were observed between patients and physicians in the importance of attributes. Significant preference heterogeneity was identified in both groups, although the attributes exhibiting heterogeneity differed between patients and physicians.
CONCLUSIONS: Patients place greater value on reduced participation burden and immediate rewards, whereas physicians emphasize reward magnitude and incentive type. These findings may inform the development of patient-centered financial incentives to improve medication adherence.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD125
Topic
Health Service Delivery & Process of Care, Patient-Centered Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas