OBJECTIVES: The objectives were to identify and quantify the value of preferences for characteristics that should influence prioritisation of patients for total joint replacement (TJR). METHODS: Interviews, a ranking study and literature review were used to identify the attributes that should influence TJR prioritisation decisions for people with equal need and expected outcomes. A discrete choice survey was designed and piloted to value preferences for key attributes. Three attributes with two levels (comorbidity; patient provides necessary care for another person; patients tries to follow doctors instructions to maintain health and weight) and two attributes with four levels (cost to the health service; age) were identified as important characteristics. A fractional factorial design was used, giving 16 patient profiles and 8 pair-wise choices. For each pair-wise choice, respondents chose whether patient A or B should be prioritised for the next available TJR or wait 12 months. Dominance and consistency tests were included. Each attribute was also ranked in order of preference. Respondents included patients waiting for or had a TJR and the general public. RESULTS: There were 80 respondents. The average age was 64 years, 63% were female, 88% were patients, 66% lived with others at home and 53% were married. In the ranking exercise willingness to follow doctors instructions was the most preferred characteristic (n=36, 45%) and cost the least preferred (n=42, 53%). The analysis indicated that the coefficients for all characteristics except comorbidity (p=0.07) were statistically significant (p<0.01). Overall, people appeared to prefer patients who were willing to follow doctors instructions, provide necessary care for another person and were younger to be treated first. CONCLUSIONS: Respondents were willing to choose between patients profiles to prioritise who should receive the next TJR. Important attributes in the choice were willingness to follow doctors instructions and whether the patient cared for another.