Development and application of discrete choice experiments to pharmacy policy

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Taking a health economics approach to pharmacy and developing the health economics methodology separates this research from much work in the field. The results of the interdisciplinary approach highlight the unique benefit of developing both the methodology and the pharmacy applications. Coronary heart disease is the subject of a recent guideline developed by the Department of Health and is a priority health area. The Community Pharmacy Medicines Management project, springboard to my completed doctoral program, was funded by the Department of Health to promote the development of an innovative pharmacy-based medicines management service. The Discrete Choice Experiments (DCEs) technique allows evaluation, from a patient perspective, of an alternative pharmaceutical service for patients with chronic disease. Different traditional approaches in benefit evaluations, such as clinical outcome, quality of life and patient satisfaction, are commonly used in pharmacy health services research. Their contribution to benefit evaluation is presented, possible limitations are discussed and results are compared to the innovative DCE methodology. Such approaches are then incorporated into the economic evaluation framework in order to advise how to maximise the allocation of scarce resources when implementing pharmacy health services. The impact on policy makers of different results from such alternative approaches is then discussed. Understanding the choices made by patients is important for health professionals and policy makers such that health promotion and health interventions can be improved to fully incorporate a patient-centred approach.