Background: Consumers face an array of multiattribute prescription benefit insurance programs that include different access points (retail, supermarket, Internet, etc) and levels of pharmacist interaction (including medication therapy management services [MTMSs]). Because of this, there is a need for more sophisticated information to drive prescription benefit plan design.
Objectives: A pilot study to determine if choice-based conjoint (CBC) analysis with hierarchical Bayes (HB) estimation for individual level part-worths could provide a stable model for attribute preferences for prescription benefit insurance; to pilot test the addition of MTMSs to a prescription benefit management model; and to pilot and compare logit-based utility estimates to HB estimations in a conjoint market simulator.
Methods: A mail-based survey was conducted using a random sample of 1500 residents of the United States. A CBC analysis instrument was developed to provide a single-stated choice from a selection of different prescription benefit plans. Choice tasks were varied based on the attributes: co-payment, pharmacy access, formulary, level of pharmacist interaction including MTMSs and monthly premium. Analysis included logit-based and HB estimation for utilities, and preference share market simulation testing.
Results: The utility estimations from HB analysis were consistent with those seen in the logit-based analysis. A goodness of fit of 83% (root likelihood) was achieved in the HB utility estimations with only 4 choice tasks per respondents and the inclusion of MTM-like services. There was convergence on preference shares from the market simulation between the 2 estimation methods.
Conclusions: The use of CBC analysis with HB estimation provided utilities similar to those estimated using aggregated logit-based methods, with the added benefit of respondent specific part-worth scores for each attribute level. A larger sample, changes in the instrument design, more panels (tasks) per respondent, and selection of conjoint methods may allow for more predictive information from market simulators.