Challenges and opportunities of choice modelling in health

In his dissertation, Vikas Soekhai explores different methods used to collect patients’ preferences. There is a variety of methods available. Vikas Soekhai identified 32 and has focused particularly on two of the most popular ones in his dissertation: Discrete choice experiments and what is called Case 2 best-worst scaling. All to provide insights into how best to elicit the preferences of patients.

(Image removed) Vikas Soekhai

“Choices in health are everywhere around us, each with their own characteristics. From treatment choices in the doctor’s office to choices on a policy level about vaccination strategies. By using choice experiments, decision-makers can get more insights into patient preferences and uptake predictions,” says Vikas Soekhai, who successfully defended his PhD thesis on 4 November 2021.

In the two survey-based preference elicitation methods Vikas Soekhai has explored, research participants are asked to choose their preferred, or least preferred, option from a set of hypotheticals. By asking individuals to make repeated choices, a preference pattern is revealed that shows how patients make trade-offs between different treatment attributes.

“We have systematically reviewed the methods available, and performed simulation studies that have allowed us to refine the use of the two most popular methods. We also compared them in an empirical study, to explore their differences. Both methods have the potential to provide useful evidence for decision-makers but they can also complicate the decision-making process as an additional source of information. As a health economist it is however very useful to see what determines health choices and what challenges we need to overcome to provide useful information for decision-making,” says Vikas Soekhai.

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His contribution to the PREFER project is one of methods refinement. PREFER is figuring out when and how to listen to the patient voice and refining the use of patient preference studies in HTA, regulatory, payer and industry decision-making. Although DCE and BWS-2 have been quite popular in health, there are several challenges regarding design and analysis.

“Preference studies offer a systematic way to incorporate the patient voice into health decision-making at various decision-points during the medical product life cycle and with various stakeholders. PREFER is filling an important gap with regard to enabling patient-centric decision-making. My work contributes to the work of this public-private partnership by ensuring that when we listen to the patient voice, that we are good listeners by using the methods we have available to us in the best way possible and doing the patients justice,” Vikas Soekhai concludes.

Vikas Soekhai’s PhD defence took place on 4 November 2021.

Thesis title

Choice Modelling in Health: Challenges and Opportunities


  • Esther de Bekker-Grob
  • Bas Donkers


  • Maureen Rutten-van Mölken

Jury members

  • Caspar Chorus
  • Karin Oudshoorn
  • Job van Exel
  • Ardine de Wit
  • Ewout W. Steyerberg





  • Disclaimer: This website and its contents reflects the PREFER project's view and not the view of IMI, the European Union or EFPIA.


The Patient Preferences in Benefit-Risk Assessments during the Drug Life Cycle (PREFER) project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115966. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA).