Introduction
heart failure, hypertension
HYPERTENSIVE HEART DISEASE, HYPERLIPIDEMIA, MINOR, REGRESSION, HEART FAILURE, HYPERTENSION
Stated-preference methods may quantify preferences for attributes of a medical product or intervention, using, for instance, Discrete Choice Experiments (DCE) [DCEs have also been used in pharmacy-based patient care services. When cost is included, we can estimate Willingness-to-Pay (WTP) or Willingness-to-Accept (WTA) [We can then further incorporate WTP/WTA into a cost-benefit analysis (CBA) [In 2019, a systematic review funded by the European Commission stated that DCEs could serve as the basis for a harmonized approach to assessing public policies on new health technologies in the European Union [In 2015, a systematic review identified 17 DCE studies of pharmacy services [Ten studies included in the Vass et al review [Since then, 12 more DCE studies were published on patient preferences for a pharmacy-delivered patient care service: 2 on minor ailments [These 22 DCE studies eliciting patient or public preferences in pharmacy patient care services were conducted in the UK (10), USA (4), Australia (3), Italy (2), The Netherlands (1), China (1), and New Zealand (1).In Portugal, a landmark study in 2008 estimated the volume, cost, and economic value of pharmacist advice on point-of-care measurements, prescription medicines, and non-prescription medicines. It appears to be the first study in pharmacy services worldwide to incorporate DCE into CBA. Three attributes were defined: counseling model; waiting time in pharmacy; and cost. The study used conditional logit regression. The WTP estimate was €76.5 M in 2008. Costs were valued at €28.4 M. The net benefit was estimated at €48.1 M [In 2013, 12.3% of all hospital admissions in Portugal were due to Ambulatory Care Sensitive Conditions (ACSCs) and 93.7% occurred following emergency room visits. The third and fourth most common ACSCs were heart failure and hypertensive heart disease, often as a consequence of poorly managed hypertension and hyperlipidemia, which creates an opportunity to improve service delivery [Planning and conducting a well-designed trial for the assessment of effectiveness and other dimensions should precede the economic evaluation of pharmacy-based public health interventions [Therefore, we developed a controlled trial to assess the effectiveness [This paper presents the third work of this research.The aims of this study are: 1) to explore variation in patient preferences and estimate WTA annual cost to the NHS for attributes of a collaborative care model between pharmacies and primary care in Portugal, using a DCE alongside a trial; 2) to incorporate DCE into an economic evaluation using CBA.This study is the first conducted in Portugal alongside a pharmacy collaborative trial, incorporating DCE into CBA.