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Patients with moderate-to-severe atopic dermatitis (AD) experience skin lesions and intense itch that substantially affect quality of life. Patients have choices among systemic AD treatments that offer varied benefit–risk profiles. Measure patients’ willingness to trade off the risks and benefits of systemic treatments among individuals with a physician-confirmed diagnosis of moderate-to-severe AD. Patients participated in a discrete choice experiment online survey with a series of choices between hypothetical AD treatments defined by six attributes reflecting benefits and risks of treatments (itch reduction, time until noticeable itch reduction, chance of clear or almost clear skin, risk of serious infection, risk of developing acne, and need for prescription topical steroids). Data were analyzed with a random parameters logit model to quantify preferences and the relative importance of attributes for treatment alternatives. Respondents (n = 200) placed the highest relative importance on itch reduction, speed of itch reduction, and skin clearance, and were generally willing to accept clinically relevant levels of risk of serious infection and acne in exchange for treatment benefits. Patients with moderate-to-severe AD were willing to trade clinically relevant treatment risks for greater or more rapid itch reduction and skin clearance offered by systemic therapies.

Supplemental material, sj-docx-1-mpp-10.1177_23814683211058663 for Exploring Decisional Conflict With Measures of Numeracy and Optimism in a Stated Preference Survey by Jessie Sutphin, Rachael L. DiSantostefano, Colton Leach, Brett Hauber and Carol Mansfield in MDM Policy & Practice

Supplemental material, sj-docx-1-mpp-10.1177_23814683211058663 for Exploring Decisional Conflict With Measures of Numeracy and Optimism in a Stated Preference Survey by Jessie Sutphin, Rachael L. DiSantostefano, Colton Leach, Brett Hauber and Carol Mansfield in MDM Policy & Practice

In the early 2000s, the Government of Sri Lanka considered engaging private sector operators to manage water and sewerage services in two separate service areas: one in the town of Negombo (north of Colombo), and one stretching along the coastal strip (south from Colombo) from the towns of Kalutara to Galle. Since then, the government has abandoned the idea of setting up a public-private partnership in these two areas. This paper is part of a series of investigations to determine how these pilot private sector transactions (forming part of the overall water sector reform strategy) could be designed in such a manner that they would benefit the poor. The authors describe the results of a conjoint survey evaluating the factors that drive customer demand for alternative water supply and sanitation services in Sri Lanka. They show how conjoint surveys can be used to unpackage household demand for attributes of urban services and improve the design of infrastructure policies. They present conjoint surveys as a tool for field experiments and a source of valuable empirical data. In the study of three coastal towns in southwestern Sri Lanka the conjoint survey allows the authors to compare household preferences for four water supply attributes-price, quantity, safety, and reliability. They examine subpopulations of different income levels to determine if demand is heterogeneous. The case study suggests that households care about service quality (not just price). In general, the authors find that households have diverse preferences in terms of quantity, safety, and service options, but not with regard to hours of supply. In particular, they find that the poor have lower ability to trade off income for services, a finding that has significant equity implications in terms of allocating scarce public services and achieving universal water access.

This research considers whether the principles developed to analyze the optimal jurisdiction for producing public goods can be applied in cases where regulations of private activities provide the primary means to deliver different amounts of public and quasi-public goods. The analysis evaluates how devolution affects the development of benefit cost analyses for regulations and the role of economic versus environmental factors in defining the extent of the regulatory market. Using a study of nutrient control for the Neuse River in North Carolina, the analysis develops area specific measures of the benefits and costs of regulations and illustrates how changes in the composition of the areas allowed to "count" for policy design can affect decisions about the levels of control judged to meet the net benefit test.

This paper provides the results of a field test of contingent valuation estimates within a willingness to accept framework. Using dichotomous choice questions in telephone-mail-telephone interviews, we compare responses to real and hypothetical offers to survey respondents for the opportunity to spend time in a second set of interviews on an undisclosed topic. Five hundred and forty people were randomly split between the real and hypothetical treatments. Our findings indicate no significant differences between people's choices with real and hypothetical offers. Choice models indicate the size of the offer and income were significant determinants of respondents' decisions, and these models were not significantly different between real and hypothetical offers.