Preferences for Medical Consultations from Online Providers: Evidence from a Discrete Choice Experiment in the United Kingdom

James Buchanan*, Laurence S.J. Roope, Liz Morrell, Koen B. Pouwels, Julie V. Robotham, Lucy Abel, Derrick W. Crook, Tim Peto, Christopher C. Butler, A. Sarah Walker, Sarah Wordsworth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: In the UK, consultations for prescription medicines are available via private providers such as online pharmacies. However, these providers may have lower thresholds for prescribing certain drugs. This is a particular concern for antibiotics, given the increasing burden of antimicrobial resistance. Public preferences for consultations with online providers are unknown, hence the impact of increased availability of online consultations on antibiotic use and population health is unclear. Objective: To conduct a discrete choice experiment survey to understand UK public preferences for seeking online consultations, and the factors that influence these preferences, in the context of having symptoms for which antibiotics may be appropriate. Methods: In a survey conducted between July and August 2018, general population respondents completed 16 questions in which they chose a primary care consultation via either their local medical centre or an online provider. Consultations were described in terms of five attributes, including cost and similarity to traditional ‘face-to-face’ appointments. Choices were modelled using regression analysis. Results: Respondents (n = 734) placed a high value on having a consultation via their local medical centre rather than an online provider, and a low value on consultations by phone or video. However, respondents characterised as ‘busy young professionals’ showed a lower strength of preference for traditional consultations, with a higher concern for convenience. Conclusion: Before COVID-19, the UK public had limited appetite for consultations with online providers, or for consultations that were not face-to-face. Nevertheless, prescriptions from online providers should be monitored going forward, particularly for antibiotics, and in key patient groups.

Original languageEnglish
Pages (from-to)521-535
Number of pages15
JournalApplied Health Economics and Health Policy
Issue number4
Publication statusPublished - Jul 2021

Bibliographical note

Funding Information:
This research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford in partnership with Public Health England (PHE) [HPRU-2012-10041 and NIHR200915], and supported by the NIHR Oxford Biomedical Research Centre. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health or PHE. DWC, TP, CB and ASW are NIHR Senior Investigators.

Publisher Copyright:
© 2021, The Author(s).


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