Comprehensive value assessment of drugs using a multi-criteria decision analysis: An example of targeted therapies for metastatic colorectal cancer treatment


Autoři: Jason C. Hsu aff001;  Jia-Yu Lin aff002;  Peng-Chan Lin aff003;  Yang-Cheng Lee aff004
Působiště autorů: School of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan aff001;  Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan aff002;  Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan aff003;  Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225938

Souhrn

Objective

This study is aimed toward establishing a decision-making model with multiple criteria for appraisal and reimbursement to compare the attitudes of different stakeholders toward various dimensions and criteria and to evaluate the five targeted therapies (bevacizumab, cetuximab, panitumumab, aflibercept, and regorafenib) for metastatic colorectal cancer.

Method

This study is a multi-criteria decision analysis (MCDA) using a model that includes three dimensions and nine criteria. Both the overall and individual scores of the respective targeted therapies in different dimensions and criteria were calculated. A sensitivity analysis was carried out in order to evaluate the robustness of the research results. An interview-based questionnaire survey was applied to obtain the performance information for the targeted therapies and the weights of the dimensions and criteria.

Results

Overall, the clinical dimension had the highest weight, followed by the economic dimension, and finally, the social dimension. In the clinical dimension, the “comparative efficacy” criterion had the highest weight; in the economic dimension, the “cost-effectiveness” criterion” was given the greatest importance; in the social dimension, the “social concern and patient needs” criterion was given more emphasis. The overall values ranked from high to low as follows: cetuximab (overall score 3.3666), bevacizumab (3.3043), panitumumab (3.2030), aflibercept (2.8923) and regorafenib (2.8366).

Conclusions

A comprehensive value assessment system combining “multi-dimensional criteria,” “multi-perspectives,” and an “integrative assessment” is necessary to evaluate the value of medicines. The results showed not only the order of weights of different dimensions or criteria, but also the rankings of the value of the targeted therapies.

Klíčová slova:

Cancer treatment – Colorectal cancer – Cost-effectiveness analysis – Drug policy – Drug research and development – Drug therapy – Economics – Health insurance


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2019 Číslo 12