Multi-Criteria decision analysis in healthcare its usefulness and limitations for decision making

Zozaya, Néboa; Oliva‐Moreno, Juan; Hidalgo, Álvaro; Ruiz, Antonio García; Soler, Nuria García‐Agua; Puig‐Junoy, Jaume; Balbino, Jaime Espín; Saborido, C Martin; Trapero‐Bertran, Marta; Medina, Javier Mar; Campillo-Artero, Carlos; Llach, Xavier Badía; Gilabert-Perramon, A; Revilla, Bleric Alcalá

doi:10.37666/l5-2018

Cited by 4 publications

(4 citation statements)

References 108 publications

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“…The literature about MCDA methodology suggests that it is increasingly being used in the context of appraising orphan drugs ( 9 , 33 ). It has been field-tested and implemented in various real-world settings, including Spain, where the HTA body in Catalonia has explored its suitability to appraise orphan drugs ( 12 , 34 ).…”

Section: Discussionmentioning

confidence: 99%

A multicriteria decision analysis (MCDA) applied to three long-term prophylactic treatments for hereditary angioedema in Spain

Zozaya

Caballero

González-Quevedo

et al. 2022

Grhta

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Introduction: Hereditary angioedema (HAE) is a rare genetic disease that impairs quality of life and could be life-threatening. The aim of this study was to apply a multicriteria decision analysis to assess the value of three long-term prophylactic (LTP) therapies for HAE in Spain. Methods: A multidisciplinary committee of 10 experts assessed the value of lanadelumab (subcutaneous use), C1-inhibitor (C1-INH; intravenous), and danazol (orally), using placebo as comparator. We followed the EVIDEM methodology that considers a set of 13 quantitative criteria. The overall estimated value of each intervention was obtained combining the weighting of each criterion with the scoring of each intervention in each criterion. We used two alternative weighting methods: hierarchical point allocation (HPA) and direct rating scale (DRS). A reevaluation of weightings and scores was performed. Results: Lanadelumab obtained higher mean scores than C1-INH and danazol in all criteria, except for the cost of the intervention and clinical practice guidelines. Under the HPA method, the estimated values were 0.51 (95% confidence interval [CI]: 0.44-0.58) for lanadelumab, 0.47 (95%CI: 0.41-0.53) for C1-INH, and 0.31 (95%CI: 0.24-0.39) for danazol. Similar results were obtained with the DRS method: 0.51 (95%CI: 0.42-0.60), 0.47 (95%CI: 0.40-0.54), and 0.27 (95%CI: 0.18-0.37), respectively. The comparative cost of the intervention was the only criterion that contributed negatively to the values of lanadelumab and C1-INH. For danazol, four criteria contributed negatively, mainly comparative safety. Conclusion: Lanadelumab was assessed as a high-value intervention, better than C1-INH and substantially better than danazol for LTP treatment of HAE.

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Section: Discussionmentioning

confidence: 99%

A multicriteria decision analysis (MCDA) applied to three long-term prophylactic treatments for hereditary angioedema in Spain

Zozaya

Caballero

González-Quevedo

et al. 2022

Grhta

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“…For this example we assume that each treatment has log(cost) and two effectiveness outcomes following the model specified in ( 5) and (6). Under this parametric model we may proceed with a CEA of the new treatment, using the INB and incremental-cost-effectiveness ratio (ICER) metrics.…”

Section: Conflict Of Interest Statementmentioning

confidence: 99%

“…For more details, we refer to the encyclopedia entry 5 and the edited volumes. 3,6 We refer to Appendix A.3 for an illustration of the MCDA framework presented.…”

Section: Introduction 11 Backgroundmentioning

confidence: 99%

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Cost‐effectiveness analysis under multiple effectiveness outcomes: A probabilistic approach

Arsham

Bebu

Mathew

2023

Statistics in Medicine

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Probability based criteria are proposed for the assessment of cost‐effectiveness of a new treatment compared to a standard treatment when there are multiple effectiveness measures. Depending on the preferences of a policy maker, there are several options to define such criteria. Two such metrics are investigated in detail. One metric is defined as the conditional probability that a new treatment is more effective with respect to the multiple effectiveness measures for patients having lower costs under the new treatment. A second metric is defined as the conditional probability that a new treatment is less costly for patients having greater health benefits under the new treatment. The metrics offer considerable flexibility to a policy maker as thresholds for cost and effectiveness can be incorporated into the metrics. Parametric confidence limits are developed using a percentile bootstrap approach assuming multivariate normality for the joint distribution of the log(cost) and effectiveness measures. A non‐parametric estimation procedure is also developed using the theory of U‐statistics. Numerical results indicate that the proposed confidence limits accurately maintain coverage probabilities. The methodologies are illustrated using a study on the treatment of type two diabetes. Code implementing the proposed methods are provided in the supporting information.

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Multi-criteria decision-making methods applied in health-insurance underwriting

Mourmouris

Poufinas

2022

Health Systems

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Multi-Criteria decision analysis in healthcare its usefulness and limitations for decision making

Cited by 4 publications

References 108 publications

A multicriteria decision analysis (MCDA) applied to three long-term prophylactic treatments for hereditary angioedema in Spain

A multicriteria decision analysis (MCDA) applied to three long-term prophylactic treatments for hereditary angioedema in Spain

Cost‐effectiveness analysis under multiple effectiveness outcomes: A probabilistic approach

Multi-criteria decision-making methods applied in health-insurance underwriting

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