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应用多标准决策分析(MCDA)方法来获取意大利利益相关者的偏好:以奥妥珠单抗治疗利妥昔单抗难治性惰性非霍奇金淋巴瘤(iNHL)为例。

Applying a Multicriteria Decision Analysis (MCDA) Approach to Elicit Stakeholders' Preferences in Italy: The Case of Obinutuzumab for Rituximab-Refractory Indolent Non-Hodgkin Lymphoma (iNHL).

作者信息

Garau Martina, Hampson Grace, Devlin Nancy, Mazzanti Nicola Amedeo, Profico Antonio

机构信息

Office of Health Economics, London, UK.

Roche S.P.A, Milan, Italy.

出版信息

Pharmacoecon Open. 2018 Jun;2(2):153-163. doi: 10.1007/s41669-017-0048-x.

Abstract

BACKGROUND

Healthcare decision makers need to make trade-offs between different elements of value of new treatments. Multicriteria decision analysis (MCDA) provides a framework that can help decision makers to understand stakeholders' preferences and be explicit about the trade-offs that are being made.

OBJECTIVE

The objective of this study was to use MCDA to obtain preferences and views on decision criteria across three stakeholder groups (patients, clinicians and payers) in Italy and to use these to assess the performance of obinutuzumab for rituximab-refractory indolent non-Hodgkin lymphoma (iNHL).

METHODS

We used EVIDEM V3.0, an MCDA framework, and collected participants' preferences via an online survey and structured meetings.

RESULTS

Patients and clinicians expressed a preference for interventions targeting severe conditions. Payers expressed preference for treatments targeting areas with an unmet need, which are cheaper than the comparator, and with high-quality evidence. Obinutuzumab in combination with bendamustine, compared with bendamustine alone, received high positive scores for the criteria 'disease severity' and 'type of therapeutic benefit' by all three groups, and negative scores on the economic-related criteria, according to all stakeholder groups.

CONCLUSIONS

MCDA can be used to elicit the views of different stakeholder groups and has the potential to structure and inform reimbursement decisions.

摘要

背景

医疗保健决策者需要在新治疗方法的不同价值要素之间进行权衡。多标准决策分析(MCDA)提供了一个框架,可帮助决策者了解利益相关者的偏好,并明确所做的权衡。

目的

本研究的目的是使用MCDA来获取意大利三个利益相关者群体(患者、临床医生和支付方)对决策标准的偏好和观点,并利用这些来评估奥妥珠单抗治疗利妥昔单抗难治性惰性非霍奇金淋巴瘤(iNHL)的性能。

方法

我们使用MCDA框架EVIDEM V3.0,并通过在线调查和结构化会议收集参与者的偏好。

结果

患者和临床医生表示倾向于针对严重病症的干预措施。支付方倾向于针对未满足需求领域、比对照治疗更便宜且有高质量证据的治疗方法。与单独使用苯达莫司汀相比,奥妥珠单抗联合苯达莫司汀在“疾病严重程度”和“治疗益处类型”标准上获得了所有三个群体的高度正面评分,而根据所有利益相关者群体的评估,在经济相关标准上获得了负面评分。

结论

MCDA可用于引出不同利益相关者群体的观点,并有可能构建和为报销决策提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e14/5972119/401dc4eea049/41669_2017_48_Fig1_HTML.jpg

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