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MULTI-CRITERIA DECISION ANALYSIS AS A DECISION-SUPPORT TOOL FOR DRUG EVALUATION: A PILOT STUDY IN A PHARMACY AND THERAPEUTICS COMMITTEE SETTING

Published online by Cambridge University Press:  23 October 2018

Úrsula Baños Roldán ,
Xavier Badia ,
Jose Antonio Marcos-Rodríguez ,
Luis de la Cruz-Merino ,
Jaime Gómez-González ,
Ana Melcón-de Dios ,
María de la O Caraballo-Camacho ,
Jaime Cordero-Ramos ,
María Dolores Alvarado-Fernández  and
José Manuel Galiana-Auchel
...Show all authors
Úrsula Baños Roldán
Affiliation:
Department of Pharmacy, Hospital Universitario Virgen [email protected]
Xavier Badia
Affiliation:
Omakase Consulting S. L
Jose Antonio Marcos-Rodríguez
Affiliation:
Department of Pharmacy, Hospital Universitario Virgen Macarena
Luis de la Cruz-Merino
Affiliation:
Department of Medical Oncology, Hospital Universitario Virgen Macarena
Jaime Gómez-González
Affiliation:
Department of Mental Health, Hospital Universitario Virgen Macarena
Ana Melcón-de Dios
Affiliation:
Department of Clinical Pharmacology, Hospital Universitario Virgen Macarena
María de la O Caraballo-Camacho
Affiliation:
Department of Pharmacy, Sevilla Primary Health Care Area
Jaime Cordero-Ramos
Affiliation:
Department of Pharmacy, Hospital Universitario Virgen Macarena
María Dolores Alvarado-Fernández
Affiliation:
Department of Pharmacy, Hospital Universitario Virgen Macarena
José Manuel Galiana-Auchel
Affiliation:
Medical Director, Hospital Universitario Virgen Macarena
Miguel Ángel Calleja-Hernández
Affiliation:
Department of Pharmacy, Hospital Universitario Virgen Macarena
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Abstract

Objectives:

The aim of this study was to develop and to assess a specific Multi-Criteria Decision Analysis (MCDA) framework to evaluate new drugs in an hospital pharmacy and therapeutics committee (P&TC) setting.

Methods:

A pilot criteria framework was developed based on the EVIDEM (Evidence and Value: Impact on DEcisionMaking) framework, together with other relevant criteria, and assessed by a group of P&TC's members. The weighting of included criteria was done using a 5-point weighting technique. Two drugs were chosen by evaluation: an orphan-drug for Gaucher disease, and a nonorphan drug for the treatment of inflammatory bowel disease. Evidence matrices were developed, and value contribution of each drug was evaluated by P&TC's members. An agreed final framework was obtained through a discussion between the P&TC's members.

Results:

After criteria assessment, the pilot framework included eight quantitative criteria: “disease severity,” “unmet needs,” “comparative efficacy/effectiveness,” “comparative safety/tolerability,” “comparative patient-reported outcomes,” “comparative cost consequences-cost of treatment,” “comparative cost consequences-other medical costs,” and “quality of evidence”; and one contextual criterion: “opportunity costs and affordability.” The most valued criteria were: “comparative safety/tolerability,” “disease severity,” and “comparative efficacy/effectiveness.” When assessing the drugs most valued characteristics of the MCDA were the possibility that all team may contribute to drug assessment by means of scoring the matrices and the discussion to reach a consensus in drug positioning and value decision making.

Conclusions:

The reflective MCDA would integrate quantitative and qualitative criteria relevant for a P&TC setting, allowing reflective discussions based on the criteria weighting score.

Keywords

Drug decision makingDrug evaluationHospital pharmacyMulti-criteria decision analysis
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 5 , 2018 , pp. 519 - 526
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

*

Multidisciplinary Commission Rational Use of Medicine (CMURM) members, Hospital Universitario Virgen Macarena, Sevilla, Spain.

We thank the anonymous referees that helped us with their comments to improve the study

References

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