Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: the Advance Value Framework

Angelis, Aris ORCID: 0000-0002-0261-4634 and Kanavos, Panos ORCID: 0000-0001-9518-3089 (2017) Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: the Advance Value Framework. Social Science & Medicine, 188. pp. 137-156. ISSN 0277-9536

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Abstract

Escalating drug prices have catalysed the generation of numerous “value frameworks” with the aim of informing payers, clinicians and patients on the assessment process of new medicines for the purpose of coverage and treatment selection decisions. Although this is an important step towards a more inclusive Value Based Assessment (VBA) approach, aspects of these frameworks are based on weak methodologies and could potentially result in misleading recommendations or decisions. A Multiple Criteria Decision Analysis (MCDA) methodological process based on Multi Attribute Value Theory (MAVT) is adopted for building a multi-criteria evaluation model. A five-stage model-building process is followed, using a top-down “value-focused thinking” approach, involving literature reviews and expert consultations. A generic value tree is structured capturing decision-makers’ concerns for assessing the value of new medicines in the context of Health Technology Assessment (HTA) and in alignment with decision theory. The resulting value tree (Advance Value Tree) spans three levels of criteria (top level criteria clusters, mid-level criteria, bottom level sub-criteria or attributes) relating to five key domains that can be explicitly measured and assessed: (a) burden of disease, (b) therapeutic impact, (c) safety profile (d) innovation level, and (e) socioeconomic impact. A number of MAVT modelling techniques are introduced for operationalising (i.e. estimating) the model, for scoring the alternative options, assigning relative weights of importance to the criteria, and combining scores and weights. Overall, the combination of these MCDA modelling techniques for the elicitation and construction of value preferences across the generic value tree provides 3 a new value framework (Advance Value Framework) enabling the comprehensive measurement of value in a transparent and structured way. Given the flexibility to meet diverse requirements and become readily adaptable across different settings, it could be tested as a decision-support tool for decision-makers to aid coverage and reimbursement of new medicines.

Item Type:	Article
Official URL:	https://www.journals.elsevier.com/social-science-a...
Additional Information:	© 2017 The Authors © CC BY-NC-ND 4.0
Divisions:	LSE Health
Subjects:	J Political Science > JN Political institutions (Europe) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RS Pharmacy and materia medica
Date Deposited:	23 Jun 2017 11:25
Last Modified:	15 Nov 2024 00:11
Projects:	305983
Funders:	Seventh Framework Programme
URI:	http://eprints.lse.ac.uk/id/eprint/82131

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