Development of a Multicriteria Decision Analysis Framework for Evaluating and Positioning Oncologic Treatments in Clinical Practice


Por: Camps, C, Badia, X, Garcia-Campelo, R, Garcia-Foncillas, J, Lopez, R, Massuti, B, Provencio, M, Salazar, R, Virizuela, J and Guillem, V

Publicada: 1 mar 2020
Resumen:
PURPOSE Several frameworks have been developed to define and quantify the value of oncologic therapies and to support decision making; however, they define treatment value mainly in terms of clinical benefit. As part of its mission to improve oncologic care, the ECO Foundation (Excellence and Quality in Oncology) directed this pilot study aimed at developing a reflective multicriteria decision analysis (MCDA)-based framework for evaluating and positioning oncologic drugs in the clinical setting. METHODS The framework was developed following Evidence and Value: Impact on Decision-Making methodology, and literature was reviewed to identify relevant criteria. The selected criteria were then presented to a group of experts composed of 9 clinical oncologists who assessed each criterion for inclusion in the framework and suggested modifications in their definition and/or response scale. The framework was tested in 2 case studies (abemaciclib for advanced or metastatic hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer and TAS-102 for metastatic colorectal cancer) to validate the proposed framework; this was followed by a discussion of the results. RESULTS Eight of the 15 criteria presented to the experts were included in the framework: disease severity, unmet needs, comparative efficacy, comparative safety/tolerability, treatment intent, comparative treatment cost, comparative other medical costs, and quality of evidence. Framework validation in 2 drug cases resulted in similar value scores, although they were based on different contributing criteria and resulted in different clinical recommendations. CONCLUSION We developed and validated a reflective MCDA framework for the assessment and positioning of oncologic therapies in Spain. Additional work is needed to create a manual for practical decision making in the clinical setting. (c) 2020 by American Society of Clinical Oncology

Filiaciones:
Camps, C:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Hosp Gen Valencia, Serv Oncol Med, Valencia, Spain

 Univ Valencia, Valencia, Spain

 Ctr Invest Biomed Red Canc, Madrid, Spain

Badia, X:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Omakase Consulting SL, Barcelona, Spain

Garcia-Campelo, R:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Complejo Hosp Univ A Coruna, Serv Oncol Med, La Coruna, Spain

Garcia-Foncillas, J:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Hosp Univ Fdn Jimenez Diaz, Serv Oncol Med, Madrid, Spain

Lopez, R:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Ctr Invest Biomed Red Canc, Madrid, Spain

 Hosp Clin Univ Santiago de Compostela, Serv Oncol Med, Santiago De Compostela, Spain

:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Hosp Gen Univ Alicante, Serv Oncol Med, Alicante, Spain

Provencio, M:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Hosp Puerta Hierro, Serv Oncol Med, Madrid, Spain

Salazar, R:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Inst Catala Oncol, Serv Oncol Med, Barcelona, Spain

Virizuela, J:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Hosp Univ Virgen Macarena, Serv Oncol Med, Seville, Spain

Guillem, V:
 Fdn ECO Excelencia & Calidad Oncol, Madrid, Spain

 Inst Valenciano Oncol, Serv Oncol Med, Valencia, Spain
ISSN: 26881527





Jco Oncology Practice
Editorial
AMER SOC CLINICAL ONCOLOGY, 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA, Estados Unidos America
Tipo de documento: Article
Volumen: 16 Número: 3
Páginas: 133
WOS Id: 000533647400009
ID de PubMed: 32160482
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