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
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