Multiple criteria decision analysis in the context of health technology assessment: A simulation exercise on metastatic colorectal cancer with multiple stakeholders in the English setting

© 2017 The Author(s). Background: Multiple criteria decision analysis (MCDA) has appeared as a methodology to address limitations of economic evaluation in health technology assessment (HTA), however there are limited empirical evidence from real world applications. The aim of this study is to test...

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Main Authors: Aris Angelis, Gilberto Montibeller, Daniel Hochhauser, Panos Kanavos
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Published: 2017
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Online Access:https://hdl.handle.net/2134/27701
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spelling rr-article-95022652017-01-01T00:00:00Z Multiple criteria decision analysis in the context of health technology assessment: A simulation exercise on metastatic colorectal cancer with multiple stakeholders in the English setting Aris Angelis (5751797) Gilberto Montibeller (1257105) Daniel Hochhauser (1920799) Panos Kanavos (832408) Other commerce, management, tourism and services not elsewhere classified Information systems not elsewhere classified Multiple criteria decision analysis (MCDA) Health technology assessment (HTA) Advance Value Framework (AVF) Metastatic colorectal cancer (mCRC) England National Institute for Health and Care Excellence (NICE) Value assessment New medicines Information Systems Business and Management not elsewhere classified © 2017 The Author(s). Background: Multiple criteria decision analysis (MCDA) has appeared as a methodology to address limitations of economic evaluation in health technology assessment (HTA), however there are limited empirical evidence from real world applications. The aim of this study is to test in practice a recently developed MCDA methodological framework known as Advance Value Framework (AVF) through a proof-of-concept case study engaging multiple stakeholders. Methods: A multi-attribute value theory methodological process was adopted involving problem structuring, model building, model assessment and model appraisal phases. A facilitated decision analysis modelling approach was used as part of a decision conference with thirteen participants. An expanded scope of the National Institute for Health and Care Excellence (NICE) remit acted as the study setting with the use of supplementary value concerns. Second-line biological treatments were evaluated for metastatic colorectal cancer (mCRC) patients having received prior chemotherapy, including cetuximab monotherapy, panitumumab monotherapy and aflibercept in combination with FOLFIRI chemotherapy. Initially 18 criteria attributes were considered spanning four value domains relating to therapeutic impact, safety profile, innovation level and socioeconomic impact. Results: Nine criteria attributes were finally included. Cetuximab scored the highest overall weighted preference value score of 45.7 out of 100, followed by panitumumab with 42.3, and aflibercept plus FOLFIRI with 14.4. The relative weights of the two most important criteria (overall survival and Grade 4 adverse events) added up to more than the relative weight of all other criteria together (52.1%). Main methodological limitation was the lack of comparative clinical effects across treatments and challenges included the selection of "lower" and "higher" reference levels on criteria attributes, eliciting preferences across attributes where participants had less experience, and ensuring that all attributes possess the right decision theory properties. Conclusions: This first application of AVF produced transparent rankings for three mCRC treatments based on their value, by assessing an explicit set of evaluation criteria while allowing for the elicitation and construction of participants' value preferences and their trade-offs. It proved it can aid the evaluation process and value communication of the alternative treatments for the group participants. Further research is needed to optimise its use as part of policy-making. 2017-01-01T00:00:00Z Text Journal contribution 2134/27701 https://figshare.com/articles/journal_contribution/Multiple_criteria_decision_analysis_in_the_context_of_health_technology_assessment_A_simulation_exercise_on_metastatic_colorectal_cancer_with_multiple_stakeholders_in_the_English_setting/9502265 CC BY 4.0
institution Loughborough University
collection Figshare
topic Other commerce, management, tourism and services not elsewhere classified
Information systems not elsewhere classified
Multiple criteria decision analysis (MCDA)
Health technology assessment (HTA)
Advance Value Framework (AVF)
Metastatic colorectal cancer (mCRC)
England
National Institute for Health and Care Excellence (NICE)
Value assessment
New medicines
Information Systems
Business and Management not elsewhere classified
spellingShingle Other commerce, management, tourism and services not elsewhere classified
Information systems not elsewhere classified
Multiple criteria decision analysis (MCDA)
Health technology assessment (HTA)
Advance Value Framework (AVF)
Metastatic colorectal cancer (mCRC)
England
National Institute for Health and Care Excellence (NICE)
Value assessment
New medicines
Information Systems
Business and Management not elsewhere classified
Aris Angelis
Gilberto Montibeller
Daniel Hochhauser
Panos Kanavos
Multiple criteria decision analysis in the context of health technology assessment: A simulation exercise on metastatic colorectal cancer with multiple stakeholders in the English setting
description © 2017 The Author(s). Background: Multiple criteria decision analysis (MCDA) has appeared as a methodology to address limitations of economic evaluation in health technology assessment (HTA), however there are limited empirical evidence from real world applications. The aim of this study is to test in practice a recently developed MCDA methodological framework known as Advance Value Framework (AVF) through a proof-of-concept case study engaging multiple stakeholders. Methods: A multi-attribute value theory methodological process was adopted involving problem structuring, model building, model assessment and model appraisal phases. A facilitated decision analysis modelling approach was used as part of a decision conference with thirteen participants. An expanded scope of the National Institute for Health and Care Excellence (NICE) remit acted as the study setting with the use of supplementary value concerns. Second-line biological treatments were evaluated for metastatic colorectal cancer (mCRC) patients having received prior chemotherapy, including cetuximab monotherapy, panitumumab monotherapy and aflibercept in combination with FOLFIRI chemotherapy. Initially 18 criteria attributes were considered spanning four value domains relating to therapeutic impact, safety profile, innovation level and socioeconomic impact. Results: Nine criteria attributes were finally included. Cetuximab scored the highest overall weighted preference value score of 45.7 out of 100, followed by panitumumab with 42.3, and aflibercept plus FOLFIRI with 14.4. The relative weights of the two most important criteria (overall survival and Grade 4 adverse events) added up to more than the relative weight of all other criteria together (52.1%). Main methodological limitation was the lack of comparative clinical effects across treatments and challenges included the selection of "lower" and "higher" reference levels on criteria attributes, eliciting preferences across attributes where participants had less experience, and ensuring that all attributes possess the right decision theory properties. Conclusions: This first application of AVF produced transparent rankings for three mCRC treatments based on their value, by assessing an explicit set of evaluation criteria while allowing for the elicitation and construction of participants' value preferences and their trade-offs. It proved it can aid the evaluation process and value communication of the alternative treatments for the group participants. Further research is needed to optimise its use as part of policy-making.
format Default
Article
author Aris Angelis
Gilberto Montibeller
Daniel Hochhauser
Panos Kanavos
author_facet Aris Angelis
Gilberto Montibeller
Daniel Hochhauser
Panos Kanavos
author_sort Aris Angelis (5751797)
title Multiple criteria decision analysis in the context of health technology assessment: A simulation exercise on metastatic colorectal cancer with multiple stakeholders in the English setting
title_short Multiple criteria decision analysis in the context of health technology assessment: A simulation exercise on metastatic colorectal cancer with multiple stakeholders in the English setting
title_full Multiple criteria decision analysis in the context of health technology assessment: A simulation exercise on metastatic colorectal cancer with multiple stakeholders in the English setting
title_fullStr Multiple criteria decision analysis in the context of health technology assessment: A simulation exercise on metastatic colorectal cancer with multiple stakeholders in the English setting
title_full_unstemmed Multiple criteria decision analysis in the context of health technology assessment: A simulation exercise on metastatic colorectal cancer with multiple stakeholders in the English setting
title_sort multiple criteria decision analysis in the context of health technology assessment: a simulation exercise on metastatic colorectal cancer with multiple stakeholders in the english setting
publishDate 2017
url https://hdl.handle.net/2134/27701
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