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Patient involvement in reflective multicriteria decision analysis to assist decision making in oncology

Published online by Cambridge University Press:  07 February 2019

Xavier Badia ,
Alfonso Aguarón ,
Ana Fernández ,
Antonia Gimón ,
Begoña Nafria ,
Bernard Gaspar ,
Laura Guarga ,
María Gálvez ,
Marta Fuentes  and
Noelia Paco
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Xavier Badia*
Affiliation:
Omakase Consulting S.L.
Alfonso Aguarón
Affiliation:
Myeloma Patients Europe
Ana Fernández
Affiliation:
Spanish Association Against Cancer
Antonia Gimón
Affiliation:
Spanish Breast Cancer Federation
Begoña Nafria
Affiliation:
Patient Advocacy Manager in Research at Institut de Recerca Sant Joan de Déu Innovation and Research Department- Hospital Sant Joan de Déu
Bernard Gaspar
Affiliation:
Spanish Affected Lung Cancer Association
Laura Guarga
Affiliation:
Omakase Consulting S.L.
María Gálvez
Affiliation:
Patient Association Platform
Marta Fuentes
Affiliation:
Spanish Melanoma
Noelia Paco
Affiliation:
Omakase Consulting S.L.
Roberto Saldaña
Affiliation:
ACCU Confederation
*
Author for correspondence: Xavier Badia, E-mail: xbadia@omakaseconsulting.com
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Abstract

Objectives

Patient involvement in drug evaluation decision making is increasing. The aim of the current study was to develop a multi-criteria decision analysis (MCDA) framework that would enable the inclusion of the patient perspective in the selection of appropriate criteria for MCDAs being used in the value assessments of oncologic drugs.

Methods

A literature review was conducted to identify and define criteria used in drug assessments from patient perspectives. The Evidence and Value: Impact on Decision Making methodology was used to develop a MCDA framework. Identified criteria were discussed by a sample of oncology patient association representatives who decided which criteria were important from patient perspectives. Selected criteria were rated by importance. The preliminary MCDA framework was tested through the assessment of a hypothetical oncology treatment. A discussion was carried out to agree on a final pilot MCDA framework.

Results

Twenty-two criteria were extracted from the literature review. After criteria discussion, sixteen criteria remained. The most important criteria were comparative patient reported outcomes (PRO), comparative efficacy and disease severity. After the discussion generated by the scoring of the hypothetical oncology treatment, the final pilot MCDA framework included seven quantitative criteria (“disease severity”, “unmet needs”, “comparative efficacy / effectiveness”, “comparative safety / tolerability”, “comparative PROs”, “contribution of oncological innovation”) and one contextual criterion (“population priorities and access”).

Conclusions

The present study developed a pilot reflective MCDA framework that could increase patient's capability to participate in the decision-making process by providing systematic drug assessments from the patient perspective.

Keywords

Patient empowermentMCDADrug assessment
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 1 , 2019 , pp. 56 - 63
Copyright
Copyright © Cambridge University Press 2019 

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