Abstract
The use of multi-criteria decision analysis (MCDA) in the economic evaluation of drugs has been widely discussed. Thus, this study aims to propose a way to enhance the cost-effectiveness analysis (CEA) of health interventions using the PROMETHEE II multi-criteria method. In order to accomplish this, PROMETHEE II was applied to the same data used in the CEA of lipegfilgrastim in the Brazilian healthcare system for the reduction of chemotherapy-induced neutropenia. In this application, lipegfilgrastim and its comparators formed a set of alternatives. The cost parameters used to compute the total costs of the treatments along with the effectiveness outcomes formed a set of criteria, showing that a conventional CEA is in an MCDA setting. The CEA demonstrated lipegfilgrastim as a cost-saving strategy over its comparators. PROMETHEE II generated the following outcomes to contribute to the CEA: (1) a ranking of studied interventions; (2) a classification level for each intervention from A (best level) to E (worst level); (3) a positioning scenario showing the dominance relation and distance among the interventions; and (4) a criteria panel classifying each criterion as strong or weak point for each intervention when compared to the others. The MCDA approach presented in this study does not exclude the use of CEA but complements it to support the decision-making process.
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