Abstract
ObjectiveThis study is aimed toward establishing a decision-making model with multiple criteria for appraisal and reimbursement to compare the attitudes of different stakeholders toward various dimensions and criteria and to evaluate the five targeted therapies (bevacizumab, cetuximab, panitumumab, aflibercept, and regorafenib) for metastatic colorectal cancer.MethodThis study is a multi-criteria decision analysis (MCDA) using a model that includes three dimensions and nine criteria. Both the overall and individual scores of the respective targeted therapies in different dimensions and criteria were calculated. A sensitivity analysis was carried out in order to evaluate the robustness of the research results. An interview-based questionnaire survey was applied to obtain the performance information for the targeted therapies and the weights of the dimensions and criteria.ResultsOverall, the clinical dimension had the highest weight, followed by the economic dimension, and finally, the social dimension. In the clinical dimension, the “comparative efficacy” criterion had the highest weight; in the economic dimension, the “cost-effectiveness” criterion” was given the greatest importance; in the social dimension, the “social concern and patient needs” criterion was given more emphasis. The overall values ranked from high to low as follows: cetuximab (overall score 3.3666), bevacizumab (3.3043), panitumumab (3.2030), aflibercept (2.8923) and regorafenib (2.8366).ConclusionsA comprehensive value assessment system combining “multi-dimensional criteria,” “multi-perspectives,” and an “integrative assessment” is necessary to evaluate the value of medicines. The results showed not only the order of weights of different dimensions or criteria, but also the rankings of the value of the targeted therapies.
Highlights
A value assessment of medicines can serve as a basis for national health insurance (NHI) payments, hospital drug procurement, clinical treatment selection, drug research, and development on the part of pharmaceutical companies
A comprehensive value assessment system combining “multi-dimensional criteria,” “multiperspectives,” and an “integrative assessment” is necessary to evaluate the value of medicines
The results showed the order of weights of different dimensions or criteria, and the rankings of the value of the targeted therapies
Summary
A value assessment of medicines can serve as a basis for national health insurance (NHI) payments, hospital drug procurement, clinical treatment selection, drug research, and development on the part of pharmaceutical companies. Drugs with the highest level of demand and most cost-effectiveness should be chosen among many drug options.[3,4,5] During clinical diagnosis and treatment, a value assessment process jointly decided by the doctor and the patient should be adopted to help select the most suitable drugs.[1, 6] drug efficacy, quality, and cost value assessments should be conducted during the new drug development process in order to assist pharmaceutical companies with determining the most suitable research targets and methods and assist with the adoption of corresponding R&D strategies.[7]
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