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Early Health Technology Assessment during Nonalcoholic Steatohepatitis Drug Development: A Two-Round, Cross-Country, Multicriteria Decision Analysis

Author

Listed:
  • Aris Angelis

    (Department of Health Policy and LSE Health, London School of Economics and Political Science, London, UK)

  • Mark Thursz

    (Imperial College Healthcare NHS Trust and Imperial College London, London, UK)

  • Vlad Ratziu

    (Université Pierre et Marie Curie and the Hôpital Pitié Salpêtrière Medical School, Paris, France)

  • Alastair O’Brien

    (Royal Free London NHS Foundation Trust and University College London, London, UK)

  • Lawrence Serfaty

    (Hautepierre Hospital, University of Strasbourg, Strasbourg, France)

  • Ali Canbay

    (Department of Gastroenterology, Hepatology and Infectious Diseases, University Magdeburg, Magdeburg, Germany)

  • Ingolf Schiefke

    (Department of Internal Medicine, Ruhr-University Bochum, Bochum, Germany)

  • Joao Bana e Costa

    (Decision Eyes, Lisbon, Portugal)

  • Pascal Lecomte

    (Novartis Pharma AG, Basel, Switzerland)

  • Panos Kanavos

    (Department of Health Policy and LSE Health, London School of Economics and Political Science, London, UK)

Abstract

Background. The assessment of value along the clinical development of new biopharmaceutical compounds is a challenging task. Complex and uncertain evidence has to be analyzed, considering a multitude of value preferences from different stakeholders. Objective. To investigate the use of multicriteria decision analysis (MCDA) to support decision making during drug development while considering payer and health technology assessment (HTA) value concerns, by applying the Advance Value Framework in nonalcoholic steatohepatitis (NASH) and testing for the consistency of the results. Design. A multiattribute value theory methodology was applied and 2 rounds of decision conferences (DCs) were organized in 3 countries (England, France, and Germany), with the participation of national key experts and stakeholders using the MACBETH questioning protocol and algorithm. A total of 51 health care professionals, patient advocates, and methodologists, including (ex-) committee members or assessors from national HTA bodies, participated in 6 DCs in the study countries. Target Population. NASH patients in fibrosis stages F2 to 3 were considered. Interventions. The value of a hypothetical product profile was assessed against 3 compounds under development using their phase 2 results. Outcome Measures. DC participants’ value preferences were elicited involving criteria selection, options scoring, and criteria weighting. Results. Highly consistent valuation rankings were observed in all DCs, always favoring the same compound. Highly consistent rankings of criteria clusters were observed, favoring therapeutic benefit criteria, followed by safety profile and innovation level criteria. Limitations. There was a lack of comparative treatment effects, early evidence on surrogate endpoints was used, and stakeholder representativeness was limited in some DCs. Conclusions. The use of MCDA is promising in supporting early HTA, illustrating high consistency in results across countries and between study rounds.

Suggested Citation

  • Aris Angelis & Mark Thursz & Vlad Ratziu & Alastair O’Brien & Lawrence Serfaty & Ali Canbay & Ingolf Schiefke & Joao Bana e Costa & Pascal Lecomte & Panos Kanavos, 2020. "Early Health Technology Assessment during Nonalcoholic Steatohepatitis Drug Development: A Two-Round, Cross-Country, Multicriteria Decision Analysis," Medical Decision Making, , vol. 40(6), pages 830-845, August.
    • Handle: RePEc:sae:medema:v:40:y:2020:i:6:p:830-845
    DOI: 10.1177/0272989X20940672
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    References listed on IDEAS

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    1. Mónica D. Oliveira & Inês Mataloto & Panos Kanavos, 2019. "Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 891-918, August.
    2. Keeney,Ralph L. & Raiffa,Howard, 1993. "Decisions with Multiple Objectives," Cambridge Books, Cambridge University Press, number 9780521438834.
    3. Angelis, Aris & Kanavos, Panos, 2017. "Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework," Social Science & Medicine, Elsevier, vol. 188(C), pages 137-156.
    4. Bana e Costa, Carlos A. & Corrêa, Émerson C. & De Corte, Jean-Marie & Vansnick, Jean-Claude, 2002. "Facilitating bid evaluation in public call for tenders: a socio-technical approach," Omega, Elsevier, vol. 30(3), pages 227-242, June.
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    6. Angelis, A. & Linch, M. & Montibeller, G. & Molina-Lopez, T. & Zawada, A. & Orzel, K. & Arickx, F. & Espin, J. & Kanavos, P., 2020. "Multiple Criteria Decision Analysis for HTA across four EU Member States: Piloting the Advance Value Framework," Social Science & Medicine, Elsevier, vol. 246(C).
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