Author(s)
Aiello A1, Amoroso C2, Berto P1, Canonica GW3, Cattani L4, Cicchetti A5, Coratella G6, Di Marco F7, Fedriga AL1, Lombardo FP8, Maffezzoli S9, Manna G10, Ruggeri I11, Saleri C9, Samaha D12, Trifirò G13, Ubertazzo L14
1Certara, Milano, MI, Italy, 2Associazione Regionale Economi Abruzzo e Molise, Chieti, Italy, 3Humanitas University, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy, 4Associazione Federasma e Allergie Onlus, Roma, Italy, 5Università Cattolica del Sacro Cuore, Rome, Italy, 6Distretto n.1 Andria, BT, Andria, Italy, 7Università degli Studi di Milano, Milano, Italy, 8SIMG Area Pneumologica, Palermo, Italy, 9AstraZeneca, Milano, Italy, 10AstraZeneca, Basiglio, MI, Italy, 11UOC Vigilanza Farmaceutica, ATS Milano Città Metropolitana, Milano, Italy, 12Certara Evidence & Access, London, UK, 13A.O.U. Policlinico “G. Martino”, Messina, Italy, 14U.O.C. Farmacia Territoriale Asl Roma 4, Roma, Italy
OBJECTIVES : Multicriteria Decision Analysis (MCDA) is an analytical quantitative instrument focused on supporting the decision-making process between alternative technologies based on multiple criteria, to facilitate a conscious decision on resource allocation. Aim of this study was to apply an MCDA framework for the value assessment of budesonide-formoterol maintenance and reliever therapy in asthma and explore the utility of this analysis for a drug advisory committee. METHODS : The evaluation was conducted by mapping the available evidence in an MCDA decision tree including criteria from the EVIDEM and ADVANCE frameworks. This comprehensive framework allowed the inclusion of a number of criteria representing the different components of a decision-making process. Based on an extensive literature review, evidence was outlined for each criterion of the framework into a structured health technology assessment (HTA) report on budesonide-formoterol maintenance and reliever therapy in asthma. Evidence was presented to the members of a multidisciplinary committee (n=10) to explore the value of this therapeutic approach in the Italian context, by weighting the relative importance of each criteria. For each criterion, participants were prompted to assign a score on the strength/quality of the supporting data. Scores ranged 0 (lowest) to 5 (highest) strength for non-comparative criteria and -5 (favours comparator) to +5 (favours technology), for comparative criteria. RESULTS : The highest mean scores were attributed to (mean;SD): quality of evidence of budesonide-formoterol (4.44;0.53), impact of asthma on morbidity (4.33;0.71) and rationale for developing budesonide-formoterol as maintenance and reliever therapy in asthma (4.22;0.67). Criteria with lowest quality of evidence scores were: mechanism of action (0.89;1.05) and potential spill-over effect (1.39;1.36). CONCLUSIONS : A number of patient- and system-level considerations come in place when identifying the value of a new therapeutic approach in asthma. MCDA allowed to systematically consider the evidence on the different attributes and proved to be a useful tool to support the decision-making process.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PRS62
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Novel & Social Elements of Value, Public Health, Reimbursement & Access Policy, Value Frameworks & Dossier Format
Disease
Respiratory-Related Disorders