OBJECTIVES: Introducing costly new drugs with high uncertainty in treatment efficacy highlights the urgency for comprehensive value-based assessment in support of drug pricing and reimbursement policy. Given the lack of a value framework in assessing new health technologies in Asian settings, a value framework incorporating multiple criteria decision analysis (MCDA) for new treatments under a universal healthcare coverage system in Taiwan was proposed.

METHODS: To develop a value framework for assessing new health technologies under universal healthcare coverage in Taiwan, five value domains (i.e., “Overall clinical benefit”, “Disease burden”, “Alignment with patient concerns”, “Economic value”, and “Feasibility of adoption into the health system”) and 26 corresponding indicators derived from literatures and expert discussions was adopted. Different weighting schemes for three drug types (i.e., new oncology, new orphan, and other new drugs) were then constructed with the help of multiple stakeholders and use of different weighting methods (i.e., point allocation, Simple MultiAttribute Rating Technique Exploiting Ranks [SMARTER], and direct rating). Finally, we applied the value framework in a case study of new oncology drugs (i.e., pemigatinib, tepotinib, dinutuximab, and tisagenlecleucel).

RESULTS: “Overall clinical benefit” had the highest preference weight, irrespective of drug type, weighting method, and stakeholder type. The ranking of value domains was consistent across the domain-derived approach (i.e., a point allocation method) and the indicator-derived approach (i.e., SMARTER and direct rating methods), suggesting that the value framework with a short-form (i.e., domain-derived) weighting scheme is sufficient to support decision-makings under time and resource constraints. In this case study, tisagenlecleucel had the highest weighted value score, suggesting its prioritization for reimbursement.

CONCLUSIONS: A country-specific value framework based on MCDA for new drugs was developed in an Asian setting under universal healthcare coverage. It allows multiple stakeholders to systematically appraise all drug value attributes and provides a structured process for adapting and refining value assessments.