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Patient involvement in reflective multicriteria decision analysis to assist decision making in oncology

Published online by Cambridge University Press:  07 February 2019

Xavier Badia ,
Alfonso Aguarón ,
Ana Fernández ,
Antonia Gimón ,
Begoña Nafria ,
Bernard Gaspar ,
Laura Guarga ,
María Gálvez ,
Marta Fuentes  and
Noelia Paco
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Xavier Badia*
Affiliation:
Omakase Consulting S.L.
Alfonso Aguarón
Affiliation:
Myeloma Patients Europe
Ana Fernández
Affiliation:
Spanish Association Against Cancer
Antonia Gimón
Affiliation:
Spanish Breast Cancer Federation
Begoña Nafria
Affiliation:
Patient Advocacy Manager in Research at Institut de Recerca Sant Joan de Déu Innovation and Research Department- Hospital Sant Joan de Déu
Bernard Gaspar
Affiliation:
Spanish Affected Lung Cancer Association
Laura Guarga
Affiliation:
Omakase Consulting S.L.
María Gálvez
Affiliation:
Patient Association Platform
Marta Fuentes
Affiliation:
Spanish Melanoma
Noelia Paco
Affiliation:
Omakase Consulting S.L.
Roberto Saldaña
Affiliation:
ACCU Confederation
*
Author for correspondence: Xavier Badia, E-mail: xbadia@omakaseconsulting.com
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Abstract

Objectives

Patient involvement in drug evaluation decision making is increasing. The aim of the current study was to develop a multi-criteria decision analysis (MCDA) framework that would enable the inclusion of the patient perspective in the selection of appropriate criteria for MCDAs being used in the value assessments of oncologic drugs.

Methods

A literature review was conducted to identify and define criteria used in drug assessments from patient perspectives. The Evidence and Value: Impact on Decision Making methodology was used to develop a MCDA framework. Identified criteria were discussed by a sample of oncology patient association representatives who decided which criteria were important from patient perspectives. Selected criteria were rated by importance. The preliminary MCDA framework was tested through the assessment of a hypothetical oncology treatment. A discussion was carried out to agree on a final pilot MCDA framework.

Results

Twenty-two criteria were extracted from the literature review. After criteria discussion, sixteen criteria remained. The most important criteria were comparative patient reported outcomes (PRO), comparative efficacy and disease severity. After the discussion generated by the scoring of the hypothetical oncology treatment, the final pilot MCDA framework included seven quantitative criteria (“disease severity”, “unmet needs”, “comparative efficacy / effectiveness”, “comparative safety / tolerability”, “comparative PROs”, “contribution of oncological innovation”) and one contextual criterion (“population priorities and access”).

Conclusions

The present study developed a pilot reflective MCDA framework that could increase patient's capability to participate in the decision-making process by providing systematic drug assessments from the patient perspective.

Keywords

Patient empowermentMCDADrug assessment
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 1 , 2019 , pp. 56 - 63
Copyright
Copyright © Cambridge University Press 2019 

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References

1.Rys, A Health 2020 policy framework and strategy. EUR/RC62. http://www.euro.who.int/__data/assets/pdf_file/0020/170093/RC62wd08-Eng.pdf?ua=1 (accessed December 28, 2018).Google Scholar
2.Loukanova, S, Molnar, R and Bridges, JF (2007) Promoting patient empowerment in the healthcare system: Highlighting the need for patient-centered drug policy. Expert Rev Pharmacoecon Outcomes Res 7, 281–289.Google Scholar
3.European Patient Forum. EPF background brief: Patient empowerment. http://www.eu-patient.eu/globalassets/campaign-patient-empowerment/briefing_paperpatient-empowerment_final_external.pdf (accessed December 28, 2018).Google Scholar
4.Aslani, P (2013) Patient empowerment and informed decision-making. Int J Pharm Pract 21, 347–348.Google Scholar
5.Jørgensen, CR, Thomsen, TG, Ross, L, et al. (2018) What facilitates “patient empowerment” in cancer patients during follow-up: A qualitative systematic review of the literature. Qual Health Res 28, 292–304.Google Scholar
6.Te Boveldt, N, Vernooij-Dassen, M, Leppink, I, et al. (2014) Patient empowerment in cancer pain management: An integrative literature review. Psychooncology 1211, 1203–1211.Google Scholar
7.Davis, C, Naci, H, Gurpinar, E, et al. (2017) Availability of evidence of benefits on overall survival and quality of life of cancer drugs approved by European Medicines Agency: Retrospective cohort study of drug approvals 2009-13. BMJ 359, j4530.Google Scholar
8.European Medicines Agency (2016) Human medicines highlights, https://www.ema.europa.eu/documents/leaflet/human-medicines-highlights-2016_en.pdf (accessed December 28, 2018).Google Scholar
9.Aronson, JK, Ferner, RE and Hughes, DA (2012) Defining rewardable innovation in drug therapy. Nat Rev Drug Discov 11, 253–254.Google Scholar
10.Innovative Medicines Initiative (2016) The innovative medicines initiative and patients - A partnership, https://www.imi.europa.eu/sites/default/files/…/get…/patients/PatientBrochure2016.pdf (accessed December 20, 2018).Google Scholar
11.European Commission (2015) A focus on patients: the Innovative Medicines Initiative in action, https://ec.europa.eu/programmes/horizon2020/en/news/focus-patients-innovative-medicines-initiative-action-1 (accessed December 20, 2018).Google Scholar
12.Cherny, NI, Dafni, U, Bogaerts, J, et al. (2017) ESMO-Magnitude of Clinical Benefit Scale version 1.1. Ann Oncol 28, 2340–2366.10.1093/annonc/mdx310Google Scholar
13.Schnipper, LE, Davidson, NE, Wollins, DS, et al. (2016) Updating the American society of clinical oncology value framework: Revisions and reflections in response to comments received. J Clin Oncol 34, 2925–2933.Google Scholar
14.The National Health Council (2016) The patient voice in value, http://www.nationalhealthcouncil.org/sites/default/files/Value-Rubric.pdf (accessed December 20, 2018).Google Scholar
15.Goetghebeur, M, Castro-Jaramillo, H, Baltussen, R and Daniels, N (2017) The art of priority setting. Lancet 389, 2368–2369.Google Scholar
16.EVIDEM Collaboration (2017) EVIDEM 10th Edition. Adapt & pilot, https://www.evidem.org/wp/wp-content/uploads/2017/09/EVIDEM-10th-Edition-Adapt-and-pilot.pdf (accessed December 20, 2018).Google Scholar
17.Riva, JJ, Malik, KM, Burnie, SJ, Endicott, AR and Busse, JW (2012) What is your research question? An introduction to the PICOT format for clinicians. J Chiropratic Assoc 56, 167–171.Google Scholar
18.Patient Empowerment Foundation – Providing support and connection for patients. http://powerforpatient.org/ (accessed December 20, 2018).Google Scholar
19.European Network for Patients Empowerment. http://www.eu-patient.eu/News/News-Archive/European-Network-for-Patients-Empowerment/ (accessed December 20, 2018).Google Scholar
20.Postmus, D, Mavris, M, Hillege, HL, et al. (2016) Incorporating patient preferences into drug development and regulatory decision making: Results from a quantitative pilot study with cancer patients, carers, and regulators. Clin Pharmacol Ther 99, 548–554.Google Scholar
21.Generalitat de Catalunya. Departament de Salut. Pla de Salut de Catalunya 2016 - 2020. http://salutweb.gencat.cat/ca/el_departament/Pla_salut/pla-de-salut-2016-2020/ (accessed December 20, 2018).Google Scholar
22.Aguarón, A, et al. Evaluation of oncological innovation from the perspective of the patient through the reflective multi-criteria decision analysis in Spain. ISPOR 20th Annual European Congress, 4–8 November 2017, Glasgow, Scotland.Google Scholar
23.Facey, KM, Hansen, HP, Single, AN V (2017) Patient involvement in health technology assessment. Singapore: SpringerGoogle Scholar
24.OHTAC Public Engagement Subcommittee. Public Engagement for Health Technology Assessment at Health Quality Ontario—Final Report From the Ontario Health Technology Advisory Committee Public Engagement Subcommittee. April 2015. https://www.hqontario.ca/Portals/0/documents/evidence/special-reports/report-subcommittee-20150407-en.pdf (accessed December 20, 2018).Google Scholar
25.European Medicines Agency (EMA) (2014) Revised framework for interaction between the European Medicines Agency and patients and consumers and their organisations [Internet]. [cited September 7, 2018]. www.ema.europa.eu/contact (accessed December 20, 2018).Google Scholar
26.Patient Focused Medicines Development. The Patient Engagement Quality Guidance (PEQG) [Internet]. [cited September 7, 2018]. https://involvement-mapping.patientfocusedmedicine.org/initiatives/the-patient-engagement-quality-guidance-peqg (accessed December 20, 2018).Google Scholar