Appraising the holistic value of Lenvatinib for radio-iodine refractory differentiated thyroid cancer: A multi-country study applying pragmatic MCDA
| Autor: | Mireille Goetghebeur, X Badia, Jenifer Ehreth, Hanane Khoury, L Bennetts, Patrizia Berto, Monika Wagner |
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| Rok vydání: | 2017 |
| Předmět: |
Cancer Research
Pathology medicine.medical_specialty medicine.medical_treatment Advisory Committees Applied psychology Antineoplastic Agents Context (language use) Mcda Social value orientations lcsh:RC254-282 Decision Support Techniques Orphan drug 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Genetics medicine Humans Lenvatinib Thyroid Neoplasms 030212 general & internal medicine Evidence-Based Medicine business.industry Phenylurea Compounds 030503 health policy & services Evidence-based medicine lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Multiple-criteria decision analysis Healthcare decisionmaking Outcome and Process Assessment Health Care Italy Oncology chemistry Spain Quinolines France 0305 other medical science business Value (mathematics) Appraisal Watchful waiting Research Article |
| Zdroj: | BMC Cancer, Vol 17, Iss 1, Pp 1-12 (2017) BMC Cancer |
| ISSN: | 1471-2407 |
| DOI: | 10.1186/s12885-017-3258-9 |
| Popis: | Background The objective of the study was to reveal through pragmatic MCDA (EVIDEM) the contribution of a broad range of criteria to the value of the orphan drug lenvatinib for radioiodine refractory differentiated thyroid cancer (RR-DTC) in country-specific contexts. Methods The study was designed to enable comprehensive appraisal (12 quantitative, 7 qualitative criteria) in the current disease context (watchful waiting, sorafenib) of France, Italy and Spain. Data on the value of lenvatinib was collected from diverse stakeholders during country-specific panels and included: criteria weights (individual and social values); performance scores (judgments on evidence—collected through MCDA systematic review); qualitative impacts of contextual criteria; and verbal and written insights structured by criteria. The value contribution of each criterion was calculated and uncertainty explored. Results Comparative effectiveness, Quality of evidence (Spain and Italy) and Disease severity (France) received the greatest weights. Four criteria contributed most to the value of lenvatinib, reflecting its superior Comparative effectiveness (16–22% of value), the severity of RR-DTC (16–22%), significant unmet needs (14–21%) and robust evidence (14–20%). Contributions varied by comparator, country and individuals, highlighting the importance of context and consultation. Results were reproducible at the group level. Impacts of contextual criteria varied across countries reflecting different health systems and cultural backgrounds. The MCDA process promoted sharing stakeholders’ knowledge on lenvatinib and insights on context. Conclusions The value of lenvatinib was consistently positive across diverse therapeutic contexts. MCDA identified the aspects contributing most to value, revealed rich contextual insights, and helped participants express and explicitly tackle ethical trade-offs inherent to balanced appraisal and decisionmaking. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3258-9) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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