MULTI-CRITERIA DECISION ANALYSIS IN HEALTH TECHNOLOGY ASSESSMENT: A REVIEW OF MCDA FRAMEWORKS SUPPORTING DRUG REIMBURSEMENT DECISIONS
Author(s)
Ioannis Agorastos, PhD(c)1, Elpida Pavi, PhD1, Kostas Athanasakis, PhD1, Athanassios Vozikis, PhD2.
1University of West Attica, Athens, Greece, 2University of Piraeus, Piraeus, Greece.
1University of West Attica, Athens, Greece, 2University of Piraeus, Piraeus, Greece.
OBJECTIVES: Multi-criteria decision analysis (MCDA) is a systematic set of methods that considers multiple criteria to support healthcare decision making and priority setting. In the context of Health Technology Assessment (HTA), where reimbursement decisions become increasingly complex, MCDA offers a structured and transparent approach for the comprehensive assessment of multiple value dimensions. This study aimed to identify MCDA frameworks that have been developed in literature for the assessment of drug value.
METHODS: A targeted literature review was conducted in January 2026 in PubMed and Scopus using the search terms “MCDA framework”, “MCDA”, “multiple criteria decision analysis”, “multicriteria decision analysis”, “HTA” and “health technology assessment”. Google Scholar, grey literature sources, and reference lists of identified publications were also searched. Only full-text articles published in English were included, with no restriction on publication date.
RESULTS: From the literature review, a total of 47 MCDA frameworks were identified, involving the development and/or pilot implementation of an MCDA framework in the field of HTA worldwide. Of these, 19 were generic MCDA frameworks, while the remaining 28 were focused on specific therapeutic areas. More specifically, 15 were tailored for orphan drugs (rare diseases), 8 were oncology-focused, 2 concerned pediatric medicines, 1 focused on early access medicines, 1 on respiratory inhalers, and 1 on Diabetic Macular Edema (DME). The identified frameworks covered a broad range of countries and regions, including Europe (Spain, Italy, Poland, Bulgaria, Norway), the Americas (Canada, Brazil), Asia (Malaysia, Saudi Arabia, Turkey, Israel, United Arab Emirates, China, Taiwan, South Korea, Thailand), Oceania (Australia, New Zealand), and Africa (Ghana, Côte d'Ivoire).
CONCLUSIONS: The number and diversity of identified MCDA frameworks demonstrate the growing international interest in incorporating multiple dimensions of value into drug assessment. MCDA offers a structured method that can complement traditional HTA processes and support more comprehensive and consistent reimbursement decisions.
METHODS: A targeted literature review was conducted in January 2026 in PubMed and Scopus using the search terms “MCDA framework”, “MCDA”, “multiple criteria decision analysis”, “multicriteria decision analysis”, “HTA” and “health technology assessment”. Google Scholar, grey literature sources, and reference lists of identified publications were also searched. Only full-text articles published in English were included, with no restriction on publication date.
RESULTS: From the literature review, a total of 47 MCDA frameworks were identified, involving the development and/or pilot implementation of an MCDA framework in the field of HTA worldwide. Of these, 19 were generic MCDA frameworks, while the remaining 28 were focused on specific therapeutic areas. More specifically, 15 were tailored for orphan drugs (rare diseases), 8 were oncology-focused, 2 concerned pediatric medicines, 1 focused on early access medicines, 1 on respiratory inhalers, and 1 on Diabetic Macular Edema (DME). The identified frameworks covered a broad range of countries and regions, including Europe (Spain, Italy, Poland, Bulgaria, Norway), the Americas (Canada, Brazil), Asia (Malaysia, Saudi Arabia, Turkey, Israel, United Arab Emirates, China, Taiwan, South Korea, Thailand), Oceania (Australia, New Zealand), and Africa (Ghana, Côte d'Ivoire).
CONCLUSIONS: The number and diversity of identified MCDA frameworks demonstrate the growing international interest in incorporating multiple dimensions of value into drug assessment. MCDA offers a structured method that can complement traditional HTA processes and support more comprehensive and consistent reimbursement decisions.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA143
Topic
Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Value Frameworks & Dossier Format
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology, Pediatrics