OBJECTIVES

The Multi-criteria decision analysis (MCDA) approach has been promoted as a mean to support systematic consideration of a broad range of decision criteria when appraising healthcare interventions. While it is important to capture all relevant aspects of value, these may not be fully transferable without considering country-specific aspects. The objective of this exploratory analysis is to discuss which criteria would be relevant in value determination for a pharmaceutical product in the Lebanese context.

METHODS

A face-to-face workshop was conducted as part of ISPOR Lebanon Chapter in February 2019 and included a presentation of the concept of MCDA and the two frameworks, EVIDEM and ADVANCE. During the workshop, 37 participants expressed their individual preferences through interactive exercises comprising of a qualitative exploration of criteria and their relevance in decision making and a quantitative exercise aiming at ranking (weighting) the different criteria to reflect their relative importance.

RESULTS

In the qualitative analysis of both frameworks, participants unanimously agreed on the relevance of comparative efficacy, safety, impact of medical costs. In EVIDEM, disease severity and unmet needs were also considered to be important criteria by more than 90% of the participants.

In the quantitative analysis of both frameworks, disease severity ranked first (mean normalized weight of 0.1 in EVIDEM and 0.27 in ADVANCE), followed by the size of the population (0.09), the type of therapeutic benefit patient- level (0.09), population-level (0.08) and the efficacy (0.07) in EVIDEM. In ADVANCE, the combined unmet need/disease severity criteria were followed by the direct and meaningful endpoints (0.15), safety (0.12), contraindications (0.08), and indirect surrogate endpoints (0.07).

CONCLUSIONS

This survey’s results were concordant with those reported in countries that have conducted similar surveys such as France, Italy and Spain. MCDA methodology could be used as a cornerstone to enhance evidence-based discussions among Lebanese stakeholders involved in decision-making processes.