OBJECTIVES. To identify criteria for prioritizing treatments for maintenance therapy in newly diagnosed AOC with BRCA 1/2 mutations and apply the developed framework on treatment alternatives from the Brazilian private healthcare system perspective.

METHODS. A literature review identified criteria for technology prioritization in the patient population of interest and validated with representatives of patient associations, medical oncologists and private healthcare managers. Three representatives of each group participated in a MCDA panel to elicit weights for the validated criteria using the swing weighting methodology. Treatment alternatives included olaparib tablets, watch and wait, and other non BRCAm specific treatments used in Brazil. To assess treatments performance in the BRCA 1/2 patient population, data were derived from published literature with clinical expert input and reference cost lists.

RESULTS. Key criteria identified in the MCDA were efficacy (progression-free survival), safety (including clinically significant events and discontinuation due to adverse events), treatment free time (as a proxy for quality of life), convenience (administration) and costs. Efficacy was the top ranked criteria for all stakeholder groups, followed by safety. Sequential preferences varied between groups. Costs were considered least important criteria for patient associations and for oncologists. However, for healthcare managers, cost was the third in the rank followed by treatment free time and convenience. The top ranked technology based on overall criteria weighting was olaparib, driven particularly by its efficacy, substantial delay to subsequent treatment and relative safety to other maintenance options.

CONCLUSIONS. Final scores for the technologies varied by group, reflecting their different perspectives. For recently diagnosed BRCA 1/2 AOC, olaparib in the maintenance setting after frontline chemotherapy was evaluated as the best option by all stakeholder groups, when efficacy, safety, convenience and cost criteria are scored and weighted in a MCDA approach. This approach could be adapted to other treatment lines and disease areas.