Author(s)
de Andrés-Nogales F1, Casado MA2, Zarranz-Ventura J3, Udaondo P4, Trillo JL5, Ruiz-Moreno JM6, Rodriguez-Maqueda M7, Poveda JL4, Peralta G8, Ortiz P9, Martínez-Sesmero JM10, Martínez-Olmos J11, Ignacio E12, García-Layana A13, Álvarez E10, Zulueta J14, Mur C15, Martínez M16
1Pharmacoeconomics & Outcomes Research Iberia (PORIB), Pozuelo de Alarcon, M, Spain, 2Pharmacoeconomics & Outcomes Research Iberia (PORIB), MADRID, M, Spain, 3Instituto Clinic de Oftalmología, Hospital Clinic; RETICS-OFTARED, Instituto de Salud Carlos III, Barcelona, Spain, 4Hospital Universitari i Politècnic La Fe, Valencia, Spain, 5Departamento de Salud Clínico Malvarrosa, Madrid, M, Spain, 6Hospital Universitario Puerta de Hierro Majadahonda; Universidad Castilla-La Mancha; Vissum Corporación; RETICS-OFTARED, Instituto de Salud Carlos III, Majadahonda, Spain, 7Hospital Universitario Virgen del Rocío, Sevilla, Spain, 8Fundació Rossend Carrasco i Formiguera. MentBarcelona, Barcelona, Spain, 9Consorci MAR Parc de Salut de Barcelona, Barcelona, Spain, 10Hospital Clínico San Carlos, Madrid, Spain, 11Senado de España, Madrid, Spain, 12Universidad de Cádiz, Cádiz, Spain, 13Clínica Universidad de Navarra; RETICS-OFTARED, Instituto de Salud Carlos III, Pamplona, Spain, 14Asociación Mácula Retina, Sevilla, Spain, 15Sociedad Española de Directivos de la Salud, Madrid, Spain, 16Ministerio de Sanidad, Consumo y Bienestar Social, Madrid, Spain
OBJECTIVES A previous multi-stakeholder multicriteria decision analysis (MCDA) established the 10 relevant criteria for decision-making in diabetic macular edema (DME). This is an extension study to determine the relative importance of the previously selected criteria according to each stakeholder group separately. METHODS Nineteen participants were allocated in 4 stakeholder groups [Physicians (5); Pharmacists (3), Health authorities and management experts (6) and Patient perspective (1 psychologist and 4 patients’ representatives)]. A discrete choice experiment (DCE) was developed to determine the relative importance weight of the 10 criteria per stakeholder group by eliciting their preferences through an online questionnaire. A multinomial logit model was fitted to analyse the questionnaire response and obtain the weights. A final deliberative process was used to discuss DCE results and conclusions with the participants. RESULTS DCE established the relative importance of the 10 relevant criteria for the management of a 50-65-year-old DME patient per stakeholder group. Weights are provided in the following order: Clinicians/Pharmacists/Health authorities and management experts/Patient perspective. Mean change in best corrected visual acuity (22.79%/27.80%/24.27%/16.80%), percentage of patients with an improvement ≥15 letters (3.45%/3.81%/5.72%/4.69%), effect duration per administration (25.53%/6.69%/7.28%/0.18%), retinal detachment (8.06%/8.75%/2.66%/13.91%), endophthalmitis (17.34%/0.17%/18.64%/7.93%), myocardial infarction (4.63%/12.35%/13.03%/24.92%), intravitreal haemorrhage (4.39%/7.64%/7.92%/8.58%), annual treatment cost per patient (1.68%/0.51%/7.80%/3.19%), Health-Related Quality of life (HRQL) (0,16%/16.42%/1.87%/12.60%) and disability level (11,98%/15.85%/10.82%/7.21%). Efficacy/effectiveness criteria were the most important to clinicians (51.76%) and pharmacists (38,31%) while safety criteria were the most relevant to health authorities/management experts (42,24%) and patients (55,34%). Annual treatment costs were of little relevance to any of the groups (0.51-7,8%). HRQL and disability weights were higher for pharmacists and patients. CONCLUSIONS Safety and efficacy/effectiveness were the most relevant criteria for decision-making in DME patients to all the stakeholder groups, accounting for more than half of the relative importance, with a low relative importance to treatment costs.
Conference/Value in Health Info
2019-11, ISPOR Europe 2019, Copenhagen, Denmark
Code
PSS17
Topic
Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Insurance Systems & National Health Care, Reimbursement & Access Policy, Value Frameworks & Dossier Format
Disease
Diabetes/Endocrine/Metabolic Disorders, Drugs, Sensory System Disorders
