OBJECTIVES : Multi-criteria decision analysis (MCDA) can assist policy makers in objectively choosing between alternative therapeutic options based on multiple value attributes. Our aim was to create an MCDA tool for the national tenders of off-patent oncology drugs in Egypt.

METHODS : An initial list of criteria was developed through a literature review complemented by local expert interviews. Price or cost-related criteria were excluded to abide by the national regulations of the tender process. Next, two workshops hosting diversified stakeholders representing different governmental bodies were held. Anonymous voting was used to rank and weigh the criteria as well as assigning scores. Price was added as a separate step to identify best option based on price per point. The tool was then tested on a national tender sample of off-patent oncology drug to assess its performance, and it was adjusted accordingly.

RESULTS : Seven non-price criteria were selected, including use in reference countries (23.49% weight), equivalence with the reference product (18.79%), manufacturing quality (15.53%), provision of pharmacovigilance services (12.94%), supply reliability (10.78%), previous use in local settings (9.8%) and macro-economic benefit (8.67%).

A pharmaceutical receives a score ranging from 0% to 100% of each criterion’s weight. The aggregated score was calculated on a hundred-point scale. Based on participants’ consensus, an overall score of 65 was set as a cut-off for passing the technical eligibility phase of the tendering process. Any product receiving a lower score, would be disqualified from the tender.

For qualified products, price per point was calculated to identify cheapest price per point. Best options identified using the MCDA tool were consistent with the national tender sample final list.

CONCLUSIONS : The MCDA tool is capable of objectively comparing similar off-patent oncology pharmaceuticals by considering multiple value attributes and providing reliable scoring functions for each.