Comprehensive and Standardized Value Assessment of Innovative Cancer Treatments: A Multi-Criteria Decision Analysis (MCDA) Tool for Switzerland
Author(s)
Kuhlmey F1, Bill M2, Fischer B2, Oniangue-Ndza C3, Telser H2
1Polynomics SA, Olten, SO, Switzerland, 2Polynomics AG, Olten, Switzerland, 3Bristol Myers Squibb SA, Steinhausen, ZG, Switzerland
Presentation Documents
OBJECTIVES:
The current procedures for reimbursing new drugs and drug combinations face challenges in making effective reimbursement decisions. This study aimed to develop a model applicable to the Swiss reimbursement context, utilizing multi-criteria decision analysis (MCDA) to evaluate value components of new treatments and improve their availability for advanced cancer patients.METHODS:
Following ISPOR guidelines, a MCDA model was developed to evaluate non-curative cancer treatments. Input from stakeholders (Swiss oncologists, patient representatives, and health economists) was collected and utilized to identify the model's attributes. Attributes’ weights and value functions were derived from a discrete choice experiment (DCE) involving 1,034 participants representing the Swiss general population. The resulting value score for each therapy, ranging from 0 to 100, was calculated as the sum of the weighted attribute values. In a case study, the model compared the combination of nivolumab+ipilimumab with sunitinib as first-line therapy for advanced renal cell carcinoma, based on data from the CheckMate 214 phase III study.RESULTS:
Seven attributes were identified from stakeholders’ inputs, with four measuring treatment’s value for the patient (median overall survival, quality of life, severe adverse events, and patient convenience) and three measuring treatment’s overall societal value (DALYs, indirect, and additional medical treatment costs). The attribute with the highest weight derived from the DCE was median overall survival (44%), followed by quality of life (26%) and severe adverse events (14%). All remaining attributes were relevant but weighted <10%. In the case study, nivolumab+ipilimumab had a higher value score (80) compared to sunitinib (68). Sensitivity analyses supported the model's robustness.CONCLUSIONS:
The valuation of MCDA attributes through the general population offers a solid foundation for quantifying the value of innovative treatments. This tool can assist Swiss payers when evaluating the value of innovative medicines for advanced cancer. This information might be used for reimbursement decisions.Conference/Value in Health Info
2023-11, ISPOR Europe 2023, Copenhagen, Denmark
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Code
HPR181
Topic
Health Policy & Regulatory
Topic Subcategory
Insurance Systems & National Health Care, Pricing Policy & Schemes, Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology