OBJECTIVES:

The present study aimed at evaluating the implications related to the implementation of a multi-dimensional approach for the study of alternative technologies (Ranibixumab, Dexamethasone and Aflibercept), for treating diabetic macular edema, in 4 Italian Regional settings: Lombardia, Liguria, Toscana and Veneto.

METHODS: RESULTS:

No statistically differences emerged with regard to the prioritisation phases, except for the equity dimension (p-value=0.013) that was considered the most relevant aspect within the Toscana setting. All the other Regions reported a superior score for the safety dimensions.

The 12 evaluators, despite their different professional titles and referring to various hospitals within 4 Regional settings, attributed similar scores to the HTA dimensions during the appraisal phase, demonstrating the robustness of the MCDA process. No statistically significant differences (p-value>0.05) emerged concerning the scores attributed to Ranibizumab, Aflibercept and Dexamethasone in the 4 Regions, except for Dexamethasone’s safety and efficacy dimensions (p-value=0.002). Lombardy evaluators provided more conservative scores as the HTA was conducted in the first part of the life cycle of the technology.

CONCLUSIONS:

The results reported high homogeneity in both the prioritisation and evaluation phases, demonstrating consistent behaviour among different professionals. The MCDA approach suggests that Dexamethasone could be considered the preferable treatment to adopt within the target population, having acquired higher scores than the comparators (p-value<0.001) in all the 4 Regions under assessment.