OBJECTIVES:

: The main objective of this study was to evaluate the first line treatment of metastatic HER2 overexpressed breast cancer, from Brazilian health system, using multicriteria decision analysis.

METHODS:

: The method chosen was the analytical hierarchical process and consists of the joint trial to evaluate the importance of the established criteria and performance of the alternatives selected for evaluation. 35 oncologists that work in the care of patients with overexpressed HER-2 metastatic breast cancer were the main focus of questionnaire. They compared the relevance of 6 predefined criteria, which were overall survival, response to treatment, adverse events, quality of life, cost-effectiveness and budgetary impact. Beyond that, were also compared the performance of technologies in each criterion, which were a) pertuzumab in combination with trastuzumab and docetaxel; b) trastuzumab in combination with docetaxel; c) other technology reported by the professional. Consistency ratio and sensitivity analysis were performed.

RESULTS:

: The therapeutic scheme considered more appropriate by the model was pertuzumab in combination with trastuzumab and docetaxel. The most sensitive criteria of the model were adverse events, cost-effectiveness, and budgetary impact, which suggests that the final classification of the technologies has a close relationship with the oncologists participating in the questionnaire.

CONCLUSIONS:

: Utilization of analytical hierarchical process has shown to be an effective tool to health technology assessment field. Defining the treatment of an incurable disease associated with relative short survival time and high costs treatment options consists in a complex decision making. MCDA provided the possibility of ranging the weight of criteria and considering hardly measurable criteria and, which differ from economic models and contribute to a wider evaluation about health decision making.