OBJECTIVES: To move from a “lowest price” policy to a value-based price evaluation through multi-criteria decision analysis (MCDA), decisions makers, especially those in emerging countries, need to understand how to identify and prioritize the criteria that matters most in their population. The objective of the study is to raise the awareness of decision makers on using MCDA in health care decision making in Egypt and to do a real application on how to develop a rating tool to assess mesothelioma interventions; pemetrexed and gemcitabine.

METHODS: An MCDA framework was developed using multiple criteria for the evaluation of pemetrexed and gemcitabine, using a numerical scoring system on a scale of 1 to 3 for each criterion. A Delphi study was then performed to discuss a final list of criteria with clear definitions and potential scoring scales. An appraisal group was convened and participants were asked to express their individual perspectives, by assigning weights to each criterion of the MCDA model. Participants then assigned performance scores for each medicine using available evidence and real-world evidence. MCDA estimates of perceived value were calculated by combining normalized weights and scores.

RESULTS: This study resulted in a preliminary rating tool for assessing mesothelioma interventions in Egypt. The tool consists of 11 criteria covering context of drugs, outcomes of drugs, economics and quality of evidence, with clear definitions and potential scoring scales. By calculating the total aggregate score using average weight and average score assigned to each pemetrexed and gemcitabine on each decision criteria of the MCDA model. Pemetrexed got the highest total aggregate score equal to 1.07 compared to gemcitabine 0.99 of the MCDA models.

CONCLUSIONS: This study describes the development of a rating tool to assess mesothelioma interventions in Egypt. This tool may contribute to a more transparent priority-setting process and fairer decision-making.