Highlights
- •RA treatments differ in terms of "value", as perceived by patients and physicians
- •Discrepancies between patients’ and physicians’ perspectives on RA treatment options have been explored by various methodologies; this is the first study using dual MCDA methodology (including physicians and patients), regarding the value of RA treatments
- •Participating physicians placed important value on adverse events, efficacy and route of treatment administration
- •Participating patients considered efficacy, non-occurrence of adverse events, and "drug survival" as the most valuable aspects
ABSTRACT
Purpose
Available treatment options for rheumatoid arthritis (RA) differ in important aspects.
In this sense, each RA treatment option is accompanied by a spectrum of characteristics
that collectively constitute its comprehensive “value,” as viewed from the physician's
or the patient's perspective. The objective of this study was to perform a multiple
criteria decision analysis of different RA treatments from the perspective of physicians
and patients and to outline the respective aspects of value for each treatment
Methods
A literature review was performed for constructing a set of criteria (N = 8) for the
multiple criteria decision analysis. Workshops for the elicitation of preferences
occurred separately for physicians and patients. A performance matrix was populated
via 2 network meta-analyses plus converged clinical opinion. Criteria were hierarchically
classified by application of pairwise comparisons, and criteria weights were attributed
by point allocation through convergence of opinions. Performances in both panels were
scored by using a 100-point scale. A linear additive value function was used for the
calculation of total value estimates.
Findings
Both panels provided their consensus. The hierarchical classification of attributes
from the physician perspective placed the highest values on the criteria of severe
adverse events, clinical efficacy, route of administration, and cost per year for
the third-party payer. From the patient perspective, the highest ranking criteria
were clinical efficacy, severe adverse events, percentage of patients remaining with
the same targeted immune modulator for 1 year (“drug survival”), and cost per year
for the third-party payer.
Implications
In an era of multiple options and varying preferences, RA treatments must be evaluated
by taking into consideration patients’ preferences as well, as to cover the full spectrum
of value elements rather than simply clinical outcomes. The results of this analysis
show that physicians and patients share similarities but also marked differences in
terms of the aspects of treatment that they perceive as more valuable.
Key words
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Article info
Publication history
Published online: August 06, 2021
Accepted:
July 3,
2021
Received in revised form:
July 2,
2021
Received:
February 17,
2021
Identification
Copyright
© 2021 Elsevier Inc.
