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Multi-criteria decision analysis (MCDA) as a measure of innovation

Multi-criteria decision analysis (MCDA) as a measure of innovation. Kevin Marsh Senior Director, Evidera , London IInd INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE HEALTH TECHNOLOGY ASSESSMENT: WAYS OF DEVELOPMENT IN RUSSIA 2dn Nov 2015. Objective and overview. Objective

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Multi-criteria decision analysis (MCDA) as a measure of innovation

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  1. Multi-criteria decision analysis (MCDA) as a measure of innovation Kevin Marsh Senior Director, Evidera, London IInd INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE HEALTH TECHNOLOGY ASSESSMENT: WAYS OF DEVELOPMENT IN RUSSIA 2dn Nov 2015

  2. Objective and overview • Objective • To consider the case for using MCDA to support HTA • Overview • Why are we interested in MCDA? • What is MCDA and how is it being used to support HTA? • Limitations with current practice and a research agenda • Take away • MCDA has great potential but current practice is often lacking

  3. What is the challenge facing healthcare decision makers? Source: Golan et al., 2010

  4. HTA method only formally capture some of these criteriaExample: NICE NICE (2014)Consultation Paper. Value Based Assessment of Health Technologies

  5. Why are we interested in MCDA? • A collection of analytical methods used to support decision makingand value communication in the context of • Problems involving both monetary and non-monetary objectives • Involving multiple, potentially conflicting objectives • Involving potentially multiple stakeholders

  6. What is MCDA?Common steps Overall performance score • Identify treatments • Stakeholder preferences • Performance data Treatment C Treatment B Treatment A

  7. Why are we interested in MCDA?

  8. Why are we interested in MCDA?Evidencethat decision makers are positive about MCDA Systematic, transparent and consistent Force people to think Improved the transparency Improved understanding Facilitating knowledge transfer Supporting systematic consideration of a broad range of criteria Improve the quality of the discussion Source: Marsh et al. (2014)

  9. HTA agencies worldwide are using MCDA IQWiG: Piloting DCE and AHP for economic evaluation Russia: MCDA for orphan drugs British Columbia: Uses MCDA for HTA Hungary: Reimbursing medical technology Thailand: Applied MCDA to inform coverage decisions Columbia: Developing an MCDA for HTA Lombardi: Implement MCDA for HTA * Illustrative examples; not comprehensiveAHP: Analytic hierarchy process; DCE: discrete choice experiment; IQWiG: The Institute for Quality and Efficiency in Healthcare

  10. Using MCDA for HTACase study: Reimbursing medical technology in Hungary • Implemented in 2010 • Evaluation of 14 applications for medical technology • Criteria and weights established by a committee comprising of: • The Health Financing Agency • The Ministry of Health • Clinical experts • Health economists

  11. Critique of current practice1. Double counting Overlap?

  12. Critique of current practice2. Additive models =20%

  13. Critique of current practiceCase study: Essential medicine list in Thailand Multiplicative model Information, Efficacy, Safety, administration restriction and frequency of administration (ISafE) and treatment costs

  14. Critique of current practice3. Dealing with cost Lost opportunity cost?

  15. Critique of current practice3. Dealing with cost WTP € QALY

  16. Critique of current practice3. Dealing with cost WTP € MCDA-based benefit QALY

  17. Critique of current practice3. Dealing with cost WTP? WTP? € WTP? MCDA-based benefit

  18. Best practice recommendationsE.g. ISPOR MCDA task force

  19. Summary MCDA has the potential to support HTA Current practice fails to meet best methodological practice Initiatives are ongoing to develop best practice guidance

  20. Contact Information Kevin Marsh, PhDSenior Director, EvideraEmail: kevin.marsh@evidera.comPhone: +44 (0) 7808 795 451

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