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Appraising the holistic value of Lenvatinib for radio-iodine refractory differentiated thyroid cancer: A multi-country study applying pragmatic MCDA.

Abstract The objective of the study was to reveal through pragmatic MCDA (EVIDEM) the contribution of a broad range of criteria to the value of the orphan drug lenvatinib for radioiodine refractory differentiated thyroid cancer (RR-DTC) in country-specific contexts.
PMID
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Authors

Mayor MeshTerms

Decision Support Techniques

Keywords

Appraisal

Healthcare decisionmaking

Lenvatinib

Mcda

Journal Title bmc cancer
Publication Year Start




PMID- 28412971
OWN - NLM
STAT- MEDLINE
DA  - 20170417
DCOM- 20170418
LR  - 20170421
IS  - 1471-2407 (Electronic)
IS  - 1471-2407 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Apr 17
TI  - Appraising the holistic value of Lenvatinib for radio-iodine refractory
      differentiated thyroid cancer: A multi-country study applying pragmatic MCDA.
PG  - 272
LID - 10.1186/s12885-017-3258-9 [doi]
AB  - BACKGROUND: The objective of the study was to reveal through pragmatic MCDA
      (EVIDEM) the contribution of a broad range of criteria to the value of the orphan
      drug lenvatinib for radioiodine refractory differentiated thyroid cancer (RR-DTC)
      in country-specific contexts. METHODS: The study was designed to enable
      comprehensive appraisal (12 quantitative, 7 qualitative criteria) in the current 
      disease context (watchful waiting, sorafenib) of France, Italy and Spain. Data on
      the value of lenvatinib was collected from diverse stakeholders during
      country-specific panels and included: criteria weights (individual and social
      values); performance scores (judgments on evidence-collected through MCDA
      systematic review); qualitative impacts of contextual criteria; and verbal and
      written insights structured by criteria. The value contribution of each criterion
      was calculated and uncertainty explored. RESULTS: Comparative effectiveness,
      Quality of evidence (Spain and Italy) and Disease severity (France) received the 
      greatest weights. Four criteria contributed most to the value of lenvatinib,
      reflecting its superior Comparative effectiveness (16-22% of value), the severity
      of RR-DTC (16-22%), significant unmet needs (14-21%) and robust evidence
      (14-20%). Contributions varied by comparator, country and individuals,
      highlighting the importance of context and consultation. Results were
      reproducible at the group level. Impacts of contextual criteria varied across
      countries reflecting different health systems and cultural backgrounds. The MCDA 
      process promoted sharing stakeholders' knowledge on lenvatinib and insights on
      context. CONCLUSIONS: The value of lenvatinib was consistently positive across
      diverse therapeutic contexts. MCDA identified the aspects contributing most to
      value, revealed rich contextual insights, and helped participants express and
      explicitly tackle ethical trade-offs inherent to balanced appraisal and
      decisionmaking.
FAU - Wagner, Monika
AU  - Wagner M
AUID- ORCID: http://orcid.org/0000-0002-7654-1175
AD  - LASER Analytica, Montreal, Quebec, Canada. [email protected]
FAU - Khoury, Hanane
AU  - Khoury H
AD  - LASER Analytica, Montreal, Quebec, Canada.
FAU - Bennetts, Liga
AU  - Bennetts L
AD  - LASER Analytica, Montreal, Quebec, Canada.
FAU - Berto, Patrizia
AU  - Berto P
AD  - LASER Analytica, Milan, Italy.
FAU - Ehreth, Jenifer
AU  - Ehreth J
AD  - LASER Analytica, Paris, France.
FAU - Badia, Xavier
AU  - Badia X
AD  - LASER Analytica and Omakase Consulting, Barcelona, Spain.
FAU - Goetghebeur, Mireille
AU  - Goetghebeur M
AD  - LASER Analytica, Montreal, Quebec, Canada.
AD  - School of Public Health, University of Montreal, Montreal, Quebec, Canada.
LA  - eng
PT  - Journal Article
DEP - 20170417
PL  - England
TA  - BMC Cancer
JT  - BMC cancer
JID - 100967800
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Quinolines)
RN  - EE083865G2 (lenvatinib)
SB  - IM
MH  - Advisory Committees
MH  - Antineoplastic Agents/adverse effects/*therapeutic use
MH  - *Decision Support Techniques
MH  - Evidence-Based Medicine
MH  - France
MH  - Humans
MH  - Italy
MH  - Outcome and Process Assessment (Health Care)
MH  - Phenylurea Compounds/adverse effects/*therapeutic use
MH  - Quinolines/adverse effects/*therapeutic use
MH  - Spain
MH  - Thyroid Neoplasms/*drug therapy
PMC - PMC5393009
OTO - NOTNLM
OT  - Appraisal
OT  - Healthcare decisionmaking
OT  - Lenvatinib
OT  - Mcda
EDAT- 2017/04/18 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/18 06:00
PHST- 2016/04/07 [received]
PHST- 2017/04/03 [accepted]
AID - 10.1186/s12885-017-3258-9 [doi]
AID - 10.1186/s12885-017-3258-9 [pii]
PST - epublish
SO  - BMC Cancer. 2017 Apr 17;17(1):272. doi: 10.1186/s12885-017-3258-9.

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