Does the Future Belong to MCDA?

London, UK – A key challenge for health care decision makers is balancing the multiplicity of medical, social, and economic factors that have a bearing on their choices. These factors, and the importance attached to them, often vary from one decision to another and between the stakeholders. Ensuring accountability requires that the process for determining these factors and their relative importance is transparent. Multi-criteria Decision Analysis (MCDA) is one approach to this end that has recently received much attention.

In the article, “Does the Future Belong to MCDA,” published in ISPOR CONNECTIONS, the authors set out to review the current debates about how MCDA might be used to inform health care decision making. They identified that MCDA is being considered as a support for a number of different health care decisions. There is a growing desire to formally extend the criteria that are included in reimbursement decisions; as reflected in discussion about value-based pricing in the UK. MCDA has been proposed as a way to achieve this objective. Perhaps greatest attention has been paid to MCDA as a means to support quantitative benefit risk assessment (BRA). In an attempt to improve market authorization decisions, bodies such as the European Medicines Agency have been exploring alternative methods for BRA, including MCDA. The demand for this type of analysis to be included in submissions has seen the establishment of numerous industry-led initiatives to develop and test BRA methods, such as BRAT, PROTECT, and CASS.

The review concluded that it is likely that MCDA will have a role to play in authorisation and reimbursement decisions. Ongoing debate about the exact form of MCDA that will be adopted presents an opportunity to ensure that the methods that are adopted best capture the value of products.

Dr. Kevin Marsh, Senior Research Scientist at UBC and lead author states, “The uncertainty surrounding the precise role of MCDA in BRA and HTA presents both a challenge and an opportunity to industry. It is important that industry is involved in testing different MCDA approaches, and is participating in the debate to ensure that the most appropriate methods are adopted.”


ISPOR CONNECTIONS (ISSN 1538-5108), the bimonthly news & technical journal of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), strives to provide timely communications on methodological and health policy issues of interest to Society members.

International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is a nonprofit, international, educational and scientific organization that strives to increase the efficiency, effectiveness, and fairness of health care resource use to improve health.

For more information: www.ispor.org

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