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Assessing the Value of Healthcare Interventions Using Multi-Criteria Decision Analysis: A Review of the Literature

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Abstract

The objective of this study is to support those undertaking a multi-criteria decision analysis (MCDA) by reviewing the approaches adopted in healthcare MCDAs to date, how these varied with the objective of the study, and the lessons learned from this experience. Searches of EMBASE and MEDLINE identified 40 studies that provided 41 examples of MCDA in healthcare. Data were extracted on the objective of the study, methods employed, and decision makers’ and study authors’ reflections on the advantages and disadvantages of the methods. The recent interest in MCDA in healthcare is mirrored in an increase in the application of MCDA to evaluate healthcare interventions. Of the studies identified, the first was published in 1990, but more than half were published since 2011. They were undertaken in 18 different countries, and were designed to support investment (coverage and reimbursement), authorization, prescription, and research funding allocation decisions. Many intervention types were assessed: pharmaceuticals, public health interventions, screening, surgical interventions, and devices. Most used the value measurement approach and scored performance using predefined scales. Beyond these similarities, a diversity of different approaches were adopted, with only limited correspondence between the approach and the type of decision or product. Decision makers consulted as part of these studies, as well as the authors of the studies are positive about the potential of MCDA to improve decision making. Further work is required, however, to develop guidance for those undertaking MCDA.

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Notes

  1. See http://www.imi-protect.eu/benefitsRep.shtml.

  2. The asterisk refers to any ending to the search term being acceptable.

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Acknowledgments

This study was conducted without external funding. All authors contributed to all aspects of the paper. Kevin Marsh is the guarantor for the overall content of this paper. The authors have no conflicts of interest that are directly relevant to the contents of this study.

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Authors and Affiliations

  1. Evidera, 26–26 Hammersmith Grove, London, W6 7HA, UK

    Kevin Marsh, Tereza Lanitis, David Neasham & Panagiotis Orfanos

  2. Evidera, 430 Bedford Street, Suite 300, Lexington Office Park, Lexington, MA, 02420, USA

    Jaime Caro

  3. Faculty of Medicine, McGill University, Montreal, Canada

    Jaime Caro

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  1. Kevin Marsh
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Correspondence to Kevin Marsh.

Appendices

Appendix 1

See Fig. 5.

Fig. 5
figure 5

PRISMA flowchart describing study selection

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Appendix 2

See Table 1.

Table 1 Description of studies included in the review
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Marsh, K., Lanitis, T., Neasham, D. et al. Assessing the Value of Healthcare Interventions Using Multi-Criteria Decision Analysis: A Review of the Literature. PharmacoEconomics 32, 345–365 (2014). https://doi.org/10.1007/s40273-014-0135-0

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