PrOACT-URL and MCDA for benefit-risk assessment in multiple myeloma: A case study

Area of Science:

• Health Policy and Management
• Decision Analysis
• Pharmacoeconomics

Background:

• Incorporating new technologies into the Brazilian Unified Health System (SUS) requires robust decision-making frameworks.
• Assessing the benefit-risk balance of treatments is crucial for resource allocation in public healthcare.

Purpose of the Study:

• To evaluate the PrOACT-URL and MCDA frameworks as innovative tools for technology assessment in SUS.
• To conduct a benefit-risk assessment of multiple myeloma chemotherapy options using these frameworks.

Main Methods:

• A case study approach was employed, applying PrOACT-URL and MCDA to chemotherapy options for multiple myeloma.
• Qualitative analysis using PrOACT-URL was complemented by quantitative MCDA for benefit-risk evaluation.
• Sensitivity analysis was performed to assess the impact of stakeholder preferences.

Main Results:

• The PrOACT-URL framework alone was insufficient, necessitating the integration of MCDA.
• Overall survival was a key benefit, while thrombosis and neuropathy were significant risks.
• The cyclophosphamide, thalidomide, and dexamethasone (CTD) treatment demonstrated the most favorable benefit-risk profile across stakeholder groups.

Conclusions:

• The combined PrOACT-URL and MCDA approach enhances transparency and stakeholder engagement in healthcare technology decisions.
• The CTD regimen is recommended for multiple myeloma treatment based on its superior benefit-risk balance.
• This study underscores the value of structured decision-making methodologies in public health systems.