The value of obinutuzumab for untreated advanced Follicular Lymphoma: an assessment based on Multicriteria Decision Analysis (MCDA)

Abstract

Introduction: Multicriteria Decision Analysis (MCDA) provides a framework that enhances transparency and repeatability of decisions taken on a multicriteria basis. Objective: This analysis aims at assessing obinutuzumab compared to rituximab used as a first-line treatment for Follicular Lymphoma (FL) in the Italian health care system, using an MCDA approach. Materials and Methods: We used the EVIDEM V10 MCDA framework and a Delphi approach to scrutinize the views of a panel of physicians, payers and patients on value domains and their application to our research target. Results: All stakeholders attached medium-high scores to FL severity (patients at higher risk of relapsing), unmet needs, obinutuzumab clinical benefit and evidence quality, and lower scores to organizational impact and, except for payers, to costs. The comparative analysis highlighted positive scores for the domains “incremental efficacy” (2.6: range −5/+5) and “incremental patient benefit” (1.5: range −5/+5) of obinutuzumab compared to rituximab. A slight increase of severe adverse events (≥3) for obinutuzumab was estimated by the panellists. Obinutuzumab compared to rituximab received a neutral evaluation for costs and for organizational impact. Conclusion: This study reveals that MCDA could be a useful framework for evaluating a drug and it can be used to elicit the views of different stakeholder groups (as patients). The key criteria driving the value of obinutuzumab