Determining what represents value in the treatment of prurigo nodularis and its key unmet needs in Spain through Multi-Criteria Decision Analysis
Silvestre, Juan Francisco (Hospital General Universitario de Alicante (Alacant, País Valencià))
Tribó, María José (Hospital del Mar (Barcelona, Catalunya))
Armario-Hita, J.C. (Hospital Universitario Puerto Real (Cadis))
Calleja Hernández, Miguel Ángel (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Ortiz-Frutos, FJ. (Hospital 12 de Octubre (Madrid))
Poveda, José Luis (Hospital Universitari i Politècnic La Fe (València))
Shepherd, John (Omakase Consulting S.L)
Serra Baldrich, Esther (Institut de Recerca Sant Pau)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Prurigo nodularis (PN) is a chronic, debilitating dermatologic disease characterised by the presence of highly pruritic nodular lesions. PN highly impacts on patients' quality of life as there are no specific treatments available in Spain. Determine the main value drivers in the treatment of PN in Spain and its main unmet needs using Multi-Criteria Decision Analysis (MCDA). Methods: Literature review to synthesise relevant evidence in an evidence matrix based on the MCDA EVIDEM framework adapted to Spain. A multidisciplinary panel composed of dermatologists, hospital pharmacists and a patient weighted (5-point scale; 0 minimum importance, 5 maximum importance) and scored each criterion included in the framework (from -5 to 5 or 0 to 5 depending on the criterion). Results were discussed in a reflective group session. PN was considered a severe (3. 3 ± 0. 7) and infrequent (2. 0 ± 0. 7) disease, with high unmet needs (4. 2 ± 0. 7) mainly due to the lack of available treatments with specific indication for PN. Current off-label treatments were perceived to have limited efficacy/effectiveness (1. 8 ± 1. 1), an unfavourable long-term safety profile (2. 1 ± 0. 9) and low therapeutic impact (1. 7 ± 1. 1). The measure of patient-reported outcomes (2. 7 ± 0. 9) was perceived as important, but available tools are not specific. Although the cost of available treatments was not considered high (2. 4 ± 1. 5), experts agreed that PN is associated with moderately high other medical costs (3. 6 ± 1. 1) and indirect costs (3. 1 ± 0. 9). Experts considered that current guidelines and consensus (2. 6 ± 0. 7) are not clear on severity criteria and treatment algorithm. The quality of evidence (1. 4 ± 0. 5) of currently used off-label treatments was perceived as low due to a lack of published clinical trials. PN was considered a severe disease associated with relevant unmet needs, including the lack of specific and effective treatments for PN, the lack of consensus on the disease definition, defined severity criteria, prevalence estimations and awareness of PN in Spain.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Decision-making ; MCDA ; Multi Criteria Decision Analysis ; Multi-Criteria Decision Analysis ; Prurigo nodularis ; Unmet needs
Publicat a:	JEADV Clinical Practice, Vol. 3 Núm. 1 (march 2024) , p. 191-200, ISSN 2768-6566

DOI: 10.1002/jvc2.275

10 p, 751.4 KB

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