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A Multiattribute Model for Evaluating the Benefit-Risk Profiles of Treatment Alternatives

Author

Listed:
  • James C. Felli

    (Eli Lilly & Company, Indianapolis, IN, felli_james_c@lilly.com)

  • Rebecca A. Noel

    (Eli Lilly & Company, Indianapolis, IN)

  • Patrizia A. Cavazzoni

    (Eli Lilly & Company, Indianapolis, IN)

Abstract

The assessment of the benefits and risks associated with a medicine's use requires careful consideration of a wealth of information of varying format and quality, ranging from efficacy and safety data derived from randomized clinical trials to statistical results from health outcomes studies to spontaneously reported adverse events. Contrary to the expectations of patients, physicians, and regulators, the literature offers little guidance as to how to strike an appropriate balance between benefit and risk. Although a qualitative listing of a medicine's benefits and risks is useful, much could be gained from a systematic and transparent process to evaluate a medicine's pre- and postmarketing performance. The authors propose a representational model based on multicriteria decision analysis that can incorporate both evaluative judgments from different perspectives (e.g., physician, patient) and quantitative data to inform tradeoffs between multiple benefit and multiple risk elements in a logically consistent and transparent manner. The model is designed to highlight the relative merits and deficits of treatment alternatives in well-defined and specific contexts. It is intended to serve as a common platform to facilitate focused benefit-risk tradeoff discussions between scientists, physicians, regulatory authorities, and pharmaceutical companies, and to assist in the communication of clear and consistent messages regarding those tradeoffs.

Suggested Citation

  • James C. Felli & Rebecca A. Noel & Patrizia A. Cavazzoni, 2009. "A Multiattribute Model for Evaluating the Benefit-Risk Profiles of Treatment Alternatives," Medical Decision Making, , vol. 29(1), pages 104-115, January.
  • Handle: RePEc:sae:medema:v:29:y:2009:i:1:p:104-115
    DOI: 10.1177/0272989X08323299
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    References listed on IDEAS

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    1. Lynn A. Maguire, 2004. "What Can Decision Analysis Do for Invasive Species Management?," Risk Analysis, John Wiley & Sons, vol. 24(4), pages 859-868, August.
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    Cited by:

    1. Mónica D. Oliveira & Inês Mataloto & Panos Kanavos, 2019. "Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 891-918, August.

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