%0 Journal Article 
%A Silvestre, J.F.
%A Tribó, M.J.
%A Armario Hita, José Carlos
%A Calleja-Hernández, M.Á.
%A Ortiz-Frutos, F.J.
%A Poveda, J.L.
%A Shepherd, J.
%A Serra Baldrich, E.
%T Determining what represents value in the treatment of prurigo nodularis and its key unmet needs in Spain through Multi-Criteria Decision Analysis
%D 2024
%@ 2768-6566
%U http://hdl.handle.net/10498/33671
%X Background: 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.
Objectives: 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.
Results: 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.
%K Decision-making
%K MCDA
%K Multi Criteria Decision Analysis
%K Prurigo nodularis
%K Unmet needs
%~ Universidad de Cádiz