RT journal article
T1 Determining what represents value in the treatment of prurigo nodularis and its key unmet needs in Spain through Multi-Criteria Decision Analysis
A1 Silvestre, J.F.
A1 Tribó, M.J.
A1 Armario Hita, José Carlos
A1 Calleja-Hernández, M.Á.
A1 Ortiz-Frutos, F.J.
A1 Poveda, J.L.
A1 Shepherd, J.
A1 Serra Baldrich, E.
A2 Cirugía
A2 Medicina
K1 Decision-making
K1 MCDA
K1 Multi Criteria Decision Analysis
K1 Prurigo nodularis
K1 Unmet needs
AB Background: Prurigo nodularis (PN) is a chronic, debilitating dermatologicdisease characterised by the presence of highly pruritic nodular lesions. PNhighly impacts on patients' quality of life as there are no specific treatmentsavailable in Spain.Objectives: Determine the main value drivers in the treatment of PN in Spainand its main unmet needs using Multi‐Criteria Decision Analysis (MCDA).Methods: Literature review to synthesise relevant evidence in an evidencematrix based on the MCDA EVIDEM framework adapted to Spain. Amultidisciplinary panel composed of dermatologists, hospital pharmacists anda patient weighted (5‐point scale; 0 minimum importance, 5 maximumimportance) and scored each criterion included in the framework (from −5 to5 or 0 to 5 depending on the criterion). Results were discussed in a reflectivegroup 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 availabletreatments with specific indication for PN. Current off‐label treatments wereperceived to have limited efficacy/effectiveness (1.8 ± 1.1), an unfavourablelong‐term safety profile (2.1 ± 0.9) and low therapeutic impact (1.7 ± 1.1). Themeasure of patient‐reported outcomes (2.7 ± 0.9) was perceived as important,but available tools are not specific. Although the cost of available treatmentswas not considered high (2.4 ± 1.5), experts agreed that PN is associated withmoderately 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 notclear 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 alack of published clinical trials.
PB John Wiley and Sons Inc
SN 2768-6566
YR 2024
FD 2024
LK http://hdl.handle.net/10498/33671
UL http://hdl.handle.net/10498/33671
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 08-nov-2026