Evaluation of Clinical Value of Siltuximab in Castleman Disease Based on Multi-criteria Decision-making

Abstract

Objective To evaluate the clinical value of siltuximab in the treatment of Castleman disease based on multicriteria decision analysis (MCDA) and evidence and value: Impact on decision making (EVIDEM) framework. Methods The evidence matrix for quantitative analysis of MCDA was extracted through literature research, and the weight of each evaluation index was calculated by the maximum differentiation measure in conjoint analysis. Besides, the clinical value of siltuximab in the treatment of Castleman disease was analyzed quantitatively and qualitatively based on the results of expert questionnaire surveys. Results and Conclusion The clinical value score of siltuximab was 0.491, and the weight ratio of “therapeutic benefit” (15.39%), “drug effectiveness” (14.46%) and “drug safety” (11.43%) were the three largest. Among the indexes of “drug effectiveness” “drug safety” “patient reported outcome” “therapeutic benefit” and “non-medical cost”, siltuximab for Castleman disease was considered to be a more valuable treatment option than other first-line therapies. By qualitative analysis, 57% experts believed that siltuximab was a better treatment option. The indexes that contribute the most to the overall clinical value of siltuximab are “ therapeutic benefit” “drug effectiveness” and “quality of evidence”, while the indexes that have a negative impact on the clinical value of siltuximab is “drug treatment cost”.

Keywords

multi-criteria decision analysis / orphan medicinal product / Castleman disease / conjoint analysis / clinical value

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