BACKGROUND Globally, the rising cost of anticancer therapy has motivated efforts to quantify the overall value of new cancer treatments. Multicriteria decision analysis offers a novel approach to incorporate multiple criteria and perspectives into value assessment. METHODS The authors recruited a diverse, multistakeholder group who identified and weighted key criteria to establish the drug assessment framework (DAF). Construct validity assessed the degree to which DAF scores were associated with past pan-Canadian Oncology Drug Review (pCODR) funding recommendations and European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS; version 1.1) scores. RESULTS The final DAF included 10 criteria: overall survival, progression-free survival, response rate, quality of life, toxicity, unmet need, equity, feasibility, disease severity, and caregiver well-being. The first 5 clinical benefit criteria represent approximately 64% of the total weight. DAF scores ranged from 0 to 300, reflecting both the expected impact of the drug and the quality of supporting evidence. When the DAF was applied to the last 60 drugs (with reviewers blinded) reviewed by pCODR (2015-2018), those drugs with positive pCODR funding recommendations were found to have higher DAF scores compared with drugs not recommended (103 vs 63; Student t test P = .0007). DAF clinical benefit criteria mildly correlated with ESMO-MCBS scores (correlation coefficient, 0.33; 95% CI, 0.009-0.59). Sensitivity analyses that varied the criteria scores did not change the results. CONCLUSIONS Using a structured and explicit approach, a criterion-based valuation framework was designed to provide a transparent and consistent method with which to value and prioritize cancer drugs to facilitate the delivery of affordable cancer care.

中文翻译：

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使用基于加权标准的方法对肿瘤药物进行价值评估。

背景技术在全球范围内，抗癌疗法成本的上涨促使人们努力量化新的癌症疗法的整体价值。多准则决策分析提供了一种将多种准则和观点纳入价值评估的新颖方法。方法作者招募了一个多元化的，多利益相关方小组，他们确定并加权了建立药物评估框架（DAF）的关键标准。构建者的有效性评估了DAF评分与过去的泛加拿大肿瘤学药物评审（pCODR）资助建议和欧洲医学肿瘤学会临床效益量表（ESMO-MCBS;版本1.1）得分相关的程度。结果最终的DAF包括10条标准：总体生存，无进展生存，缓解率，生活质量，毒性，未满足需求，公平，可行性，疾病的严重程度和照顾者的幸福感。前5个临床获益标准约占总体重的64％。DAF分数介于0到300之间，既反映了药物的预期效果，又反映了支持证据的质量。当将DAF应用于pCODR（2015-2018）审查的最后60种药物（审稿人不知情）时，发现pCODR资助建议为阳性的那些药物与不推荐的药物相比具有更高的DAF分数（103比63；学生测试P = .0007）。DAF的临床获益标准与ESMO-MCBS评分呈轻度相关（相关系数为0.33； 95％CI为0.009-0.59）。改变标准分数的敏感性分析不会改变结果。结论使用结构化和明确的方法，