A quantitative approach to benefit-risk assessment of medicines - part 1: the development of a new model using multi-criteria decision analysis

Pharmacoepidemiol Drug Saf. 2007 Jul:16 Suppl 1:S2-S15. doi: 10.1002/pds.1435.

Abstract

Purpose: One of the most important uses of benefit-risk assessment pertains to approval of new medicines by regulatory authorities and the subsequent review of these products during their life-cycle when new safety and/or efficacy data becomes available. At present, there exist no validated, well-accepted models for benefit-risk assessment that have the appropriate degree of sophistication, and as a consequence no models are widely used by regulatory authorities or industry. The aim of the study was therefore to develop a new model for benefit-risk assessment of medicines using multi-criteria decision analysis (MCDA).

Methods: The MCDA methodology was used for a systematic approach to assess the benefit risk ratio of medicines. The reasons for adopting this approach were (1) taking multiple benefit and risk criteria into account, (2) making a judgement on the evidence and potential uncertainty because of the incompleteness of evidence, and (3) making trade-offs of the benefits against risks.

Results: It was demonstrated through a seven-step approach how MCDA is used to construct the model. Ten benefit and ten risk criteria were identified to form a value tree. Then fixed scales were established for all criteria and options on the criteria were scored. Weights were assigned for each criteria using swing-weighting. Finally sensitivity analysis was carried.

Conclusions: This novel approach based on MCDA has the potential for being applied as a new tool for judging and deciding on the benefits and risks, thereby helping regulators and industry in the development and approval of new medicines and their adequate use.

MeSH terms

  • Decision Support Techniques
  • Drug-Related Side Effects and Adverse Reactions
  • Humans
  • Models, Statistical
  • Pharmaceutical Preparations / administration & dosage*
  • Pharmacoepidemiology / methods*
  • Risk Assessment
  • Risk Factors

Substances

  • Pharmaceutical Preparations