Applying reflective multicriteria decision analysis to understand the value of therapeutic alternatives in the management of gestational and peripartum anaemia in Spain

BMC Pregnancy Childbirth. 2022 Feb 25;22(1):157. doi: 10.1186/s12884-022-04481-w.

Abstract

Background: The objective of the FeminFER project was to assess the value of ferric carboxymaltose following a multicriteria decision analysis in obstetrics and gynaecology in Spain.

Methods: Ferric carboxymaltose (FCM) and ferrous sulphate were evaluated using the EVIDEM framework. Ten stakeholders participated to collect different perspectives. The framework was adapted considering evidence retrieved with a PICO-S search strategy and grey literature. Criteria/subcriteria were weighted by level of relevance and an evidence-based decision-making exercise was developed in each criterion; weights and scores were combined to obtain the value of intervention relative to each criterion/subcriterion, that were further combined into the Modulated Relative Benefit-Risk Balance (MRBRB).

Results: The most important criterion favouring FCM was Compared Efficacy/Effectiveness (0.183 ± 0.07), followed by Patient Preferences (0.059 ± 0.10). Only Direct medical costs criterion favoured FS (-0.003 ± 0.03). MRBRB favoured FCM; 0.45 ± 0.19; in a scale from -1 to + 1.

Conclusions: In conclusion, considering the several criteria involved in the decision-making process, participants agreed with the use of FCM according to its MRBRB.

Keywords: Anemia; Clinical decision-making; Ferric carboxymaltose; Pregnancy; Shared decision making; Technology assessment.

Publication types

  • Systematic Review

MeSH terms

  • Anemia, Iron-Deficiency / drug therapy*
  • Decision Support Techniques*
  • Female
  • Ferric Compounds / therapeutic use*
  • Ferrous Compounds / therapeutic use*
  • Humans
  • Maltose / analogs & derivatives*
  • Maltose / therapeutic use
  • Pregnancy
  • Pregnancy Complications, Hematologic / drug therapy*
  • Risk Assessment
  • Spain / epidemiology
  • Stakeholder Participation

Substances

  • Ferric Compounds
  • Ferrous Compounds
  • ferrous sulfate
  • ferric carboxymaltose
  • Maltose