Looking at the Map, Together: Modeling Treatment Center Location Selection and its Effects on Access to Gene Therapy in Brazil

Choosing at how many and which treatment centers to offer a gene therapy to patients is a crucial decision which impacts how far the treatment has to be transported and how far patients have to travel to receive treatment. Many gene therapies are for patients with severe diseases that make it diff...

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Main Author: Wertheimer, Sarah R.
Other Authors: Goentzel, Jarrod
Format: Thesis
Published: Massachusetts Institute of Technology 2024
Online Access:https://hdl.handle.net/1721.1/157099
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author Wertheimer, Sarah R.
author2 Goentzel, Jarrod
author_facet Goentzel, Jarrod
Wertheimer, Sarah R.
author_sort Wertheimer, Sarah R.
collection MIT
description Choosing at how many and which treatment centers to offer a gene therapy to patients is a crucial decision which impacts how far the treatment has to be transported and how far patients have to travel to receive treatment. Many gene therapies are for patients with severe diseases that make it difficult to travel. On the other hand, cold chain requirements make shorter transportation preferable for gene therapies, and few centers have prior experience handling them. Using multi-criteria optimization modeling paired with local input, this thesis explores different approaches to the gene therapy treatment center location selection decision and how these approaches would affect patients’ geographic accessibility to treatment. We focus on Brazil and a specific gene therapy product as our case study. We interview local pharmaceutical company employees to understand the stakeholders involved in this decision and the approaches being considered. We model how these approaches would affect patients’ geographic accessibility to treatment and discuss potential modifications to our model. Finally, by means of an interactive workshop, we explore the decision-making discussion between stakeholders in choosing which approach to follow. We find that the approaches under consideration result in a wide range of geographic accessibility for patients. Early stage decisions have impacts across stages, and even therapies, due to a reluctance to select new locations. Patients in the northwest of Brazil would need stakeholders to consider candidate locations beyond government reference centers or those with gene therapy experience, in order to have a treatment center nearby. Regarding facilitation, we find that quick, low-stakes modeling and joint discussion could allow stakeholders to consider approaches they might not otherwise consider.
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spelling mit-1721.1/1570992024-10-03T03:34:25Z Looking at the Map, Together: Modeling Treatment Center Location Selection and its Effects on Access to Gene Therapy in Brazil Wertheimer, Sarah R. Goentzel, Jarrod Massachusetts Institute of Technology. Institute for Data, Systems, and Society Choosing at how many and which treatment centers to offer a gene therapy to patients is a crucial decision which impacts how far the treatment has to be transported and how far patients have to travel to receive treatment. Many gene therapies are for patients with severe diseases that make it difficult to travel. On the other hand, cold chain requirements make shorter transportation preferable for gene therapies, and few centers have prior experience handling them. Using multi-criteria optimization modeling paired with local input, this thesis explores different approaches to the gene therapy treatment center location selection decision and how these approaches would affect patients’ geographic accessibility to treatment. We focus on Brazil and a specific gene therapy product as our case study. We interview local pharmaceutical company employees to understand the stakeholders involved in this decision and the approaches being considered. We model how these approaches would affect patients’ geographic accessibility to treatment and discuss potential modifications to our model. Finally, by means of an interactive workshop, we explore the decision-making discussion between stakeholders in choosing which approach to follow. We find that the approaches under consideration result in a wide range of geographic accessibility for patients. Early stage decisions have impacts across stages, and even therapies, due to a reluctance to select new locations. Patients in the northwest of Brazil would need stakeholders to consider candidate locations beyond government reference centers or those with gene therapy experience, in order to have a treatment center nearby. Regarding facilitation, we find that quick, low-stakes modeling and joint discussion could allow stakeholders to consider approaches they might not otherwise consider. S.M. 2024-10-02T17:30:26Z 2024-10-02T17:30:26Z 2024-09 2024-09-16T19:32:19.477Z Thesis https://hdl.handle.net/1721.1/157099 Attribution 4.0 International (CC BY 4.0) Copyright retained by author(s) https://creativecommons.org/licenses/by/4.0/ application/pdf Massachusetts Institute of Technology
spellingShingle Wertheimer, Sarah R.
Looking at the Map, Together: Modeling Treatment Center Location Selection and its Effects on Access to Gene Therapy in Brazil
title Looking at the Map, Together: Modeling Treatment Center Location Selection and its Effects on Access to Gene Therapy in Brazil
title_full Looking at the Map, Together: Modeling Treatment Center Location Selection and its Effects on Access to Gene Therapy in Brazil
title_fullStr Looking at the Map, Together: Modeling Treatment Center Location Selection and its Effects on Access to Gene Therapy in Brazil
title_full_unstemmed Looking at the Map, Together: Modeling Treatment Center Location Selection and its Effects on Access to Gene Therapy in Brazil
title_short Looking at the Map, Together: Modeling Treatment Center Location Selection and its Effects on Access to Gene Therapy in Brazil
title_sort looking at the map together modeling treatment center location selection and its effects on access to gene therapy in brazil
url https://hdl.handle.net/1721.1/157099
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