The Importance of Clinical Context and Consistency in Methodology When Using Matching-Adjusted Indirect Comparisons (MAICs) to Compare Outcomes

Hemophilia A is rare, which makes large, randomized, controlled, statistically driven, head-to-head comparison trials difficult. Matching-adjusted indirect comparisons (MAICs) are validated statistical tools designed to help make the results of noncomparative trials more comparable. The purpose of this commentary is to provide an insight into the MAIC method, in order to assist the hemophilia community with interpretation of MAIC data. It includes a comparison of the findings from previously published MAICs comparing recombinant factor replacement options and their methodologies. As MAICs are being used more often to compare treatment options for patients with hemophilia A, it is paramount that robust and consistent methodologies for cross-trial comparisons are used and that all efficacy analysis findings are linked to factor utilization.