ORIGINAL RESEARCH article
Front. Health Serv.
Sec. Cost and Resource Allocation
Volume 5 - 2025 | doi: 10.3389/frhs.2025.1650709
This article is part of the Research TopicInnovative Value-Based Medicine: Lessons from China's Healthcare EvolutionView all 10 articles
A multi-stakeholder multicriteria decision analysis for implantable medical devices assessment in China
Provisionally accepted
- 1School of Pharmacy, Nanjing medical university, Nanjing, China
- 2China Pharmaceutical University School of International Pharmaceutical Business, Nanjing, China
- 3The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
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Objectives. This study aims to develop a standardized multicriteria decision analysis (MCDA) framework tailored for implantable medical devices in China, addressing the challenges of inconsistent evaluation processes under China's evolving healthcare financing policies. Methods. A mixed-methods design combining a discrete choice experiment (DCE) and MCDA was employed. Six criteria (clinical effectiveness, clinical safety, innovation, disease severity, implementation capacity, and cost) were identified through literature reviews and expert consultations. A DCE survey with 540 multi-stakeholder participants (decision-makers, HTA experts, clinicians, hospital administrators, and citizens) was conducted to derive criterion weights using mixed logit models. The framework was validated through a real-world case study assessing endoscopic linear staplers. Results. Clinical safety (35.45%) and cost (27.94%) emerged as the most critical criteria, followed by implementation capacity (16.56%) and clinical effectiveness (15.07%). Innovation (2.54%) and disease severity (2.44%) received minimal weight. The MCDA application demonstrated high inter-rater consistency (CV<0.25). Conclusions. This study proposes a transparent, stakeholder-driven framework for evaluating implantable medical devices, specifically designed to support China's healthcare policies. The framework ensures that healthcare decisions are grounded in clinical effectiveness, safety, and long-term economic viability.
Keywords: medical devices, Multicriteria decision analysis, Discrete choiceexperiment, Technology assessment, preference, China
Received: 20 Jun 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Xu, Wan, Wan and Ding. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haixia Ding, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.