ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1588056
This article is part of the Research TopicOptimizing GLP-1 Receptor Agonist Use: Mechanisms, Clinical Applications, and Safety ProfilesView all 11 articles
Digital multicriteria evaluation of negotiated medicines using Chinese mini-HTA: Application of structured methodologies in assessing once-weekly GLP-1 RAs for improved clinical decision-making
Provisionally accepted
- Hebei General Hospital, Shijiazhuang, China
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Background: Systematic and transparent evaluation of medicines 8 remains a global challenge. In China, structured frameworks for clinical 9 value assessment are underutilized despite improved access to negotiated 10 medicines. Once-weekly glucagon-like peptide-1 receptor agonists 11 (GLP-1 RAs) were selected as a representative case for their 12 reimbursement status and clinical and economic relevance. This study 13 applied a quantitative mini-health (mini-HTA) technology assessment to 14 support rational drug selection.1 15 Methods: A structured, three-stage methodology was employed to 16 evaluate four once-weekly GLP-1 RAs. First, a weighted scoring system 17 was established for five dimensions—pharmaceutical properties, 18 effectiveness, safety, economy, and other considerations—based on 19 expert consensus using the Quantitative Record Form for Drug 20 Evaluation and Selection in Medical Institutions. Second, evidence for 21 each dimension was systematically collected using a PICO-based search 22 strategy across guideline databases, literature sources, and official 23 documents. Third, each drug was quantitatively scored in each dimension 24 according to predefined criteria and expert-assigned weights; the total 25 scores were used to classify drugs into recommendation levels ("strongly 26 recommended," "weakly recommended," or "not recommended") to 27 guide evidence-based selection in medical institutions. 28 Results: 29 Semaglutide (77.8) and dulaglutide (76.3) achieved the highest totals, 30 driven by superior HbA1c reduction and proven cardiovascular benefit, 31 and were strongly recommended. Exenatide microspheres scored 70.2, 32 mainly owing to favourable acquisition cost, and was also strongly 33 recommended. PEG loxenatide scored 62.9, limited by narrower 34 reimbursement coverage and lower international uptake, and received a 35 weak recommendation. Safety profiles were comparable across agents. 36 Conclusion: The study demonstrates that a structured, expert-informed 37 mini-HTA framework can be feasibly applied for quantitative evaluation 38 and selection of once-weekly GLP-1 RAs in Chinese medical institutions. 39 Key differentiators among agents were efficacy (notably cardiovascular 40 benefit) and economic/policy factors, while safety differences were 41 minimal. This replicable approach improves transparency, consistency, 42 and evidence-based decision-making in clinical pharmacy and 43 institutional formulary management.
Keywords: Selection evaluation, Digital evaluation, National health insurance negotiated medicines, once-weekly GLP-1 RAs, Mini HTA
Received: 05 Mar 2025; Accepted: 27 Aug 2025.
Copyright: © 2025 Li, Qiu, Xue and Dong. 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:
Xiao Li, Hebei General Hospital, Shijiazhuang, China
Zhanjun Dong, Hebei General Hospital, Shijiazhuang, 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.