{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:25:36Z","timestamp":1787027136257,"version":"build-2736575974"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Systematic and transparent evaluation of medicines remains a global challenge. In China, structured frameworks for clinical value assessment are underutilized despite improved access to negotiated medicines. Once-weekly glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were selected as a representative case for their reimbursement status and clinical and economic relevance. This study applied a quantitative mini-health (mini-HTA) technology assessment to support rational drug selection.\n                      <jats:sup>1<\/jats:sup>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A structured, three-stage methodology was employed to evaluate four once-weekly GLP-1 RAs. First, a weighted scoring system was established for five dimensions\u2014pharmaceutical properties, effectiveness, safety, economy, and other considerations\u2014based on expert consensus using the Quantitative Record Form for Drug Evaluation and Selection in Medical Institutions. Second, evidence for each dimension was systematically collected using a PICO-based search strategy across guideline databases, literature sources, and official documents. Third, each drug was quantitatively scored in each dimension according to predefined criteria and expert-assigned weights; the total scores were used to classify drugs into recommendation levels (\u201cstrongly recommended,\u201d \u201cweakly recommended,\u201d or \u201cnot recommended\u201d) to guide evidence-based selection in medical institutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Semaglutide (77.8) and dulaglutide (76.3) achieved the highest totals, driven by superior HbA1c reduction and proven cardiovascular benefit, and were strongly recommended. Exenatide microspheres scored 70.2, mainly owing to favourable acquisition cost, and was also strongly recommended. PEG loxenatide scored 62.9, limited by narrower reimbursement coverage and lower international uptake, and received a weak recommendation. Safety profiles were comparable across agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study demonstrates that a structured, expert-informed mini-HTA framework can be feasibly applied for quantitative evaluation and selection of once-weekly GLP-1 RAs in Chinese medical institutions. Key differentiators among agents were efficacy (notably cardiovascular benefit) and economic\/policy factors, while safety differences were minimal. This replicable approach improves transparency, consistency, and evidence-based decision-making in clinical pharmacy and institutional formulary management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2025.1588056","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T04:20:23Z","timestamp":1758082823000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["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"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiao","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihong","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaojun","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaokai","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanjun","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S8","DOI":"10.2337\/dc22-S008","article-title":"Standards of medical care in Diabetes\u20142022","volume":"45","year":"2022","journal-title":"Diabetes Care"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.2337\/dc24-SREV","article-title":"Summary of revisions: standards of care in Diabetes\u20142024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"B3","volume-title":"IDF diabetes atlas","author":"Author anonymous","year":"2021"},{"key":"B4","doi-asserted-by":"publisher","first-page":"120484","DOI":"10.1016\/j.techfore.2020.120484","article-title":"Consensus in the Delphi method: what makes a decision change?","volume":"163","author":"Barrios","year":"2021","journal-title":"Technol. Forecast Soc. Change"},{"key":"B5","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/S2213-8587(17)30412-6","article-title":"Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis","volume":"6","author":"Bethel","year":"2018","journal-title":"lancet Diabetes and Endocrinol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2909","DOI":"10.1007\/s00210-024-03435-7","article-title":"Daily defined dose-costs have a stronger influence on antibacterial drug prescriptions in Germany than bacterial resistance: economic factors are more important than scientific evidence","volume":"398","author":"Bindel","year":"2025","journal-title":"Schmiedeb. Arch. Pharmacol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1514","DOI":"10.3390\/curroncol29030127","article-title":"Health technology assessment process for oncology drugs: impact of CADTH changes on public payer reimbursement recommendations","volume":"29","author":"Binder","year":"2022","journal-title":"Curr. Oncol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1016\/j.amjopharm.2011.09.007","article-title":"Comparison of the efficacy and tolerability profile of liraglutide, a once-daily human GLP-1 analog, in patients with type 2 diabetes\u2265 65 and< 65 years of age: a pooled analysis from phase III studies","volume":"9","author":"Bode","year":"2011","journal-title":"Am. J. Geriatric Pharmacother."},{"key":"B9","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1111\/dom.12687","article-title":"Similar efficacy and safety of once\u2010weekly dulaglutide in patients with type 2 diabetes aged\u2265 65 and< 65 years","volume":"18","author":"Boustani","year":"2016","journal-title":"Diabetes, Obes. Metabolism"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.1016\/j.jval.2022.05.015","article-title":"A comprehensive comparison of additional benefit assessment methods applied by institute for quality and efficiency in health care and european society for medical oncology for time-to-event endpoints after significant phase III trials\u2014A simulation study","volume":"25","author":"B\u00fcsch","year":"2022","journal-title":"Value Health"},{"key":"B11","first-page":"242","article-title":"Multicriteria quantitative evaluation practice of oral proton pump inhibitors","volume":"39","author":"Chaojun","year":"2022","journal-title":"Chin. J. Mod. Appl. Pharm."},{"key":"B12","doi-asserted-by":"publisher","first-page":"836","DOI":"10.3760\/cma.j.cn112138-20200704-00646","article-title":"Consensus recommendations on utilizing glucagon-like peptide-1 (GLP-1) receptor agonists in the treatment of type 2 diabetes mellitus","volume":"59","author":"Chinese Diabetes","year":"2020","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"B13","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/S0140-6736(19)31149-3","article-title":"Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial","volume":"394","author":"Gerstein","year":"2019","journal-title":"Lancet"},{"key":"B14","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1186\/s13098-023-01195-7","article-title":"Efficacy and tolerability of the subcutaneous semaglutide for type 2 diabetes patients: an updated systematic review and meta-analysis","volume":"15","author":"Hu","year":"2023","journal-title":"Diabetol. Metab. Syndr."},{"key":"B15","doi-asserted-by":"publisher","first-page":"152","DOI":"10.2165\/00019053-199610020-00007","article-title":"Hypnotics: drug selection by means of the system of objectified judgement analysis (SOJA) method","volume":"10","author":"Janknegt","year":"1996","journal-title":"Pharmacoeconomics"},{"key":"B16","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1002\/jcph.443","article-title":"Semaglutide, a once\u2010weekly human GLP\u20101 analog, does not reduce the bioavailability of the combined oral contraceptive, ethinylestradiol\/levonorgestrel","volume":"55","author":"Kapitza","year":"2015","journal-title":"J. Clin. Pharmacol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"7370","DOI":"10.1021\/acs.jmedchem.5b00726","article-title":"Discovery of the once-weekly glucagon-like peptide-1 (GLP-1) analogue semaglutide","volume":"58","author":"Lau","year":"2015","journal-title":"J. Med. Chem."},{"key":"B18","first-page":"353","article-title":"Expert guidance on clinical applications of GLP-1 recept or agonists","volume":"26","author":"Linong","year":"2018","journal-title":"Chin. J. Of Diabetes"},{"key":"B19","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.ejim.2014.03.005","article-title":"Glucagon-like peptide-1 receptor agonists for the treatment of type 2 diabetes: differences and similarities","volume":"25","author":"Lund","year":"2014","journal-title":"Eur. J. Intern Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1021\/jm500810s","article-title":"Glucagon-like Peptide-1 (GLP-1) analogs: recent advances, new possibilities, and therapeutic implications","volume":"58","author":"Manandhar","year":"2015","journal-title":"J. Med. Chem."},{"key":"B21","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1111\/dom.13888","article-title":"Glucagon-like peptide-1 receptor agonists and cardiovascular outcomes in patients with and without prior cardiovascular events: an updated meta-analysis and subgroup analysis of randomized controlled trials","volume":"22","author":"Mannucci","year":"2020","journal-title":"Diabetes Obes. Metab."},{"key":"B22","doi-asserted-by":"publisher","first-page":"3346","DOI":"10.1093\/eurheartj\/ehaa082","article-title":"Effects of glucagon-like peptide-1 receptor agonists on major cardiovascular events in patients with type 2 diabetes mellitus with or without established cardiovascular disease: a meta-analysis of randomized controlled trials","volume":"41","author":"Marsico","year":"2020","journal-title":"Eur. Heart J."},{"key":"B23","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1056\/nejmoa1603827","article-title":"Liraglutide and cardiovascular outcomes in type 2 diabetes","volume":"375","author":"Marso","year":"","journal-title":"N. Engl. J. Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","article-title":"Semaglutide and cardiovascular outcomes in patients with type 2 diabetes","volume":"375","author":"Marso","year":"","journal-title":"N. Engl. J. Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.jbi.2015.12.002","article-title":"Combining multi-criteria decision analysis and mini-health technology assessment: a funding decision-support tool for medical devices in a university hospital setting","volume":"59","author":"Martelli","year":"2016","journal-title":"J. Biomed. Inf."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3897\/pharmacia.71.e132148","article-title":"Systematic review of the efficacy and safety of GLP-1 receptor agonists in the treatment of patients with type 2 diabetes mellitus","volume":"71","author":"Petrova","year":"2024","journal-title":"Pharmacia"},{"key":"B27","first-page":"2311","article-title":"A case of acute attack of cholecystitis induced by polyethylene glycol loxenatide","volume":"42","author":"Ping","year":"2022","journal-title":"Chin. J. Hosp. Pharm."},{"key":"B28","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/S2213-8587(19)30382-1","article-title":"Exendin-based glucagon-like peptide-1 receptor agonists and anaphylactic reactions: a pharmacovigilance analysis","volume":"8","author":"Pradhan","year":"2020","journal-title":"Lancet Diabetes and Endocrinol."},{"key":"B29","first-page":"930","article-title":"Literature analysis of adverse drug reactions induced by dulaglutide","volume":"42","author":"Sha","year":"2022","journal-title":"Chin. J. Hosp. Pharm."},{"key":"B30","first-page":"2828","article-title":"Reflections on the establishment of clinical comprehensive evaluation mechanism for drugs in China","author":"Shi","year":"2020","journal-title":"China Pharm."},{"key":"B31","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1017\/S0266462320000264","article-title":"Cost-effectiveness evaluation for pricing medicines and devices: a new value-based price adjustment system in Japan","volume":"36","author":"Shiroiwa","year":"2020","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B32","first-page":"1757","article-title":"Benefit-risk assessment in drugs evaluation (in Chinese)","volume":"37","author":"Shuning","year":"2021","journal-title":"Chin. J. Clin. Pharmacol."},{"key":"B33","first-page":"315","article-title":"Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition)","volume":"13","author":"Society","year":"2021","journal-title":"Chin J. Diabetes Mellitus"},{"key":"B34","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1186\/s12902-024-01805-z","article-title":"Evaluation and comparison of efficacy and safety of tirzepatide, liraglutide and SGLT2i in patients with type 2 diabetes mellitus: a network meta-analysis","volume":"24","author":"Teng","year":"2024","journal-title":"BMC Endocr. Disord."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.18553\/jmcp.2020.26.9.1162","article-title":"HTA\u2019d in the USA: a comparison of ICER in the United States with NICE in England and Wales","volume":"26","author":"Thokala","year":"2020","journal-title":"J. Manag. Care and Specialty Pharm."},{"key":"B36","doi-asserted-by":"publisher","first-page":"e28","DOI":"10.1017\/S0266462325000224","article-title":"Redefining value assessment and healthcare funding priorities for medicines: the journey to patient-centric decision making in APAC \u2013 a systematic literature review","volume":"41","author":"Wong-Rieger","year":"2025","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1244432","DOI":"10.3389\/fendo.2023.1244432","article-title":"Comparison of the efficacy and safety of 10 glucagon-like peptide-1 receptor agonists as add-on to metformin in patients with type 2 diabetes: a systematic review","volume":"14","author":"Xie","year":"2023","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B38","first-page":"354","article-title":"Cardiovascular benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in type 2 diabetes: a systematic review and network meta-analysis","volume":"40","author":"Yanlan","year":"2022","journal-title":"J. Pharm. Pract. Serv."},{"key":"B39","first-page":"421","article-title":"Expert consensus on the management of diabetic patients with cardiovascular diseases (in Chinese)","volume":"60","author":"Yihong","year":"2021","journal-title":"Chin. J. Intern Med."},{"key":"B40","first-page":"447","article-title":"A quick guideline for drug evaluation and selection in Chinese medical institutions (the second edition)","volume":"42","author":"Zhao","year":"2023","journal-title":"Her. Med."},{"key":"B41","first-page":"1457","article-title":"A quick guideline for drug evaluation and selection in Chinese medicalinstitutions","volume":"39","author":"Zhao","year":"2020","journal-title":"Her. Pharm."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1588056\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T04:20:25Z","timestamp":1758082825000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1588056\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":41,"alternative-id":["10.3389\/fphar.2025.1588056"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2025.1588056","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,17]]},"article-number":"1588056"}}