Informing Hospital Formulary Decisions in China: A Multi-Criteria Value Framework for GLP-1 Receptor Agonists

Area of Science:

• Pharmacoeconomics
• Health Services Research
• Clinical Pharmacy

Background:

• Glucagon-like peptide-1 (GLP-1) receptor agonists offer dual benefits for glycemic control and weight reduction.
• Despite inclusion in China's National Reimbursement Drug List, hospital-level adoption of GLP-1 receptor agonists faces challenges.
• A structured evaluation framework is essential for integrating these drugs into hospital formularies.

Purpose of the Study:

• To develop a comprehensive clinical evaluation system for GLP-1 receptor agonists in public hospital drug selection.
• To provide a systematic and quantifiable tool for rational selection and implementation of GLP-1 receptor agonists (GLP-1RAs).
• To enhance the scientific basis for hospital formulary decisions regarding GLP-1RAs.

Main Methods:

• Integration of the Delphi method and multi-criteria decision analysis (MCDA).
• Utilized literature review, expert consultations, and questionnaire surveys for indicator selection and weighting.
• Developed a three-tier evaluation system with primary, secondary, and tertiary indicators.

Main Results:

• Established a three-tier system with 4 primary, 8 secondary, and 17 tertiary indicators.
• "Clinical Value" (0.5373) received the highest weight, followed by "Hospital Admission Demand" (0.1924) and "Hospital Management" (0.1379).
• Key tertiary indicators influencing decisions included "Cost-Effectiveness Advantage," "Glycosylated Hemoglobin," "Cardiovascular, Hepatic, and Renal Benefits," "Addressing Unmet Clinical Needs," and "Hypoglycemia Incidence."

Conclusions:

• This study addresses the gap in clinical evaluation research for GLP-1RAs in China.
• The proposed evaluation system offers scientific support for hospital pharmaceutical management, medical insurance, and drug procurement.
• Promotes value-based hospital drug selection strategies for GLP-1 receptor agonists.