A MULTI-CRITERIA DECISION ANALYSIS FRAMEWORK FOR INNOVATIVE MEDICINE LISTING IN ALGERIA: DEVELOPMENT AND ILLUSTRATIVE APPLICATION TO SEMAGLUTIDE
Author(s)
Rania Maria Yettouche, PharmD1, Rafie Hani Krachni, PharmD2, El Hadia Mansouri, PharmD, PhD3, Ryad Dekhli, Postgrad4.
1Faculty of Pharmacy, University of health science of Algeirs, Algeirs, Algeria, 2Faculty of Pharmacy, University of health science of Algeirs, Algiers, Algeria, 3Ministry of Health, Algeirs, Algeria, 4Market Access and Public Affairs, NOVO NORDISK ALGERIA, Algeirs, Algeria.
1Faculty of Pharmacy, University of health science of Algeirs, Algeirs, Algeria, 2Faculty of Pharmacy, University of health science of Algeirs, Algiers, Algeria, 3Ministry of Health, Algeirs, Algeria, 4Market Access and Public Affairs, NOVO NORDISK ALGERIA, Algeirs, Algeria.
OBJECTIVES: The rapid expansion of innovative medicines, together with budgetary constraints in resource-limited health systems, increases pressure on pharmaceutical listing decisions. In Algeria, the absence of a health technology assessment body or formal evaluation framework remains a barrier to structured, evidence-based decision-making. This study developed a multi-criteria decision analysis methodology tailored to the Algerian health system and illustrated its application to semaglutide, an innovative medication for type 2 diabetes.
METHODS: This methodological study had three phases. Phase 1 reviewed criteria used by international HTA agencies and scientific societies. Phase 2 used these findings and ISPOR principles of relevance, non-redundancy, and local feasibility to construct an MCDA model weighted at domain and criterion levels, inspired by a swing-weighting method. Phase 3 applied the model to semaglutide to assess feasibility and performed sensitivity analyses across four weighting scenarios.
RESULTS: The review identified twelve criteria grouped into four domains: clinical (40%), economic (30%), organizational (15%), and ethical/social (15%). A comprehensive scoring grid (v1.0) and a lighter Starter grid (v2.0) were developed; the Starter grid was designed for immediate use by countries at an early stage of HTA institutionalization and focused on locally available criteria. Applied to semaglutide, the v1.0 grid produced a normalized global score of 71.2%, placing the product in a moderate-value category and supporting conditional listing with price negotiation, a managed-entry agreement, and reinforced monitoring. The v2.0 grid yielded 79.66% and led to the same recommendation, demonstrating model robustness. Sensitivity analyses showed the recommendation remained stable under clinical weighted scenarios but shifted under a budget-constraint scenario, identifying the economic domain as the pivotal driver.
CONCLUSIONS: The proposed MCDA framework provides a transparent, reproducible approach to guide innovative medicine listing in Algeria. Feasibility was confirmed despite partial data availability; validation by a multidisciplinary panel of national experts is the next critical step toward policy integration.
METHODS: This methodological study had three phases. Phase 1 reviewed criteria used by international HTA agencies and scientific societies. Phase 2 used these findings and ISPOR principles of relevance, non-redundancy, and local feasibility to construct an MCDA model weighted at domain and criterion levels, inspired by a swing-weighting method. Phase 3 applied the model to semaglutide to assess feasibility and performed sensitivity analyses across four weighting scenarios.
RESULTS: The review identified twelve criteria grouped into four domains: clinical (40%), economic (30%), organizational (15%), and ethical/social (15%). A comprehensive scoring grid (v1.0) and a lighter Starter grid (v2.0) were developed; the Starter grid was designed for immediate use by countries at an early stage of HTA institutionalization and focused on locally available criteria. Applied to semaglutide, the v1.0 grid produced a normalized global score of 71.2%, placing the product in a moderate-value category and supporting conditional listing with price negotiation, a managed-entry agreement, and reinforced monitoring. The v2.0 grid yielded 79.66% and led to the same recommendation, demonstrating model robustness. Sensitivity analyses showed the recommendation remained stable under clinical weighted scenarios but shifted under a budget-constraint scenario, identifying the economic domain as the pivotal driver.
CONCLUSIONS: The proposed MCDA framework provides a transparent, reproducible approach to guide innovative medicine listing in Algeria. Feasibility was confirmed despite partial data availability; validation by a multidisciplinary panel of national experts is the next critical step toward policy integration.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA402
Topic
Economic Evaluation, Health Technology Assessment, Methodological & Statistical Research
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure, Value Frameworks & Dossier Format
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas