There are plenty of different clinical and economic parameters to consider in order to choose the best treatments. RCT and consequent Mixed Treatment Comparison (MTC) are based on the assessment of one single criterion, we need to move to a transparent and systematic framework enabling decision makers to assess all relevant parameters simultaneously in order to evaluate the best intervention. In order to apply the Multiple Criteria Decision Analysis (MCDA) methodology to both clinical setting and  decision making process we suggest the application of a model of  MCDA as Clinical Multi-criteria Decision Assessment  (CMDA). In this model of CMDA, we apply the methodology of MCDA in the context of a single disease, ie to compare  biologicals in rheumatoid arthritis. Like for the general framework of MCDA, in CMDA there is not one predominant criterion; the innovative approach is to consider a “clinical consensus” for the selection of all relevant criteria (domains) and related parameters for evaluation, and the following   attribution of specific weights. This means that clinical outcome measured on a specific endpoint (parameters) will be weighted according to the importance that a clinical consensus will give to the specific domain. This helps guaranty a transparent and objective evaluation.  Results from both meta-analysis and observational studies are used by a clinical consensus after attributing weights to specific domains and related parameters. Decision will result from a related comparison of all parameters (i.e. efficacy, safety). The match will yield a score (in absolute value) that link each parameter with a specific intervention, and then a final score for each treatment. The higher is the final score; the most appropriate is the intervention to treat disease considering all criteria (domain and parameters).  The results will allow physicians evaluate best clinical treatment considering at the same time all relevant criteria.