Assessing the holistic value of Danhong injection for chronic stable angina: a multi-criteria decision analysis in China

This study aimed to assess the holistic value of Danhong injection (DHI) for treating chronic stable angina (CSA) and to identify the therapeutic characteristics of DHI. The holistic value of DHI was assessed using a well-established evaluation index system including 34 criteria based on the Multi-criteria decision analysis (MCDA) model. Each criterion was rated by seven experts based on an evidence matrix comprising a literature review on DHI for treating CSA. The overall value of DHI for the treatment of CSA was evaluated by aggregating these performance scores and predetermined weights. Additionally, the contributions of each domain and criterion to the overall value estimate were calculated. Uncertainty was explored using an online retest and intra-rater correlation coefficient (ICC). We found that the comprehensive value estimate of DHI for treating CSA was 80.18 points. The domain of “safety and risk management” was the strongest contributor to the final estimated value (30.37), followed by “effectiveness” (23.75). The criteria “size of population affected by disease” (3.79), “risk control of toxic medicinal materials” (4.38), “comparative non-medical costs” (1.14), “clarity of the mechanism of drug action” (0.6), “sustainability of medicinal materials resources” (1.91) and “patient compliance” (4.59) were found to be the most significant contributors to the overall value estimate across the 6 evaluation domains. The initial scores for DHI over the two rounds showed good consistency across panelists (ICC = 0.886 [0.858–0.909]). Compared with standard treatment alone, DHI was perceived as being at a “good level” intervention.