{
  "schema_version": "1.0",
  "thresholds": {
    "NICE_standard": {"low_GBP": 20000, "high_GBP": 30000, "label": "£20-30k/QALY"},
    "NICE_end_of_life": {"low_GBP": 50000, "high_GBP": 70000, "label": "£50-70k/QALY (EoL)"},
    "ICER_US": {"low_USD": 50000, "high_USD": 150000, "label": "$50-150k/QALY"},
    "CADTH": {"threshold_CAD": 50000, "label": "C$50k/QALY"},
    "PBAC": {"threshold_AUD": 50000, "label": "A$50k/QALY (informal)"},
    "HIRA_1x_GDP": {"threshold_KRW": 38000000, "label": "1배 GDP per capita ≈ 38,000,000 KRW/QALY"},
    "HIRA_2x_GDP": {"threshold_KRW": 76000000, "label": "2배 GDP per capita ≈ 76,000,000 KRW/QALY (희귀 등 예외)"},
    "HAS_SMR_ASMR": {"levels": ["I major", "II important", "III modere", "IV mineur", "V insuffisant"], "label": "SMR/ASMR qualitative"},
    "G-BA_AMNOG": {"levels": [1, 2, 3, 4, 5, 6], "label": "AMNOG Stufe 1=major to 6=less"},
    "JP_C2H": {"threshold_JPY": 5000000, "label": "¥5M/QALY ≈ KRW 4,500만"}
  },
  "drugs": [
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "annual_cost_KRW_estimate": 8400000, "weight_loss_pct_mean": 14.9, "MACE_HR": 0.80, "T2DM_prevention_HR": 0.27, "MASLD_remission_OR": 2.6, "HFpEF_KCCQ_delta": 7.8, "fracture_safety": "neutral", "sarcopenia_safety": "concern: 30-40% lean mass loss"},
    {"drug_id": "tirzepatide_15mg", "brand": "Zepbound", "annual_cost_KRW_estimate": 9600000, "weight_loss_pct_mean": 22.5, "MACE_HR": 0.78, "T2DM_prevention_HR": 0.18, "MASLD_remission_OR": 3.4, "HFpEF_KCCQ_delta": 10.2, "fracture_safety": "neutral", "sarcopenia_safety": "concern: 25-35% lean mass loss"},
    {"drug_id": "liraglutide_3.0mg", "brand": "Saxenda", "annual_cost_KRW_estimate": 7200000, "weight_loss_pct_mean": 8.0, "MACE_HR": 0.87, "T2DM_prevention_HR": 0.21, "MASLD_remission_OR": 1.8, "HFpEF_KCCQ_delta": 4.5, "fracture_safety": "neutral", "sarcopenia_safety": "concern: 20-30% lean mass loss"},
    {"drug_id": "CagriSema", "brand": "CagriSema", "annual_cost_KRW_estimate": null, "weight_loss_pct_mean": 22.7, "MACE_HR": null, "T2DM_prevention_HR": null, "MASLD_remission_OR": null, "HFpEF_KCCQ_delta": null, "fracture_safety": "TBD", "sarcopenia_safety": "TBD: amylin theoretical lean mass sparing"},
    {"drug_id": "MariTide", "brand": "MariTide", "annual_cost_KRW_estimate": null, "weight_loss_pct_mean": 19.5, "MACE_HR": null, "T2DM_prevention_HR": null, "MASLD_remission_OR": null, "HFpEF_KCCQ_delta": null, "fracture_safety": "TBD", "sarcopenia_safety": "TBD: monthly dosing"},
    {"drug_id": "retatrutide", "brand": "retatrutide", "annual_cost_KRW_estimate": null, "weight_loss_pct_mean": 24.2, "MACE_HR": null, "T2DM_prevention_HR": null, "MASLD_remission_OR": null, "HFpEF_KCCQ_delta": null, "fracture_safety": "TBD", "sarcopenia_safety": "TBD"},
    {"drug_id": "orforglipron", "brand": "orforglipron", "annual_cost_KRW_estimate": null, "weight_loss_pct_mean": 14.7, "MACE_HR": null, "T2DM_prevention_HR": null, "MASLD_remission_OR": null, "HFpEF_KCCQ_delta": null, "fracture_safety": "TBD", "sarcopenia_safety": "TBD: oral dosing"},
    {"drug_id": "survodutide", "brand": "survodutide", "annual_cost_KRW_estimate": null, "weight_loss_pct_mean": 18.7, "MACE_HR": null, "T2DM_prevention_HR": null, "MASLD_remission_OR": 4.1, "HFpEF_KCCQ_delta": null, "fracture_safety": "TBD", "sarcopenia_safety": "TBD: GCGR may preserve lean mass"},
    {"drug_id": "amycretin", "brand": "amycretin", "annual_cost_KRW_estimate": null, "weight_loss_pct_mean": 22.0, "MACE_HR": null, "T2DM_prevention_HR": null, "MASLD_remission_OR": null, "HFpEF_KCCQ_delta": null, "fracture_safety": "TBD", "sarcopenia_safety": "TBD"},
    {"drug_id": "setmelanotide", "brand": "Imcivree", "annual_cost_KRW_estimate": 320000000, "weight_loss_pct_mean": 23.0, "MACE_HR": null, "T2DM_prevention_HR": null, "MASLD_remission_OR": null, "HFpEF_KCCQ_delta": null, "fracture_safety": "TBD", "sarcopenia_safety": "limited data"},
    {"drug_id": "naltrexone_bupropion", "brand": "Contrave", "annual_cost_KRW_estimate": 2160000, "weight_loss_pct_mean": 5.0, "MACE_HR": 0.95, "T2DM_prevention_HR": 0.65, "MASLD_remission_OR": 1.2, "HFpEF_KCCQ_delta": 1.2, "fracture_safety": "neutral", "sarcopenia_safety": "neutral"},
    {"drug_id": "phentermine", "brand": "phentermine", "annual_cost_KRW_estimate": 600000, "weight_loss_pct_mean": 5.8, "MACE_HR": null, "T2DM_prevention_HR": null, "MASLD_remission_OR": null, "HFpEF_KCCQ_delta": null, "fracture_safety": "neutral", "sarcopenia_safety": "neutral"},
    {"drug_id": "orlistat", "brand": "Xenical", "annual_cost_KRW_estimate": 1080000, "weight_loss_pct_mean": 3.0, "MACE_HR": 0.96, "T2DM_prevention_HR": 0.62, "MASLD_remission_OR": 1.4, "HFpEF_KCCQ_delta": 0.8, "fracture_safety": "neutral", "sarcopenia_safety": "neutral"}
  ]
}