Drug formulary decision-making in two regional health authorities in British Columbia, Canada

Abstract Objectives Growing pharmaceutical demands challenge healthcare organizations to set drug funding priorities (i.e. establish a formulary list). This responsibility typically rests with pharmacy and therapeutics (P&T) committees, yet how the process transpires within regional health autho...

Full description

Saved in:
Bibliographic Details
Published in:Health policy (Amsterdam) 2008-12, Vol.88 (2), p.308-316
Main Authors: Armstrong, Kristy, Mitton, Craig, Carleton, Bruce, Shoveller, Jean
Format: Article
Language:English
Subjects:
British Columbia
Canada
Decision Making
Drugs
Formularies as Topic
Health administration
Health care industry
Health services
Internal Medicine
Interviews as Topic
Organizational
Pharmacy and Therapeutics Committee
Pharmacy and Therapeutics Committee Decision-making Organizational Qualitative research
Qualitative analysis
Qualitative research
Regional health authorities
Reimbursement
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Objectives Growing pharmaceutical demands challenge healthcare organizations to set drug funding priorities (i.e. establish a formulary list). This responsibility typically rests with pharmacy and therapeutics (P&T) committees, yet how the process transpires within regional health authorities is unclear. The purpose of this study was to construct an explanatory model of drug formulary priority-setting as it occurs within regional health authorities. Methods A grounded theory approach was employed to study the practices of two regional health authority P&T committees in British Columbia, Canada. Data sources spanned committee documents, meeting observations ( n = 4), and semi-structured interviews with committee members ( n = 15). Data analysis involved coding using the constant comparative technique and writing analytic memos. Results Regional P&T committees engaged in two activities related to drug formulary priority-setting: developing auto-substitution policies and reviewing drug addition requests. Four processes were central to decision-making: (i) negotiating margins of therapeutic advantage; (ii) seeking value for the resources allocated; (iii) interfacing between community and institutional settings; (iv) situating decisions within an organizational context. Conclusions Findings highlight opportunities for institutions to improve the fairness of agenda-setting practices, and for additional collaboration between policy-makers who prioritize drugs for publicly funded formularies applicable to institutional versus community settings.
ISSN:0168-8510
1872-6054
DOI:10.1016/j.healthpol.2008.04.006