Natasha Burke1, James M Bowen2, Sue Troyan3, Jathishinie Jegathisawaran4, Carolyn Gosse5, Marita Tonkin6, Sandra Kagoma7, Ron Goeree8, Anne Holbrook9. 1. MSc, is with McMaster University and St Joseph's Health-care Hamilton (Programs for Assessment of Technology in Health [PATH]), Hamilton, Ontario. 2. RPh, BScPhm, MSc, is with McMaster University and St Joseph's Healthcare Hamilton (Programs for Assessment of Technology in Health [PATH]), Hamilton, Ontario. 3. is with St Joseph's Healthcare Hamilton, Hamilton, Ontario. 4. MHEcon, was, at the time of this study, with McMaster University and St Joseph's Healthcare Hamilton (Programs for Assessment of Technology in Health [PATH]), Hamilton, Ontario. 5. RPh, ACPR, PharmD, is with St Joseph's Healthcare Hamilton, Hamilton, Ontario. 6. RPh, BScPhm, PharmD, ACPR, is with Hamilton Health Sciences, Hamilton, Ontario. 7. DiplPharm, BScPharm, MBA/HCM, is with Brant Community Healthcare System, Brantford, Ontario. 8. MA, is with McMaster University, Hamilton, Ontario. 9. MD, PharmD, MSc, FRCPC, is with McMaster University and St Joseph's Healthcare Hamilton, Hamilton, Ontario.
Abstract
BACKGROUND: Expenditures on drugs dispensed and administered to patients in Canadian hospitals have been estimated at $2.4 billion per year. Pharmacy and therapeutics (P&T) committees play a key role in the evaluation and management of drug therapies in this setting. Hospitals differ with respect to the composition of these committees, their members' expertise, and the processes used for making formulary decisions. OBJECTIVES: To examine the current processes for formulary drug review from the perspective of P&T committees and their individual members, and to examine the needs and preferences of these stakeholders related to evidence review and potential collaborative drug review processes within a large Local Health Integration Network (LHIN) in Ontario. METHODS: Twenty-three sites within 10 hospital corporations in LHIN 4 (Hamilton Niagara Haldimand Brant) were recruited. A 2-part questionnaire was developed and pretested for clarity and comprehensiveness. The institution profile section of the questionnaire was to be completed by pharmacy directors and the P&T section by committee members. RESULTS: Ten pharmacy directors and 28 committee members representing 10 P&T committees responded. A mean of 6.4 new drug requests were reviewed annually by each P&T committee. Across the LHIN, the workload associated with reviewing submissions for new drugs to be added to the formulary represented 0.84 full-time equivalent. The quality of clinical evidence in the drug submissions was rated more favourably than the quality of economic evidence; furthermore, the use of economic evidence was limited by a lack of health economics expertise within the committees. A centralized review process for the LHIN was perceived as beneficial to improve efficiency, the quality of review, and standardization, and also to reduce costs. CONCLUSIONS: Across the Hamilton Niagara Haldimand Brant LHIN, considerable time and resources are spent on the review of potential new drugs for addition to the hospitals' formularies. A standardized formulary review process, with greater use of provincial and national drug reviews, would likely benefit all LHINs.
BACKGROUND: Expenditures on drugs dispensed and administered to patients in Canadian hospitals have been estimated at $2.4 billion per year. Pharmacy and therapeutics (P&T) committees play a key role in the evaluation and management of drug therapies in this setting. Hospitals differ with respect to the composition of these committees, their members' expertise, and the processes used for making formulary decisions. OBJECTIVES: To examine the current processes for formulary drug review from the perspective of P&T committees and their individual members, and to examine the needs and preferences of these stakeholders related to evidence review and potential collaborative drug review processes within a large Local Health Integration Network (LHIN) in Ontario. METHODS: Twenty-three sites within 10 hospital corporations in LHIN 4 (Hamilton Niagara Haldimand Brant) were recruited. A 2-part questionnaire was developed and pretested for clarity and comprehensiveness. The institution profile section of the questionnaire was to be completed by pharmacy directors and the P&T section by committee members. RESULTS: Ten pharmacy directors and 28 committee members representing 10 P&T committees responded. A mean of 6.4 new drug requests were reviewed annually by each P&T committee. Across the LHIN, the workload associated with reviewing submissions for new drugs to be added to the formulary represented 0.84 full-time equivalent. The quality of clinical evidence in the drug submissions was rated more favourably than the quality of economic evidence; furthermore, the use of economic evidence was limited by a lack of health economics expertise within the committees. A centralized review process for the LHIN was perceived as beneficial to improve efficiency, the quality of review, and standardization, and also to reduce costs. CONCLUSIONS: Across the Hamilton Niagara Haldimand Brant LHIN, considerable time and resources are spent on the review of potential new drugs for addition to the hospitals' formularies. A standardized formulary review process, with greater use of provincial and national drug reviews, would likely benefit all LHINs.
Authors: Linda S Tyler; Sabrina W Cole; J Russell May; Mirta Millares; Michael A Valentino; Lee C Vermeulen; Andrew L Wilson Journal: Am J Health Syst Pharm Date: 2008-07-01 Impact factor: 2.637
Authors: Mark Tatangelo; George Tomlinson; J Michael Paterson; Vandana Ahluwalia; Alex Kopp; Tara Gomes; Nick Bansback; Claire Bombardier Journal: JAMA Netw Open Date: 2019-12-02