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

Kristy Armstrong, Craig Mitton, Bruce Carleton and Jean Shoveller

Health Policy, 2008, vol. 88, issue 2-3, 308-316

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.

Keywords: Pharmacy; and; Therapeutics; Committee; Decision-making; Organizational; Qualitative; research (search for similar items in EconPapers)
Date: 2008
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Citations: View citations in EconPapers (5)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:88:y:2008:i:2-3:p:308-316

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