Priority setting in a hospital drug formulary: a qualitative case study and evaluation

Martin, Douglas K.; Hollenberg, Daniel; MacRae, Sue; Madden, Shannon; Сингер, Петер

doi:10.1016/s0168-8510(03)00063-0

Cited by 46 publications

(47 citation statements)

References 17 publications

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“…The literature points to clusters of factors affecting decision-making as well as complexity in the decision-making process. Martin et al [64] in a qualitative case study of priority setting (using key document review, interviews, and observations) for new drugs in a hospital formulary in Toronto, Canada, found that formulary decisions are based on a complex cluster of factors including benefit, toxicity, ability of the nurse to administer the drug, and so on. Decision-making seems to be opaque in the sense that the goals of the committees involved in formulary decisions were unclear and the focus on the clinical nature of the drugs did not match the financial factors, which they often needed to consider.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the use of economic evaluation in local decision-making

2008

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Section: Discussionmentioning

confidence: 99%

A systematic review of the use of economic evaluation in local decision-making

2008

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“…Martin et al [14], describing the decision making process to list a new drug by the Pharmacy and Therapeutics Committee (P&T) in three teaching hospitals in Toronto, Canada, reported that formal pharmacoeconomic analyses (e.g. cost-effectiveness analysis) were rarely used.…”

Section: Hospital Drug and Therapeutics Committees (Dtcs)mentioning

confidence: 99%

Hospital Drug and Therapeutics Committees in Australia: is there a role for economic evaluation at the institutional level?

Gallego

2011

Int J Clin Pharm

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Decisions about spending on medicines occur at different levels in the Australian health care system. This commentary describes the role of economic evaluation at the institutional (public hospital) level. In contrast to the decisions taken at the level of Federal subsidy (listing on the Pharmaceutical Benefits Scheme) formal pharmacoeonomic data analyses are usually not available, and arguably often not relevant to decision making within the public hospital setting. Future research is needed to develop and explore models of best practice and how to incorporate pharmacoeconomic evidence into local decisions.

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“…For instance, there have been a number of investigations of priority setting in Canadian healthcare organizations based on the Accountability for Reasonableness (A4R) framework (Bell et al, 2004;Madden et al, 2005;Martin et al, 2003). Other Canadian research into priority setting and resource allocation also has been selfcharacterized as case studies, reporting results in the form of themes developed inductively Patten et al, 2005).…”

Section: The Current State Of Qualitative Methods In Priority Settingmentioning

confidence: 99%

Qualitative methodologies in health‐care priority setting research

2009

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Priority setting research in health economics has traditionally employed quantitative methodologies and been informed by post-positivist philosophical assumptions about the world and the nature of knowledge. These approaches have been rewarded with well-developed and validated tools. However, it is now commonly noted that there has been limited uptake of economic analysis into actual priority setting and resource allocation decisions made by health-care systems. There seem to be substantial organizational and political barriers. The authors argue in this paper that understanding and addressing these barriers will depend upon the application of qualitative research methodologies. Some efforts in this direction have been attempted; however these are theoretically under-developed and seldom rooted in any of the established qualitative research traditions. Two such approaches - narrative inquiry and discourse analysis - are highlighted here. These are illustrated with examples drawn from a real-world priority setting study. The examples demonstrate how such conceptually powerful qualitative traditions produce distinctive findings that offer unique insight into organizational contexts and decision-maker behavior. We argue that such investigations offer untapped benefits for the study of organizational priority setting and thus should be pursued more frequently by the health economics research community.

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Priority setting in a hospital drug formulary: a qualitative case study and evaluation

Cited by 46 publications

References 17 publications

A systematic review of the use of economic evaluation in local decision-making

A systematic review of the use of economic evaluation in local decision-making

Hospital Drug and Therapeutics Committees in Australia: is there a role for economic evaluation at the institutional level?

Qualitative methodologies in health‐care priority setting research

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