1 / 10

About the study

A pilot study examining criteria used to select drugs for hospital, provincial and national formularies J Robertson, D Newby, T Pillay, E. Walkom. About the study. Questionnaire survey Members of Australian PBAC/ESC Members of 6 provincial PTCs in South Africa

kostya
Download Presentation

About the study

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A pilot study examining criteria used to select drugs for hospital, provincial and national formularies J Robertson, D Newby, T Pillay, E. Walkom

  2. About the study • Questionnaire survey • Members of Australian PBAC/ESC • Members of 6 provincial PTCs in South Africa • Participants in pharmacoeconomics short course • Objectives of the study • Establish importance of 22 criteria for selecting drugs for inclusion in national, provincial or hospital formularies • Compare ratings of criteria between 3 groups surveyed

  3. Results • Clinical factors • Efficacy and safety were most important factors • Availability of other treatment options important • Quality of life less important than efficacy, safety • Cost factors • Cost-effectiveness important criterion in SA • Cost offsets ranked more highly in SA • Pharmacological factors varied by setting • Other factors • External pressure sometimes an influence in all settings

  4. Our intentions • Survey instrument • Decision-making criteria, information sources, understanding of clinical & economic terms • Australia: national, hospital P&T committee • Feedback responses on importance of criteria • Explore complexity using hypothetical scenarios • South Africa: provincial PTCs • ? Discuss scenarios with committee members • Others: opportunistic • Short course participants, other contacts • ? Survey only

  5. Variable response rates • Pilot in Australian hospital area PTC (postal) • 2/17 responses, no interest in phase II • SA PTCs, (completed as part of meeting) • 100% response rate but limited time to complete • SA PTC (started in meeting, to return by post) • 0% response, Relevance of participating? • Threatening questions? Lack of interest? • Modified for Australian PBAC/ESC (postal) • 9 PBAC, 2 ESC members responded • Short course (completed as part of workshop) • 100% response rate

  6. Scientifically rational description of decision-making • Survey did not focus on specific examples • Importance of criteria across all decisions • Could not identify when criteria may be more or less important • Could not capture complexity of decisions • ? Expected responses, consistent with NDP • Modified survey for PBAC/ESC • How important is criterion for decision-making? • How important should it be for decision-making?

  7. Uncertainty in interpretation of terms • Survey in English; pilot tested Australia, SA • Aware of ‘difficult’ knowledge questions • Assessing capacity of committee, not individuals • Modified approach for more recent surveys • No chance to clarify questions, responses • Meaning of cost-effectiveness (Doubilet 1986) • Cost saving • Effective • Cost savings with equal or better outcomes • Having additional benefits worth additional cost

  8. Failed to capture complexity of decision-making and engage decision-makers • Opinions and views of whole committee may not be sum of individual views • Not account for group dynamics • Time pressure to complete complex survey may compromise quality of responses • Work not of sufficient interest or perceived importance to encourage responses • Threatening nature of knowledge questions may have discouraged completion of survey

  9. Our lessons • Survey too complex; tried to do too much • Knowledge questions were threatening • Not appropriate method for capturing complexities of decision-making process • Need examples to anchor questions • Trade-off quantity vs quality of information • Surveys - larger numbers, variety of settings, low cost • Jenkings & Barber SocSciMed 2004;58(9):1757-1766 observed meetings, analysed taped discussions, assessed local context

More Related