IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v88y2008i2-3p308-316.html
   My bibliography  Save this article

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

Author

Listed:
  • Armstrong, Kristy
  • Mitton, Craig
  • Carleton, Bruce
  • Shoveller, Jean

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.

Suggested Citation

  • Armstrong, Kristy & Mitton, Craig & Carleton, Bruce & Shoveller, Jean, 2008. "Drug formulary decision-making in two regional health authorities in British Columbia, Canada," Health Policy, Elsevier, vol. 88(2-3), pages 308-316, December.
    • Handle: RePEc:eee:hepoli:v:88:y:2008:i:2-3:p:308-316
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(08)00099-7
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Martin, Douglas K. & Giacomini, Mita & Singer, Peter A., 2002. "Fairness, accountability for reasonableness, and the views of priority setting decision-makers," Health Policy, Elsevier, vol. 61(3), pages 279-290, September.
    2. Martin, Douglas K. & Hollenberg, Daniel & MacRae, Sue & Madden, Shannon & Singer, Peter, 2003. "Priority setting in a hospital drug formulary: a qualitative case study and evaluation," Health Policy, Elsevier, vol. 66(3), pages 295-303, December.
    3. Sassi, Franco, 2003. "Setting priorities for the evaluation of health interventions: when theory does not meet practice," Health Policy, Elsevier, vol. 63(2), pages 141-154, February.
    4. Jenkings, K Neil & Barber, Nick, 2004. "What constitutes evidence in hospital new drug decision making?," Social Science & Medicine, Elsevier, vol. 58(9), pages 1757-1766, May.
    5. Wirtz, Veronika & Cribb, Alan & Barber, Nick, 2005. "Reimbursement decisions in health policy--extending our understanding of the elements of decision-making," Health Policy, Elsevier, vol. 73(3), pages 330-338, September.
    6. McMahon, Meghan & Morgan, Steve & Mitton, Craig, 2006. "The Common Drug Review: A NICE start for Canada?," Health Policy, Elsevier, vol. 77(3), pages 339-351, August.
    7. Mitton, Craig & Patten, San & Waldner, Howard & Donaldson, Cam, 2003. "Priority setting in health authorities: a novel approach to a historical activity," Social Science & Medicine, Elsevier, vol. 57(9), pages 1653-1663, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Branko Bo_skovic, David. P. Byrne, Arvind Magesan, 2012. "Herding Among Bureaucrats," Department of Economics - Working Papers Series 1153, The University of Melbourne.
    2. Smith, Neale & Mitton, Craig & Hall, William & Bryan, Stirling & Donaldson, Cam & Peacock, Stuart & Gibson, Jennifer L. & Urquhart, Bonnie, 2016. "High performance in healthcare priority setting and resource allocation: A literature- and case study-based framework in the Canadian context," Social Science & Medicine, Elsevier, vol. 162(C), pages 185-192.
    3. repec:clg:wpaper:2012-06 is not listed on IDEAS
    4. Wranik, Wiesława Dominika & Zielińska, Dorota Anna & Gambold, Liesl & Sevgur, Serperi, 2019. "Threats to the value of Health Technology Assessment: Qualitative evidence from Canada and Poland," Health Policy, Elsevier, vol. 123(2), pages 191-202.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Vuorenkoski, Lauri & Toiviainen, Hanna & Hemminki, Elina, 2008. "Decision-making in priority setting for medicines--A review of empirical studies," Health Policy, Elsevier, vol. 86(1), pages 1-9, April.
    2. Salome A. Bukachi & Washington Onyango-Ouma & Jared Maaka Siso & Isaac K. Nyamongo & Joseph K. Mutai & Anna Karin Hurtig & Øystein Evjen Olsen & Jens Byskov, 2014. "Healthcare priority setting in Kenya: a gap analysis applying the accountability for reasonableness framework," International Journal of Health Planning and Management, Wiley Blackwell, vol. 29(4), pages 342-361, October.
    3. Eddama, Oya & Coast, Joanna, 2008. "A systematic review of the use of economic evaluation in local decision-making," Health Policy, Elsevier, vol. 86(2-3), pages 129-141, May.
    4. Hodgetts, Katherine & Elshaug, Adam G. & Hiller, Janet E., 2012. "What counts and how to count it: Physicians’ constructions of evidence in a disinvestment context," Social Science & Medicine, Elsevier, vol. 75(12), pages 2191-2199.
    5. Gregory Merlo & Katie Page & Julie Ratcliffe & Kate Halton & Nicholas Graves, 2015. "Bridging the Gap: Exploring the Barriers to Using Economic Evidence in Healthcare Decision Making and Strategies for Improving Uptake," Applied Health Economics and Health Policy, Springer, vol. 13(3), pages 303-309, June.
    6. Mitton, Craig R. & McMahon, Meghan & Morgan, Steve & Gibson, Jennifer, 2006. "Centralized drug review processes: Are they fair?," Social Science & Medicine, Elsevier, vol. 63(1), pages 200-211, July.
    7. Razavi, S. Donya & Kapiriri, Lydia & Wilson, Michael & Abelson, Julia, 2020. "Applying priority-setting frameworks: A review of public and vulnerable populations’ participation in health-system priority setting," Health Policy, Elsevier, vol. 124(2), pages 133-142.
    8. Neale Smith & Craig Mitton & Stuart Peacock, 2009. "Qualitative methodologies in health‐care priority setting research," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1163-1175, October.
    9. Jommi, Claudio & Costa, Enrico & Michelon, Alessandra & Pisacane, Maria & Scroccaro, Giovanna, 2013. "Multi-tier drugs assessment in a decentralised health care system. The Italian case-study," Health Policy, Elsevier, vol. 112(3), pages 241-247.
    10. Gregory Merlo & Katie Page & Pauline Zardo & Nicholas Graves, 2019. "Applying an Implementation Framework to the Use of Evidence from Economic Evaluations in Making Healthcare Decisions," Applied Health Economics and Health Policy, Springer, vol. 17(4), pages 533-543, August.
    11. Robbins, Geraldine & Lapsley, Irvine, 2015. "From secrecy to transparency: Accounting and the transition from religious charity to publicly-owned hospital," The British Accounting Review, Elsevier, vol. 47(1), pages 19-32.
    12. Vuorenkoski, Lauri & Toiviainen, Hanna & Hemminki, Elina, 2003. "Drug reimbursement in Finland--a case of explicit prioritising in special categories," Health Policy, Elsevier, vol. 66(2), pages 169-177, November.
    13. Klerkx, Laurens & Leeuwis, Cees, 2008. "Institutionalizing end-user demand steering in agricultural R&D: Farmer levy funding of R&D in The Netherlands," Research Policy, Elsevier, vol. 37(3), pages 460-472, April.
    14. Sofaer, Neema & Kapiriri, Lydia & Atuyambe, Lynn M. & Otolok-Tanga, Erasmus & Norheim, Ole Frithjof, 2009. "Is the selection of patients for anti-retroviral treatment in Uganda fair?: A qualitative study," Health Policy, Elsevier, vol. 91(1), pages 33-42, June.
    15. Gallagher, Siun & Little, Miles, 2019. "Procedural justice and the individual participant in priority setting: Doctors' experiences," Social Science & Medicine, Elsevier, vol. 228(C), pages 75-84.
    16. Kleinhout-Vliek, Tineke & de Bont, Antoinette & Boer, Bert, 2017. "The bare necessities? A realist review of necessity argumentations used in health care coverage decisions," Health Policy, Elsevier, vol. 121(7), pages 731-744.
    17. McMahon, Meghan & Morgan, Steve & Mitton, Craig, 2006. "The Common Drug Review: A NICE start for Canada?," Health Policy, Elsevier, vol. 77(3), pages 339-351, August.
    18. Kapiriri, Lydia & Norheim, Ole F. & Martin, Douglas K., 2009. "Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making?," Social Science & Medicine, Elsevier, vol. 68(4), pages 766-773, February.
    19. Edward C. F. Wilson & Stuart J. Peacock & Danny Ruta, 2009. "Priority setting in practice: what is the best way to compare costs and benefits?," Health Economics, John Wiley & Sons, Ltd., vol. 18(4), pages 467-478, April.
    20. Jennifer Whitty & Paul Scuffham & Sharyn Rundle-Thielee, 2011. "Public and decision maker stated preferences for pharmaceutical subsidy decisions," Applied Health Economics and Health Policy, Springer, vol. 9(2), pages 73-79, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:88:y:2008:i:2-3:p:308-316. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.