Pharmacoeconomics in formulary decision making

Abstract

Objectives: To assess the knowledge of pharmacoeconomic (PE) information in patient groups, healthcare professionals, Government Formulary List Advisory Committee (GFLAC) and Pharmaceutical Research Based Industry Malta Association (PRIMA) members, to determine the extent to which PE information is used in formulary decision making and to define the specific challenges to adapt and establish the PE concept locally. Method: A cross sectional study was conducted to investigate local PE knowledge and trend of use. A structured questionnaire was drafted. The questionnaire was distributed electronically to GFLAC members, health care professionals, patient groups and PRIMA members. A review of international PE guidelines was carried out followed by development of another questionnaire to obtain feedback from experienced Health Technology Assessment (HTA) and PE units in European countries. This questionnaire was disseminated to European organisations after obtaining permission to use 33 European countries listed on the International Society for Pharmacoeconomics Organisation (ISPOR) and the European Network for Health Technology Assessment (EUnetHTA) mail lists. Key Findings: Fourty out of a total of 74 electronically distributed questionnaires (response rate 54%) were returned. With regards to formulary decision making, the most influential profession was that of physicians whilst the most influential factors were drug efficacy and drug safety. The majority of participants are in favour of PE being required in formulary decision making. A total of 15 replies from 13 different European agencies were obtained. The majority of respondents agreed that Malta should adopt its own system of PE assessment. A further suggestion addressed the adaptation and tailoring of an existing national system and application of pharmacoeconomics in special cases. Conclusion: Results obtained in this study indicate that the concept of pharmacoeconomics should be required in formulary decision making and that Malta would benefit from adopting its own system of PE assessment.