Related Experiment Videos
Ontario's formulary committee: how recommendations are made
Anne M PausJenssen1, Peter A Singer, Allan S Detsky
1Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Pharmacoeconomics
|February 26, 2003
Summary
Economic analyses play a limited role in Ontario drug benefit decisions, with clinical factors often dominating. However, some form of economic evaluation is used in most cases, making requests for even simple analyses valuable for healthcare policy.
Area of Science:
- Health Economics
- Pharmaceutical Policy
- Health Technology Assessment
Background:
- Ontario's provincial formulary mandates economic analyses for new drug listings.
- The Ontario Drug Benefit (ODB) Program provides reimbursement for listed pharmaceuticals.
Purpose of the Study:
- To examine the decision-making process for drug formulary listing.
- To specifically assess the role and impact of economic analyses in these decisions.
Main Methods:
- Qualitative case study approach.
- Analysis of meeting transcripts and interviews using pattern-matching.
- Observation of nine Drug Quality and Therapeutics Committee (DQTC) meetings.
- Interviews with seven committee members.
Main Results:
- Complex economic analyses had a limited impact, primarily for expensive innovative drugs.
- Clinical factors heavily influenced cost perceptions.
- Generic and "me-too" drugs without price premiums did not necessitate complex economic evaluations.
- DQTC members' limited health economics knowledge and poor analysis quality affected discussion.
- Informal economic analyses were frequently conducted by the DQTC.
Conclusions:
- Economic analyses are valuable for guiding formulary decisions, even simple ones.
- Requesting economic analyses from manufacturers is a useful healthcare policy.
- The DQTC utilized some form of economic analysis in nearly all decisions.