Management of Hospital Formularies in Ontario: Challenges within a Local Health Integration Network.

Area of Science:

• Health Services Research
• Health Economics
• Pharmaceutical Policy

Background:

• Canadian hospitals spend $2.4 billion annually on drugs.
• Pharmacy and Therapeutics (P&T) committees are crucial for drug management.
• Current P&T committee processes, expertise, and formulary decision-making vary significantly across hospitals.

Purpose of the Study:

• To investigate P&T committee formulary drug review processes and stakeholder needs.
• To explore preferences for evidence review and collaborative drug review models.
• To assess these factors within a large Local Health Integration Network (LHIN) in Ontario.

Main Methods:

• Survey distributed to P&T committee members and pharmacy directors across 10 hospital corporations in LHIN 4.
• A two-part questionnaire assessed institutional profiles and P&T committee operations.
• Data collected from 10 pharmacy directors and 28 P&T committee members.

Main Results:

• Each P&T committee reviewed an average of 6.4 new drug requests annually, representing 0.84 FTE workload.
• Clinical evidence quality was rated higher than economic evidence quality.
• Limited health economics expertise hindered the use of economic evidence; a centralized review was favored for efficiency, quality, and cost reduction.

Conclusions:

• Significant resources are dedicated to new drug reviews in the Hamilton Niagara Haldimand Brant LHIN.
• Standardizing formulary review processes is recommended.
• Leveraging provincial and national drug reviews could benefit all LHINs.