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Tools, information sources, and methods used in deciding on drug availability in HMOs
1Pharmaceutical Economics Research Center, School of Pharmacy and Pharmacal Sciences, Purdue University, West Lafayette, IN 47907-1335, USA.
Summary
Health maintenance organizations (HMOs) commonly use decision analysis and multiattribute analysis for drug selection. Journal articles and reference books are key information sources, while retrospective drug-use review is vital for managing drug access.
Area of Science:
- Health Services Research
- Pharmaceutical Policy
- Healthcare Management
Background:
- Understanding decision-making processes for drug availability and use within Health Maintenance Organizations (HMOs) is crucial for effective resource allocation.
- Previous research has not comprehensively evaluated the specific tools, information sources, and management methods employed by HMOs in pharmaceutical decision-making.
Purpose of the Study:
- To investigate the utilization and perceived importance of formal decision-making tools, information sources, and drug-use management methods in HMOs.
- To identify factors influencing the adoption and perceived value of these pharmaceutical management strategies within diverse HMO structures.
Main Methods:
- A cross-sectional survey was administered to 303 randomly selected HMOs, assessing the use and importance of decision-making tools, information sources, and management methods on a 5-point Likert scale.
- Data analysis involved descriptive statistics and comparative analyses based on HMO type, membership size, and organizational age.
- The survey achieved a 28% response rate, providing insights from a representative sample of HMOs.
Main Results:
- Decision analysis and multiattribute analysis were frequently used (approx. 50% of respondents) and highly valued for determining drug availability.
- Journal articles and reference books were the most commonly utilized information sources.
- Retrospective drug-use review was frequently used and deemed very important for managing drug use; older HMOs demonstrated higher utilization of most management methods.
Conclusions:
- Formal decision-making tools like decision analysis and multiattribute analysis are integral to pharmaceutical availability decisions in HMOs.
- Evidence-based information sources, particularly journal articles and reference books, are primary resources for HMOs.
- Retrospective and prospective drug-use reviews are critical for managing drug access and ensuring appropriate utilization within HMOs.