Pharmaceutical Medicine

, Volume 25, Issue 2, pp 71–82 | Cite as

A Proposed Framework for Formulary Listing in Low-Income Countries

Incorporating Key Features from Established Drug Benefit Plans
  • Vakaramoko DiabyEmail author
  • Claudine Laurier
  • Jean Lachaine
Current Opinion


Formularies of reimbursed drugs are widely adopted tools in healthcare systems. However, little is known about the selection process of drugs that appear on these formularies. The aim of this paper was to shed light on this process by reviewing the way selected public Drug Benefit Plans in high-, middle- and low-income countries, including Canada, the US, UK, France, Germany, Brazil, South Korea and Ghana, manage the formulary listing process. Common steps and challenges are identified and this information used to make recommendations for developing a framework for formulary listing in low-income countries. We found that all DBPs studied used a formulary to list reimbursable drugs and the selection criteria utilized to determine which drugs should be listed were similar between plans, although weighting of individual criterion differs and the composition of the committee (i.e. physician vs economist) is likely to have an impact. The WHO model list of essential medicines plays a bigger role in formulary selection in middle-income countries than in high-income countries. In low-income countries, the focus is on the prioritization of health interventions and improving access to healthcare. On the basis of our review and an appraisal of the health needs of low-income countries, we have proposed four steps that are the pillars of our framework for formulary conception in low-income countries. These steps are the identification and weighting of relevant formulary listing criteria (combining both literature review and qualitative research approaches), the determination of priority diagnostics/treatments to be assessed, the criteria scoring and the treatment ranking by priority order of reimbursement. Finally, for the purpose of developing a formulary, we recommend use of the multicriteria decision analysis approach to guide priority drug ranking.


Discrete Choice Experiment National Health Insurance Scheme Drug Coverage Formulary Listing Cover Prescription Drug 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This article has been written from an independent perspective and has not been funded. The authors have no conflicts of interest that are directly relevant to the content of the article.


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Copyright information

© Adis Data Information BV 2011

Authors and Affiliations

  • Vakaramoko Diaby
    • 1
    Email author
  • Claudine Laurier
    • 1
  • Jean Lachaine
    • 1
  1. 1.Faculty of PharmacyUniversity of MontrealMontrealCanada

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