Literature review on the structure and operation of Pharmacy and Therapeutics Committees
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Aim of the review To review the literature on the structure and operation of hospital Pharmacy and Therapeutics Committees from an international point of view and examine the factors that influence decision-making of these committees. Method We performed a literature search in the Medline and Embase databases from 1997 to January 2009 with the search terms: formulary system decision making, pharmacy and therapeutics committee, formularies hospital, drug formulary, survey, drug selection and outcome assessment health care. Inclusion criteria were the following: studies analyzing Pharmacy and Therapeutics Committees published in English or Spanish from 1997 to January 2009. Exclusion criteria were: publications which were editorials or opinion pieces, studies relating to one hospital, and studies where full text could not be attained. The analysis was divided into structural/organizational data and data on factors affecting the decision-making process. Results Seventeen studies met the inclusion criteria. Pharmacy and Therapeutics Committees and formularies were present in more than 90% of the hospitals in four of the five countries examined. Therapeutic interchange programs existed only in two of these countries. The mean number of committee members ranged between six and eight. More than 89% of the committees included a pharmacist. Standard operating procedures were implemented by 89% of the committees. The most influential factors in the decision-making were clinical trial results or drug costs rather than pharmacoeconomic studies. Other local organization-dependent factors were also important. Conclusions The structure and operating procedures of Hospital Pharmacy and Therapeutics Committees are similar in select Western countries. Information from clinical trials is the most influential factor in the decision-making process.
KeywordsDecision-making Drug selection Formulary Formulary system Pharmacy and Therapeutics Committee PTC Survey
The authors would like to thank the Research Group for Innovation Assessment, Standardisation and Research in the Selection of Drugs (GENESIS) of the Spanish Society of Hospital Pharmacy (SEFH), in particular T Requena-Caturla (Servicio Madrileño de Salud, Madrid), JP Ordovás-Baines (Hospital General Universitario de Alicante), MA Porta-Sánchez (Complejo Hospitalario Juan Canalejo, Coruña), and JM Recalde-Manrique (Andalusian Centre for Pharmaceutical Documentation and Information, Granada) for their contribution to the initial planning and development of this review. We also thank E Corpas-Nogales, L García-Mochón and M Moya-Garrido from the Research and Methodology Support Unit of the Andalusian School of Public Health (EASP) in Granada for their contribution to the literature search.
This review was funded by the Spanish Ministry of Health and Social Policy following the Ministry’s 2006 open call for proposals. Health Research Fund, Instituto de Salud Carlos III, Project PI061546.
Conflicts of interest
The authors declare that they have no conflicts of interest.
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