UBC Theses and Dissertations
The drug formulary approval process in select Canadian hospitals D’Sa, Mel Matthew
One of the many responsibilities of the profession of pharmacy is to serve as a gatekeeper for pharmaceuticals. In contemporary hospital practice one way that pharmacy fulfills this responsibility is through its involvement in the multidisciplinary pharmacy and therapeutics (P&T) committee. By using a formulary system, a P&T committee generates a drug formulary. In essence, a drug formulary is a restricted drug list that reflects the current clinical judgement of the medical staff. It also represents a list of drugs approved for use within a hospital. However, research in the literature has identified various influences of a political, organizational, societal, legal, professional, and economic nature that have the potential to impact on the drug formulary approval process. The attitudes and opinions of key clinical decision makers such as pharmacy directors and P&T committee chairs concerning the drug formulary approval process have not been documented in the Canadian literature. This study reports the results of a national mail survey conducted to examine the attitudes and opinions of select hospital pharmacy directors and P&T committee chairs with respect to the current and future drug formulary approval process. Also obtained was information concerning demographic and organizational aspects of a large number of hospitals. The hypothesis tested is that pharmacy directors and P&T committee chairs do not believe that the drug formulary approval process will demonstrably change in the next five to ten years. Also, identified items in the literature are not expected to have significant influence on the future process. It appears that the drug formulary approval process in Canadian hospitals is a function of many underlying influences. The actual process itself is not expected to change. However, various influences, especially those of an economic nature, are expected to significantly impact the future process. Findings have implications for health care professionals, hospitals, hospital P&T committees, governments, thirdparty payers, drug companies, and pharmaceutical industry analysts.
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