Drug Funding Decision-Making in Hospital Formulary Committees in Germany

Rübesam, Tim (2015) Drug Funding Decision-Making in Hospital Formulary Committees in Germany. DBA thesis, University of Gloucestershire.

[img]
Preview
Text
20160222_DBAThesisRUEBESAM_VFinal.pdf - Accepted Version
Available under License All Rights Reserved.

Download (5MB) | Preview

Abstract

BACKGROUND: Hospital formularies are usually the gatekeepers for pharmaceutical drugs. Typical majority members of hospital formularies are physicians, although most of the time the formulary is chaired by a pharmacist. As German hospitals are struggling with a difficult economic environment the question arises: what kind of decision-making criteria are applied when pharmaceutical drugs should be added to the formulary list? Information regarding this topic is scarce due to the sensitive topic of decision-making. OBJECTIVES: Build a single decision-making framework which will be created to explain hospital drug funding decision-making and identify underlying mechanisms which explain processes and structures. The results can be used by hospitals to initiate knowledge sharing and provide a basis to analyse local formulary committee decision-making practice. Additionally, they can be used by the pharmaceutical industry to better adapt to the specific needs of the hospital decision-makers. METHODS: In this study, a mixed-methods approach has been used to confirm and further detail a preliminary hospital formulary decision-making framework derived from literature. An online survey was used to get insights on the structure of German hospital formularies and the relative importance of different decision-criteria. Additional semi-structured expert interviews were used to get in-depth information on the underlying mechanisms which influence decision-making on drug funding. RESULTS: Decisions for or against a pharmaceutical drug are influenced by a variety of perceived objective and specifically subjective criteria. Despite a consistency in a dominant, high impact role of pharmacists and lead physicians every hospital formulary member has different relative weighting of decision criteria. Drug funding decision-making in German hospital formularies is highly individual but usually starts with a quasi-rational preference influenced by a mixture of analytic and intuitive criteria. The decision to use more analytic or more intuitive criteria is influenced by a variety of factors. The two most important ones are uncertainty and power. The resulting individual preference is then challenged and adapted in a group decision-making process.

Item Type: Thesis (DBA)
Thesis Advisors:
Thesis AdvisorEmailURL
Pioch, Elkeepioch@glos.ac.ukUNSPECIFIED
Jain, Mohitmjain@glos.ac.ukUNSPECIFIED
Uncontrolled Keywords: Pharmaceutical drugs; Decision-making model; Hospital formularies; Pharmaceutical treatment, economic factors; Germany
Subjects: R Medicine > RM Therapeutics. Pharmacology
Divisions: Schools and Research Institutes > School of Business, Computing and Social Sciences
Depositing User: Susan Turner
Date Deposited: 26 Apr 2016 09:51
Last Modified: 02 Aug 2023 08:27
URI: https://eprints.glos.ac.uk/id/eprint/3432

University Staff: Request a correction | Repository Editors: Update this record

University Of Gloucestershire

Bookmark and Share

Find Us On Social Media:

Social Media Icons Facebook Twitter Google+ YouTube Pinterest Linkedin

Other University Web Sites

University of Gloucestershire, The Park, Cheltenham, Gloucestershire, GL50 2RH. Telephone +44 (0)844 8010001.