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