Drug and Therapeutics (D & T) committees in Dutch hospitals: a nation‐wide survey of structure, activities, and drug selection procedures

Abstract

Aims To determine structure, activities and drug selection processes used by Dutch hospital drug and therapeutics (D & T) committees. Methods A pretested structured survey questionnaire based on the Australian process and impact indicators, previous research, and consultation of professionals was developed. Subsequently, D & T committees that met predefined selection criteria were asked to participate. Results The overall response rate was 70% (38/54). D & T committees varied considerably in size and representation of clinical expertise. Although responsibilities were theoretically alike, actual responsibilities were frequently passed on to other authorities, such as pharmacy staff. Few committees used detailed guidelines or decision supportive matrices to establish transparency in drug selection. With respect to drug selection, the value scores on the information resources used, the factors involved, and the selection criteria used varied. Hospital pharmacists were likely to be most involved and to have the greatest impact. A consensus was most difficult to achieve for drugs used in cardiology, oncology, and psychiatry. Interference of industrial marketing strategies on drug selection was recognized and identified. Conclusions Our results indicate that Dutch hospital D & T committees differ with respect to their clinical expertise and their activities, a situation comparable with that observed in other countries. Furthermore, the lack of transparency in drug selection was considerable. These findings clarify the differences previously found between Dutch hospital drug formularies.

Structure and procedures of the pharmacy and therapeutic committees in Spanish hospitals

“…Similar to studies conducted in other countries [1][2][3][4][5][6][8][9][10][11] the very existence of the P&T Committees and Drug formularies is extended to all hospitals. However, it is a norm for Spanish hospitals to work on therapeutic interchange programmes and guidelines [2,16,17], which has been developed to help doctors to select the most appropriate medication, especially in the reconciliation of treatments.…”

“…Regarding the composition of P&T Committees, the mean number of members in Spain is quite similar to that of countries like Canada [10,11], somewhat lower than in the USA and much higher than in the UK [8], Belgium [9] and the Netherlands [3].…”

“…The evaluation and selection of drugs and the decision-making concerning their inclusion in Drug Formularies are carried out by Pharmacy and Therapeutic Committees (P&T Committees), which has been in operation for years in hospitals worldwide [1][2][3][4][5][6][7][8][9][10][11], as well as in Spain.…”

Assessment of indicators for hospital drug formulary non-adherence

“…Similar to the situation in other countries, Dutch hospital drug and therapeutics (D&T) committees are managing rational prescribing within secondary health care [7,8,9,10,11,12,13,14,15,16]. Among educational and administrative programmes, application of pharmacotherapeutic treatment guidelines (PTGs) and hospital drug formularies (HDFs) are considered e ective [17,18,19,20,21,22,23].…”

Influence of the National Hospital Pharmaceutical Strategy on the Assessment of New Medicines in New Zealand Public Hospitals

“…Efficacy, safety, quality and acquisition cost are usually assessed by a hospital Medicine and Therapeutics Committee (MTC). [4][5][6] Recent reports indicate that hospitals in the USA and Australia also consider economic benefit. [5][6][7] New Zealand has launched a unique system for the management of pharmaceuticals used in primary care and hospitals.…”