PCN82 - Assessment of Criteria for Formulary Decision-Making of Cancer Drugs in the Public Sector in Malaysia – A Pilot

Abstract

Multicriteria decision analysis (MCDA) approach is being pursued to improve and support formulary decisions for cancer drugs in the public sector in Malaysia. Decision criteria are the key component in the MCDA framework. Prior to a nationwide survey to determine healthcare professionals’ decision criteria preference, this preliminary survey was conducted with the primary aim to identify important criteria for formulary decisions relevant to local context. Secondary objective was to determine if doctors had different criteria preference for selection of cancer drugs versus other drugs. Drug formulary decision criteria identified through literature review were integrated into a survey and administered online using Google Forms. Snowballing technique was used to select respondents who were pharmacists and doctors working in the Ministry of Health. Respondents assessed the relevance of each criterion listed by answering “yes” or “no”. An open-ended question asking for additional criterion was included. The questionnaire for doctors explored if there would be a difference in the criteria selected if the formulary decision was for a cancer drug. Descriptive statistical analysis was performed using Microsoft Excel 2013, v15.0. A total of 21 responses from 10 pharmacist and 11 doctors were received. Approximately 40% of the respondents are members of formulary decision committees. 82% of the doctors are non-oncology specialist. From the list of 14 criteria, effectiveness, safety, cost effectiveness and budget impact received more than 80% agreement from both groups. Respondents recommended three additional criteria: direct cost, ease of adherence and other countries experience. Two non-oncologist reported the use of different criteria for cancer drug selection. This study highlights how views on the type and relevance of formulary decision criteria can vary according to the health system and stakeholder group. Thus its important to localize criteria to ensure a multicriteria approach relevant for local decision making can be implemented.