PHP15: A SURVEY OF PUBLIC HOSPITAL PHARMACISTS IN SINGAPORE ON THEIR VIEWS ABOUT ‘THE FORMULARY’ AND ITS DECISION-MAKING PROCESS

Abstract

OUR PREMISE: If the expectation is ?A formulary must help control drug costs but not just promote cheap drugs (i.e., compromise on quality of care)?, there clearly exists a need for pharmacoeconomics in formulary decision-making. OBJECTIVES: To understand if such expectation and need exist in Singapore, and how confident pharmacists would be if asked to use pharmacoeconomics to aid their decision-making. METHOD: After having obtained consent from the respective pharmacy managers, survey forms were circulated to all pharmacists in the 5 major public hospitals of Singapore. If after 2?3 weeks, the response rate was lower than 50% a reminder (via e-mail) and a second circulation of the questionnaire was made. In the event of any clarification(s) being required, the respondent was contacted over phone. RESULTS AND CONCLUSION: With a response rate that ranged from 50% to 85% in the individual hospitals and an overall average of ?64% (70 of 110 identified pharmacists responded) our findings delineated the following picture in Singapore. Formulary restriction is the best method to control drug costs (57%). However, it should not be a list of cheapest alternatives (90 %) but should ideally promote the use of the best drug (71%) while also controlling the hospital budget (57%). Though what factors are involved in the current formulary decision-making process are not known (49% have no knowledge), drug effectiveness (64%) as opposed to acquisition cost (5%) will be considered as the most important factor by the pharmacists if they were to decide on the formulary. However, only 1% felt very confident about being able to use pharmacoeconomics to aid their decision-making, if asked to do so. There is therefore, a definite but unstated need for use of pharmacoeconomics in the formulary setting; however, there is clearly a lack of capability to fulfill the need.