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Comprehensive Drug-Class Review Framework for improved evidence-based drug policy and formulary modernization

Published online by Cambridge University Press:  03 December 2019

Mina Tadrous Open the ORCID record for Mina Tadrous [Opens in a new window] ,
Sandra Knowles ,
Brent Ruddock ,
Paul Oh ,
Muhammad M. Mamdani ,
David N. Juurlink  and
Tara Gomes
Mina Tadrous*
Affiliation:
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada ICES, Toronto, Canada Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
Sandra Knowles
Affiliation:
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada Sunnybrook Research Institute, Toronto, Canada
Brent Ruddock
Affiliation:
Ontario Public Drug Programs, Ontario Ministry of Health and Long-Term Care, Toronto, Canada
Paul Oh
Affiliation:
Sunnybrook Research Institute, Toronto, Canada Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, Canada
Muhammad M. Mamdani
Affiliation:
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada ICES, Toronto, Canada Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
David N. Juurlink
Affiliation:
ICES, Toronto, Canada Sunnybrook Research Institute, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada
Tara Gomes
Affiliation:
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada ICES, Toronto, Canada Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
*
Author for correspondence: Mina Tadrous, E-mail: tadrousm@smh.ca
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Abstract

Formularies are used by payers to optimize access and ensure the appropriate use of medications. Lack of follow-up and re-evaluation can lead to outdated formularies that are not reflective of current evidence. Formulary modernization, an approach to re-align formularies with current evidence has proven successful. The Ontario Drug Policy Research Network (ODPRN) launched a framework for conducting comprehensive drug-class reviews. This commentary describes the individual components of this framework and lessons learned through completion of 12 reviews between 2013 and 2016. We present the ODPRN drug-class review of treatments for chronic hepatitis B as a case example to illustrate the components and impact. The incorporation of foundational health technology assessment components such as economic evaluations and knowledge synthesis with contextualizing evidence such as patient and clinician perspectives (through qualitative studies), real-world evidence (through data analytics), and cross-jurisdictional comparisons (through environmental scans and data analytics), successfully developed jurisdictionally specific policy recommendations grounded in up-to-date evidence. The ODPRN framework for conducting comprehensive drug-class reviews is a robust and feasible approach to conduct formulary modernization. This framework allows for actionable and specific policies which are likely to be considered by decision makers. Adoption of similar frameworks in other jurisdictions may improve uptake of evidence-informed policy recommendations.

Keywords

Technology assessmentBiomedicalDataEvidence generationHealthcare policyReal-world data
Type
Article Commentary
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 1 , 2020 , pp. 12 - 19
Copyright
Copyright © Cambridge University Press 2019

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