Evidence, cost and decision making criteria by provincial PTCs in SA

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Evidence, cost and decision making criteria by
provincial PTCs in SA Pillay T, Hill SR, Walkom
E University of Newcastle
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What criteria should we use to select drugs?

• WHO efficacy, safety, cost effectiveness,
  quality of drugs and burden of disease.
• NDP PTCs should consider efficacy, safety and
  cost effectiveness.
• Other criteria procurement factors, external
  pressures.

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What do we know about studies on drug selection
by PTCs

• This topic has not been well researched.
• Most studies are from developed countries
• USA-HMOs, hospital level
• Europe-national, state level
• Australia-hospital level
• No studies in developing countries

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Objectives

• Identify criteria that drug selection committees
  in South Africa consider important in decision
  making
• Examine the influence of a limited budget on drug
  selection
• Assess drug selection committees knowledge of
  terminology used in clinical studies and economic
  analyses

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Methods

• Six of nine provinces participated.
• PTC committee members required to complete the
  questionnaire during meeting.
• Key topics in questionnaire
• Drug selection criteria considered important
• Role of disease burden on drug selection
• Understanding and knowledge of terminology in
  clinical trials and economic analyses.

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Results Criteria considered to be most and least
important
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Results Drug selection with a capped budget
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Self reported understanding vs actual knowledge
of clinical trial terms
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Self reported understanding vs actual knowledge
of terms used in economic analyses
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Key messages

• Committees consider other factors in addition to
  WHO criteria.
• Cost factors appear to be very important
  committees consider themselves as cost saving
  committees
• Burden of disease not always important in drug
  selection
• There was an over estimation of knowledge and
  understanding.

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Conclusions

• PTC decision making should be supported with the
  necessary skills required to evaluate clinical
  trials and economic analyses.