Improving hospital formulary drug decision making with multi-criteria decision analysis (MCDA): case study from a national government hospital in Indonesia

Erna Kristin; Mursyid Bustami; Rizaldy Taslim Pinzon; Alfi Yasmina; Agnes Susanto; Ratih Puspita Febrinasari

doi:10.22146/ijpther.7932

Erna Kristin Department of Pharmacology and Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Mursyid Bustami National Brain Center Hospital, Jakarta, Indonesia
Rizaldy Taslim Pinzon Neurology Department, Duta Wacana Christian University, Yogyakarta, Indonesia
Alfi Yasmina Department of Pharmacology, Faculty of Medicine, Universitas Lambung Mangkurat, Banjarmasin, Indonesia
Agnes Susanto PT Atoma Medical, Jakarta, Indonesia
Ratih Puspita Febrinasari Department of Pharmacology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

DOI: https://doi.org/10.22146/ijpther.7932

Keywords: multi-criteria decision analysis, drug procurement, decision-making, government hospital, formulary

Abstract

This study aimed to look at the applicability of the multi-criteria decision analysis (MCDA) framework to improve hospital formulary drug decision-making. The case study method was used to investigate MCDA implementation in the National Brain Center Hospital Jakarta, Indonesia. A two stage-workshop was held on October 29^th, 2019 and 5 February 5^th, 2020, where participants conducted a hands-on experience in applying MCDA for selecting off-patent pharmaceuticals (OPPs) for the hospital formulary. The results of the workshop created awareness of MCDA that can be beneficial in transparently selecting OPP, which is not based only on price while involving multiple stakeholders. As a follow-up, MCDA was used during the drug selection process for the National Brain Center Hospital formulary in 2021 with criteria in accordance with the workshops, namely: 1) equivalence with the reference (originator) product; 2) real-world clinical or economic outcomes; 3) quality assurance; 4) reliability of drug supply; 5) stability and drug formulation; 6) pharmacovigilance, and 7) price advantages. In conclusion, the MCDA method can be implemented with customized criteria and weighting based on hospital needs to help with drug selection for the hospital formularies.

References

Thokala P, Devlin N, Marsh K, Baltussen R, Boysen M, Kalo Z, et al. Multiple criteria decision analysis for health care decision making - an introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force. Value Heal [Internet]. 2016;19(1):1–13. Available from: http://dx.doi.org/10.1016/j.jval.2015.12.003

Adunlin G, Diaby V, Xiao H. Application of multicriteria decision analysis in health care: A systematic review and bibliometric analysis. Heal Expect. 2015;18(6):1894–905.

Glaize A, Duenas A, Di Martinelly C, Fagnot I. Healthcare decision-making applications using multicriteria decision analysis: a scoping review. J Multi-Criteria Decis Anal. 2019;26(1–2):62–83.

Dai Z, Xu S, Wu X, Hu R, Li H, He H, et al. Knowledge mapping of multicriteria decision analysis in healthcare: a bibliometric analysis. Front Public Health 2022;10(:1–15.

Brixner D, Maniadakis N, Kaló Z, Hu S, Shen J, Wijaya K. Considering multicriteria decision analysis (MCDA) simple scoring as an evidence-based HTA methodology for evaluating off-patent pharmaceuticals (OPPs) in emerging markets. Value Heal Reg Issues [Internet]. 2017;13:1–6. Available from: http://dx.doi.org/10.1016/j.vhri.2017.02.001

Farghaly MN, Al Dallal SAM, Fasseeh AN, Monsef NAK, Suliman EAMA, Tahoun MA, et al. Recommendation for a pilot MCDA tool to support the value-based purchasing of generic medicines in the UAE. Front Pharmacol 2021; 12:1–5.

Elezbawy B, Fasseeh AN, Sedrak A, Eldessouki R, Gamal M, Eldebeiky M, et al. A multi-criteria decision analysis (MCDA) tool for purchasing off-patent oncology medicines in Egypt. J Pharm Policy Pract [Internet]. 2022;15(1):4–11. Available from: https://doi.org/10.1186/s40545-022-00414-2

Abdullah AH, Holtorf AP, Al-Hussaini M, Lemay J, Alowayesh M, Kaló Z. Stakeholder driven development of a multi-criteria decision analysis tool for purchasing off-patent pharmaceuticals in Kuwait. J Pharm Policy Pract. 2019;12(1):1–7.

Inotai A, Brixner D, Maniadakis N, Dwiprahasto I, Kristin E, Prabowo A, et al. Development of multi-criteria decision analysis (MCDA) framework for off-patent pharmaceuticals - an application on improving tender decision making in Indonesia. BMC Health Serv Res. 2018;18(1):1–12.

Laba TL, Jiwani B, Crossland R, Mitton C. Can multi-criteria decision analysis (MCDA) be implemented into real-world drug decision-making processes? A Canadian provincial experience. Int J Technol Assess Health Care. 2020;36(4):434–9.

Bao Y, Gao B, Meng M, Ge B, Yang Y, Ding C, et al. Impact on decision making framework for medicine purchasing in Chinese public hospital decision-making: determining the value of five dipeptidyl peptidase 4 (DPP-4) inhibitors. BMC Health Serv Res. 2021;21(1):1–7.

Assawamakin A, Holtorf AP, Maniadakis N. Weighing price and performance for decisions for multisource pharmaceutical bidding in public hospitals in Thailand. In: Evaluation of Health Services. London: IntechOpen; 2020.

Management Sciences for Health. Managing medicine selection. MDS-3: managing access to medicines and health technologies. Arlington, VA: Management Sciences for Health; 2012.

Yang C, Wang Y, Hu X, Chen Y, Qian L, Li F, et al. Improving hospital based medical procurement decisions with health technology assessment and multi-criteria decision analysis. Inq (United States). 2021;58.