THE SYSTEM OF OBJECTIFIED JUDGMENT ANALYSIS (SOJA) - A TOOL IN RATIONAL DRUG SELECTION FOR FORMULARY INCLUSION

Rational drug selection for formulary purposes is important. Besides r ational selection criteria, other factors play a role in drug decision making, such as emotional, personal financial and even unconscious cr iteria. It is agreed that these factors should be excluded as much as possible in the decision making process. A model for drug decision mak ing for formulary purposes is described, the System of Objectified Jud gement Analysis (SOJA). in the SOJA method, selection criteria for a g iven group of drugs are prospectively defined and the extent to which each drug fulfils the requirements for each criterion is determined. E ach criterion is given a relative weight, i.e. the more important a gi ven selection criterion is considered, the higher the relative weight. Both the relative scores for each drug per selection criterion and th e relative weight of each criterion are determined by a panel of exper ts in this field. The following selection criteria are applied in all SOJA scores: clinical efficacy, incidence and severity of adverse effe cts, dosage frequency, drug interactions, acquisition cost, documentat ion, pharmacokinetics and pharmaceutical aspects. Besides these criter ia, group specific criteria are also used, such as development of resi stance when a SOJA score was made for antimicrobial agents. The relati ve weight that is assigned to each criterion will always be a subject of discussion. Therefore, interactive software programs for use on a p ersonal computer have been developed, in which the user of the system may enter their own personal relative weight to each selection criteri on and make their own personal SOJA score. The main advantage of the S OJA method is that all nonrational selection criteria are excluded and that drug decision making is based solely on rational criteria. The u se of the interactive SOJA discs makes the decision process fully tran sparent as it becomes clear on which criteria and weighting decisions are based. We have seen that the use of this method for drug decision making greatly aids the discussion in the formulary committee, as disc ussion becomes much more concrete. The SOJA method is time dependent. Documentation on most products is still increasing and the score for t his criterion will therefore change continuously. New products are int roduced and prices are also subject to change. To overcome the time-de pendence of the SOJA method, regular updates of interactive software p rograms are being made, in which changes in acquisition cost, document ation or a different weighting of criteria are included, as well as ne wly introduced products. The possibility of changing the official acqu isition cost into the actual purchasing costs for the hospital in ques tion provides a tailor-made interactive program.