Pharmacoeconomics and clinical practice guidelines - A survey of attitudesin Swedish formulary committees

Background: Swedish formulary committees are expected to influence prescrib ing practice by establishing and issuing drug lists and clinical practice g uidelines, particularly now that financial responsibility for prescription drugs has been transferred from the national to the county council level. Objective: The purpose of this exploratory study was to identify the inform ation sources and decision criteria that individual committee members perce ive as important in establishing clinical practice guidelines. Moreover, ob stacles to the increased use of pharmacoeconomic evaluations in decision-ma king were also identified. Design and setting: Data were gathered through a survey questionnaire admin istered in 1998 to members of central formulary committees throughout Swede n, as determined by a national register. Participants: 312 members of central formulary committees, of whom 69% resp onded. Results: Treatment policies/guidelines supplied by government authorities, or found in reviewed journals, are considered the most important sources of information, and criteria associated with costs and effects are considered the most important decision criteria. The members' years of experience and their professions affect their assessments of information sources, whereas education in health economics affects their assessments of decision criter ia. Committee members voiced an interest in pharmacoeconomic issues, but wa rned that there was neither sufficient competence among committee members n or an adequate supply of relevant studies. Furthermore, a majority of the m embers identified difficulty in translating study results into clinical pra ctice guidelines and limited possibilities in comparing studies as obstacle s to the increased use of pharmacoeconomic evaluations. Conclusions: The results of this survey may be useful in designing future e conomic evaluations and when presenting and diffusing study results.