Using health outcomes data to inform decision-making - Formulary committeeperspective

When healthcare resources are limited, decisions about the treatments to fu nd can be complex and difficult to make, involving the careful balancing of multiple factors. The decisions taken may have far-reaching consequences a ffecting many people. Clearly, decisions such as the choice of products on a formulary must be taken using a selection process that is fully transpare nt and that can be justified to all parties concerned. Although everyone would agree that drug selection should be a rational proc ess that follows the guidelines of evidence-based medicine, many other fact ors may play a role in decision-making. Although some of these are explicit and rational, others are less clearly defined, and decision-makers may be unaware of the influence exerted by some of these factors. In order to faci litate transparent decision-making that makes rational use of health outcom es information, the System of Objectified Judgement Analysis (SOJA) has bee n developed by the author. SOJA includes interactive software that combines the quality advantages of the 'top-down' approach to drug selection, based on a thorough literature review, with the compliance advantages of a 'bott om-up' approach, where the final decision is made by the individual formula ry committee and not by the authors of the review. The SOJA method, based on decision-making processes in economics, ensures t hat health outcomes information is given appropriate weight. Such approache s are valuable tools in discussions about product selection for formularies .