IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0084824.html
   My bibliography  Save this article

The Role of Evidence in the Decision-Making Process of Selecting Essential Medicines in Developing Countries: The Case of Tanzania

Author

Listed:
  • Amani Thomas Mori
  • Eliangiringa Amos Kaale
  • Frida Ngalesoni
  • Ole Frithjof Norheim
  • Bjarne Robberstad

Abstract

Background: Insufficient access to essential medicines is a major health challenge in developing countries. Despite the importance of Standard Treatment Guidelines and National Essential Medicine Lists in facilitating access to medicines, little is known about how they are updated. This study aims to describe the process of updating the Standard Treatment Guidelines and National Essential Medicine List in Tanzania and further examines the criteria and the underlying evidence used in decision-making. Methods: This is a qualitative study in which data were collected by in-depth interviews and document reviews. Interviews were conducted with 18 key informants who were involved in updating the Standard Treatment Guidelines and National Essential Medicine List. We used a thematic content approach to analyse the data. Findings: The Standard Treatment Guidelines and National Essential Medicine List was updated by committees of experts who were recruited mostly from referral hospitals and the Ministry of Health and Social Welfare. Efficacy, safety, availability and affordability were the most frequently utilised criteria in decision-making, although these were largely based on experience rather than evidence. In addition, recommendations from international guidelines and medicine promotions also influenced decision-making. Cost-effectiveness, despite being an important criterion for formulary decisions, was not utilised. Conclusions: Recent decisions about the selection of essential medicines in Tanzania were made by committees of experts who largely used experience and discretionary judgement, leaving evidence with only a limited role in decision-making process. There may be several reasons for the current limited use of evidence in decision-making, but one hypothesis that remains to be explored is whether training experts in evidence-based decision-making would lead to a better and more explicit use of evidence.

Suggested Citation

  • Amani Thomas Mori & Eliangiringa Amos Kaale & Frida Ngalesoni & Ole Frithjof Norheim & Bjarne Robberstad, 2014. "The Role of Evidence in the Decision-Making Process of Selecting Essential Medicines in Developing Countries: The Case of Tanzania," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-10, January.
  • Handle: RePEc:plo:pone00:0084824
    DOI: 10.1371/journal.pone.0084824
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0084824
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0084824&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0084824?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Anders Anell, 2004. "Priority setting for pharmaceuticals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(1), pages 28-35, February.
    2. Hans-Martin Späth & Marie Charavel & Magali Morelle & Marie-Odile Carrère, 2003. "A qualitative approach to the use of economic data in the selection of medecines for hospital formularies: a French survey," Post-Print halshs-00335137, HAL.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gregory Merlo & Katie Page & Pauline Zardo & Nicholas Graves, 2019. "Applying an Implementation Framework to the Use of Evidence from Economic Evaluations in Making Healthcare Decisions," Applied Health Economics and Health Policy, Springer, vol. 17(4), pages 533-543, August.
    2. Katharina Fischer & Reiner Leidl, 2014. "Analysing coverage decision-making: opening Pandora’s box?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(9), pages 899-906, December.
    3. Morgan, Steve & McMahon, Meghan & Greyson, Devon, 2008. "Balancing health and industrial policy objectives in the pharmaceutical sector: Lessons from Australia," Health Policy, Elsevier, vol. 87(2), pages 133-145, August.
    4. Margreet Franken & Fredrik Nilsson & Frank Sandmann & Anthonius Boer & Marc Koopmanschap, 2013. "Unravelling Drug Reimbursement Outcomes: A Comparative Study of the Role of Pharmacoeconomic Evidence in Dutch and Swedish Reimbursement Decision Making," PharmacoEconomics, Springer, vol. 31(9), pages 781-797, September.
    5. Gregory Merlo & Katie Page & Julie Ratcliffe & Kate Halton & Nicholas Graves, 2015. "Bridging the Gap: Exploring the Barriers to Using Economic Evidence in Healthcare Decision Making and Strategies for Improving Uptake," Applied Health Economics and Health Policy, Springer, vol. 13(3), pages 303-309, June.
    6. Fischer, Katharina E. & Leidl, Reiner & Rogowski, Wolf H., 2011. "A structured tool to analyse coverage decisions: Development and feasibility test in the field of cancer screening and prevention," Health Policy, Elsevier, vol. 101(3), pages 290-299, August.
    7. Greß, Stefan & Klaucke, Lena & Kötting, Cosima & May, Uwe & Wasem, Jürgen, 2008. "Preisregulierung von verschreibungspflichtigen Arzneimitteln in der gesetzlichen Krankenversicherung nach dem GKV-Wettbewerbsstärkungsgesetz," IBES Diskussionsbeiträge 170, University of Duisburg-Essen, Institute of Business and Economic Studie (IBES).
    8. Fischer, Katharina Elisabeth, 2012. "A systematic review of coverage decision-making on health technologies—Evidence from the real world," Health Policy, Elsevier, vol. 107(2), pages 218-230.
    9. Anders Anell & Ulf Persson, 2005. "Reimbursement and clinical guidance for pharmaceuticals in Sweden," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(3), pages 274-279, September.
    10. Jommi, Claudio & Costa, Enrico & Michelon, Alessandra & Pisacane, Maria & Scroccaro, Giovanna, 2013. "Multi-tier drugs assessment in a decentralised health care system. The Italian case-study," Health Policy, Elsevier, vol. 112(3), pages 241-247.
    11. Aris Angelis & Ansgar Lange & Panos Kanavos, 2018. "Using health technology assessment to assess the value of new medicines: results of a systematic review and expert consultation across eight European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 123-152, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0084824. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.