Collaboration for a Provincial Hospital Formulary: The New Brunswick Experience Faith Louis Regional Manager QI & Support, Pharmacy Services Horizon Health Network April 13, 2015
Speaker Disclosure Presenter has no real or potential conflicts to disclose
Background – New Brunswick • • • Population: 754, 524 Only official bilingual province 2 Regional Health Authorities (RHAs) – Vitalité & Horizon 22 hospitals (small rural to large tertiary care site) 2013/2014 RHA Drug Expenditure: $70, 848, 457 (previous year $71, 138, 716) • Regionalization in Sept 2008 (8 to 2 RHAs) • Provincial Health Plan 2009 – Included single provincial hospital formulary • Provincial Drugs & Therapeutics committee (D&T) launched in Fall 2010 – Single committee structure with representation and support from both RHAs; universal decision binding to all hospital sites; single provincial hospital formulary
Areas of Collaboration with Provincial Pharmaceutical Services • New Brunswick Department of Health, Pharmaceutical Services underwrites and administratively supports Provincial D&T – Meeting costs, per diems for physicians, admin support, translation, Share. Point collaborative site • Personnel supporting NB Prescription Drug Plan (NBPDP) sit at main D&T committees/working groups and share information with RHA team – Status of medications under evaluation by D&T with NBPDP including restrictions, existence of price listing agreements (PLAs), upcoming reviews or changes at NBPDP • Regular bi-weekly teleconferences between Executive Director, Department of Health, Pharmaceutical Services Branch, RHA Directors of Pharmacy, and Secretary of D&T (forms D&T secretariat)
Speaker Perspective • Regional Manager of Quality Improvement and Support Services, Pharmacy, Horizon Health Network • Pharmacist Manager in Regional Health Authority (RHA) • Hospital perspective • Principal Secretariat for NB Provincial Drugs and Therapeutics committee (D&T) • Act as secretary for Provincial D&T working with RHA Directors of Pharmacy and Executive Director, Department of Health, Pharmaceutical Services Branch • Provincial mandate & scope (Provincial Hospital Formulary)
Decision Making Process • Representation at all levels by both RHAs (committee/subcommittee/working groups) – Provincial stakeholder feedback process – Subcommittees vet evaluations and submitted information: make recommendations to D&T – Decisions at D&T by majority vote (use electronic voting) • Considerations – evidence informed approach • Includes consideration of CADTH evaluations and reports, The Institut national d’excellence en santé et en services sociaux (INESSS) recommendations, NBPDP status – Seamless Care between hospitals and between hospital and community after discharge
Opportunities and Challenges • Opportunities – Greater alignment between hospitals and publicly funded provincial outpatient drug program – Seamless Care between hospitals as well as between hospital & community post discharge – Better use of resources (financial, HR); potential for cost savings with better overall formulary management • Challenges – What works in community doesn’t always work in hospitals and vice versa – Delays in decisions to allow alignment of formulary listings • E. g. dabigatran, ticagrelor, chemotherapy agents
Rewards • Major provincial initiative – great buy-in – closer working relationship and alignment with publicly funded provincial drug program – greater alignment of formulary listings between hospital and community and continuity of care post discharge • Higher level of practice – evidence informed approach – degree of scrutiny is higher/expectations are higher – consolidation of human resources
Thank You Faith. Louis@Horizon. NB. ca
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