An analytical framework for assessing drug and therapeutics committee structure and work processes in tertiary Brazilian hospitals

Elisangela da Costa Lima-Dellamora*, Rosângela Caetano, Lars L. Gustafsson, Brian B. Godman, Ken Patterson, Claudia Garcia Serpa Osorio-de-Castro

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


University teaching hospitals usually provide tertiary care and are subject to early adoption of new technologies, which may compromise healthcare systems when uncritically adopted. Knowledge on the decision-making process - drug selection by drug selection committees or DTCs - is crucial to improve the quality of care. There are no models for studying the selection of drugs in Brazilian healthcare services. This study aims to discuss DTC structure and the processes regarding adoption of medicines in tertiary university hospitals in Brazil and to propose an analytical structure for providing direction for the future. State of the art content regarding drug selection processes and DTC procedures was reviewed in three databases. Information on the medicine selection process in a Brazilian gold standard teaching hospital was collected through observations and a review of existing procedures. A structured discussion on medicine selection and DTC procedures in tertiary hospitals ensued. This discussion resulted in findings that were organized in three dimensions, composing an analytical framework for the application in tertiary Brazilian hospitals (i) motivations for the adoption of drugs; (ii) necessary structural and organizational aspects for decision-making; and (iii) criteria and methods employed by the decision-making process. We believe that the suggested framework is compatible with tertiary Brazilian hospitals, because a gold standard in the country was able to conduct all its procedures in the light of WHO and international recommendations. We hope to contribute in producing knowledge which may hopefully be adopted in tertiary hospitals across Brazil.

Original languageEnglish
Pages (from-to)268-276
Number of pages9
JournalBasic and Clinical Pharmacology and Toxicology
Issue number3
Publication statusPublished - Sept 2014
Externally publishedYes


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