Drug Selection for Formulary Inclusion: An Exploratory Case Study of Oncology Medicines in Jordan

¹Ibrahim Alabbadi, PhD, ²Emad Almomani, MSc, ³Muna Alshazili, MSc

¹The University of Jordan; ²Center for Health Technology Assessment, Jordanian Royal Medical Services; ³Pharmacy One, Amman, Jordan

Background: Access to healthcare services including innovative treatments is one of the most important objectives of healthcare system in Jordan. This research summarized one of the actual practices pertaining to health priority setting in Jordan with official requirement to use cost-effectiveness analysis.

Objectives: To address the role of economic evidence to inform the decisions and rationales drawn by health policy experts to optimize resources mobilization for new cancer drugs.

Method: The research reported a case study of formulary setting priority in Jordan. Documentary collation and analysis of a secondary source (meeting minutes) produced by decision committee were conducted by the research team. The decisions and rationales shaped by panelists for 22 newly registered oncology drugs at Jordan Food and Drug Administration were reviewed and described.

Results: It was found that the absence of official health economic guidelines in the country and informal use of cost-effectiveness analysis by the panelists appeared to flaw the importance of incremental cost-effectiveness ratio (ICER).

Nevertheless, “the lower the ICER, the better the drug” was the primary factor in all committee’s decisions to inform resources mobilization. Despite of the latter, 7 drugs were selected for formulary inclusion for different oncology disease areas in Jordan.

Conclusions: Priority setting for new cancer drugs is not well-informed in Jordan. Nevertheless, this research revealed different disadvantages that appear to militate against the perspective of the study. Recommendations for implementation and enhancement of health economic evaluation include further investment in capacity building (eg, prepare qualified health economists) and create incentive to improve availability and accessibility of local data.