OBJECTIVES:

Hospital Drugs and Therapeutic Committee (DTC) or its equivalent are responsible for making recommendations to fund new medicines on the hospital formulary. These decisions are complex. While safety, efficacy and cost-effectiveness are key considerations, there is limited information surrounding the trade-offs and relative importance of other factors that influence their decisions. This study aimed to understand hospital decision makers (HDMs) stated preferences and the value placed on specific attributes of new treatments for hyperkalaemia to a relevant comparator. Other factors influencing their decision-making were explored.

METHODS:

Six HDMs were involved in qualitative interviews to inform the design of the discrete choice experiment (DCE). HDMs (n=60) from public and private hospitals in Australia were recruited through a specialist healthcare panel to complete the survey. HDMs were members of the DTC or equivalent and/or had made applications to the hospital formulary. Survey questions elicited treatment attitudes, decision-making criteria and the evidence considered. The DCE required HDMs to trade-off attributes including hospital resource use, frequency and mode of administration, onset of action, side effects, drug interactions and cost. The relative priority HDMs place on different attributes and estimate their willingness to pay for new treatments was assessed using latent class models.

RESULTS: HDMs primary clinical role and hospital funding model influenced the key factors driving funding decisions. HDMS were less willing to trade off safety, efficacy and administration to competing considerations such as access and cost-effectiveness.

CONCLUSIONS:

HDMs preferences were consistent with clinical roles and treatment experience. Overall, HDMs were willing to trade-off between the benefits (clinical and patient), risks (safety) and cost (resource use and treatment cost) when considering the funding of new treatments in the hospital setting.