Knowledge about evidence-based medicine selection and the role of the Drug and Therapeutics Committee DTC is an important topic in the literature but is scarcely discussed in Brazil. Our objective, using a qualitative design, was to analyze the medicine selection process performed in four large university hospitals in the state of Rio de Janeiro. Information was collected from documents, interviews with key informants and direct observations. Two dimensions were analyzed: the structural and organizational aspects of the selection process and the criteria and methods used in medicine selection.
The findings showed that the DTC was active in two hospitals. The structure for decision-making was weak. DTC members had little experience in evidence-based selection, and their everyday functions did not influence their participation in DTC activities. The methods used to evaluate evidence were inadequate. The uncritical adoption of new medicines in these complex hospital facilities may be hampering pharmaceutical services, with consequences for the entire health system.
Although the qualitative approach considerably limits the extent to which the results can be extrapolated, we believe that our findings may be relevant to other university hospitals in the country.
The rational use of health technologies - medicines, equipment and devices, medical and surgical procedures, organization and support systems Brasil, - implies that their selection must be satisfactory to justify financing decisions and also requires the identification of the conditions in which they must be used Krauss-Silva, Clinical, social and economic impacts should be considered in terms of analyses of efficacy, safety and comparative cost-effectiveness.
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In the case of medicines, the World Health Organization states that activities linked to the selection process must be performed, either in institutions or in health systems, by the Drug and Therapeutics Committee DTC , with the participation of health professionals with expertise in the assessment of scientific evidence WHO, The DTC must have clear goals, a firm mandate, support from institutional management or government, transparency in its procedures, wide representation, technical competence, multidisciplinary focus and sufficient resources to implement its decisions WHO, These Committees have several functions.
