Transparency in Evidence Evaluation And Formulary Decision-Making: From Conceptual Development to Real-World Implementation

Objective: Establishing a better understanding of the relationship between evidence evaluation and formulary decision-making has important implications for patients, payers, and providers. The goal of our study was to develop and test a structured approach to evidence evaluation to increase clarity, consistency, and transparency in formulary decision-making. Study Design: The study comprised three phases. First, an expert panel identified key constructs to formulary decision-making and created an evidence-assessment tool. Second, with the use of a balanced incomplete block design, the tool was validated by a large group of decision-makers. Third, the tool was pilot-tested in a real-world PT however, pilot-testing of the structured tool in a realworld P&T committee environment highlighted some of the limitations of our structured approach. Conclusion: Although a structured approach to formulary decision-making is beneficial for patients, health care providers, and other stakeholders, this benefit was not realized in a realworld environment. A method to improve clarity, consistency, and transparency is still needed.