THE MEDICINE SELECTION PROCESS IN HOSPITALS: LOGIC MODEL BETWEEN HOSPITAL-BASED HTA NUCLEI AND PHARMACY AND THERAPEUTICS COMMISSIONS

Abstract

Introduction: The selection of medicines is a critical axis for promoting rational use and access to safe and effective therapies. In hospitals, this process remains incipient, and Health Technology Assessment (HTA) is a key strategy to provide scientific evidence to support decision-making. Objectives: To develop and validate a logic model for the medicine selection process, focusing on the interaction between Pharmacy and Therapeutics Committees (PTCs) and Hospital-Based Health Technology Assessment Centers (HB-HTA Centers) in federal university hospitals in Brazil. Methodology: This is a qualitative study based on case studies from eight hospitals and theoretical frameworks on the topic. Validation was conducted through a focus group. Results: Two models were developed: one to explain the inadequacy of medicine selection due to the lack of HTA-based evidence, and another presenting actions to address the issue, centered on the interaction between the two groups. Seven actions were identified as joint efforts between PTCs and HTA Centers, including documentation, workflow organization, HTA application, auditing, and post- selection monitoring. Invalidation conditions were also described to guide the development of monitoring indicators. Conclusion: The logic model offers a structured view of fifteen actions involved in the hospital medicine selection process. These models aim to guide institutional practices and serve as a foundation for future evaluative studies.