Drugs are emerging technologies that improve people’s health outcomes. The evaluation of optimal drug utilization in health-care facilities is the responsibility of the Chief of Pharmacy and the heads of the medical departments and units concerned, the Pharmacy and Therapeutics Committee, and the Council of Physicians, Dentists and Pharmacists.
To promote optimal drug utilization, Quebec’s five university teaching hospitals, which are listed below, put in place, in January 2004, a therapeutic drug management program: the Programme de gestion thérapeutique des médicaments (PGTM):
- The Centre hospitalier de l’Université de Montréal (CHUM)
- The McGill University Health Centre (MUHC)
- The Centre hospitalier universitaire Sainte-Justine (CHUSJ)
- The Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke (CIUSSS de l’Estrie-CHUS)
- The Centre hospitalier universitaire de Québec – Université de Laval (CHU de Québec)
This website is intended for Quebec’s health professionals. It is not a drug information platform. The following series of questions and answers is aimed at further explaining what the PGTM is.
Where did the idea for a therapeutic management program originate from?
The Programme de gestion thérapeutique des médicaments, hereinafter referred to as the PGTM, is an initiative of Quebec’s five university teaching hospitals (UTHs): the McGill University Health Centre (MUHC), the Centre hospitalier de l’Université de Montréal (CHUM), the Centre hospitalier universitaire de Québec (CHUQ), the Centre hospitalier universitaire Sainte-Justine (CHUSJ), and the Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke (CIUSSS de l’Estrie-CHUS).
What is therapeutic management?
In the context of the PGTM, therapeutic management is defined as a systematic approach to evaluating drugs, from appraising them with a view to their inclusion in the UTHs’ local formularies to assessing their impact on different patient populations. Therapeutic management integrates systematic literature reviews and evaluative research on practices pertaining to drug utilization and on measuring the impact on health care costs. Therapeutic management is also aimed at developing decision support tools and methods for working with clinicians to promote optimal drug utilization.
What is the PGTM’s mandate?
The PGTM is accountable to the Conférence des centres hospitaliers universitaires du Québec. Its mandate is to promote optimal drug utilization at the UTHs by means of care, teaching, research and technology assessment activities.
What are the guiding principles of the PGTM?
The PGTM is based on the following guiding principles:
Collaboration, real and equitable collaboration between the UTHs and between health professionals (e.g., physicians and pharmacists).
Scientific validity through the use of appropriate evidence-based evaluation methods.
Transparency throughout the process, taking the legal constraints into account.
Relevance through the development of tools that meet clinicians’ needs and support decision-making and teaching activities.
Scientific dissemination in order for the system’s health professionals to benefit from the program and for it to be peer-recognized.
Continuity through the development of methods, databases and tools that promote the ongoing evaluation of the drugs of interest.
Ethics, by complying with ethical principles.
What are the objectives of the PGTM?
- To promote optimal drug utilization in terms of efficacy, safety and efficiency by making quality in the provision of care and the communication of information priorities in order to improve the health of patients and the general public.
- To limit drug utilization that would be suboptimal in terms of costs and efficiency.
- To develop and apply a standardized
process for evaluating all the stages of drug utilization, including:
- The systematic evaluation of evidence concerning drugs, including evaluating the scientific literature, assigning levels of scientific evidence with regard to safety and efficacy, a literature review of the available pharmacoeconomic data, the potential budget impact of drugs on the UTHs, and developing drug utilization rules.
- Evaluating drug utilization by means of descriptive analyses, drug utilization reviews (DURs) and follow-up DURs.
- To develop clinical intervention models aimed at instituting effective tools that are useful to clinicians in order to promote optimal drug utilization at the UTHs.
- To ensure the program’s effectiveness and efficiency by pooling expertise and resources through the following:
- Developing and sharing standardized documents (utilization rules [URs], descriptive analyses [DAs], drug utilization reviews [DURs], follow-up drug utilization reviews
and clinical intervention models [CIMs]).
- Developing and sharing clinical, scientific and methodological expertise.
- To develop and share common, effective methods of disseminating information.
- To conduct evaluative research.
The goal of the PGTM is not to replace the UTHs’ Pharmacy and Therapeutics Committees. Rather, it seeks to limit duplication in the different pre-decision-making steps at these hospitals and at providing them with tools that will make it easier to monitor drug utilization. The decisions made by the TDMP apply only to the program. Therefore, each Pharmacy and Therapeutics Committee is independent in terms of the recommendations it makes at its hospital.
Who is part of the PGTM?
The PGTM is a team of pharmacists and physicians from UTHs with an interest in drug evaluation. Two committees make up the PGTM. A physician and a pharmacist from each of the five centers form the scientific committee that evaluates the projects and makes scientific recommendations. The executive committee is made up of the directors of professional services (DSP) and the heads of the pharmacy departments of the five university hospitals and considers the pharmaco-economic aspect and the applicability of the recommendations. If necessary, and depending on the nature of the projects, additional experts may be asked to participate in their production or as reviewers.