STEP I: clinical evaluation
The basis for this step was predicated on the SOJA system developed in the eighties of last century by hospital pharmacist in the Netherlands.
In the SOJA method, selection criteria for a given group of medicines are prospectively developed, and the extent to which each individual medicine fulfils the requirement for each criteria is studied. Each criterion is given a relative weight determined by an expert panel in this area. The properties of all agents within a therapeutic class are effectively compared against the hypothetical ‘ ideal ’ medicine for this group. The methodology, and many SOJA productions, have been widely published over the last few decades is described fully elsewhere on the www.stepselect.com website.
The draft scoring system arrived at by the expert panel was then circulated to all secondary care consultants in Northern Ireland with an interest in the specific therapeutic area, key decision makers (including GPs with special interests in primary care), specialist clinical pharmacists,primary care prescribing advisors ,other specialist healthcare professionals,and the Association of the British Pharmaceutical Industry (ABPI) l These decision makers were asked to comment on the allocation of the scores, and to amend, delete or add new criteria if considered appropriate. Responses were anonymous in terms of individuals, but were known by speciality (e.g., cardiologist, nephrologist, general practitioner).
The last part of this step was to send the matrix to all relevant pharmaceutical companies to complete the matrix for their product as well as to provide a hospital price and confirm the current NHS price in primary care.(as regulated by the Prescription Price Regulation Scheme (PPRS)) The companies were made aware of the implications of the process, which were that it was envisaged that within the therapeutic area, at least 70% of the prescribing of the products in that particular class will be constituted by the agents selected at the end of the process.
