• Joan Prades and Josep M Borràs.
• Pla Director d'Oncologia, Departament de Salut, Hospitalet de Llobregat, Barcelona, España. jlprades@iconcologia.net
• Gac Sanit. 2010 Sep 1; 24 (5): 416-22.

ObjectivesTo analyze the prioritization process for chemotherapy drugs in the Drug-Therapeutic Committees (DTCs) in Catalan hospitals and assess their impact on patients' access to these drugs.MethodsA case qualitative study of the DTCs of tertiary hospitals in Catalonia was performed, based on semi-structured interviews and a review of the scientific literature. Key professionals were interviewed with technical and institutional involvement in the DTCs assessment process, including pharmacists, oncologists, clinical pharmacologists and other physicians with different medical specialties. The conceptual framework "accountability for reasonableness", by Daniels and Sabin, which analyzes prioritization processes from a "fair and legitimate decision-making" perspective, was used.ResultsThe current regulatory framework for the introduction of drugs is characterized by a fragmented hospital system and lacks coordination strategies. These weaknesses fail to allow the prioritization and optimization of resources in the Catalan health service.ConclusionWe propose the implementation of a decision-making coordination strategy for all public sector hospitals. This strategy would allow an increasingly innovative environment to be exploited, in which inequalities in access to drugs at the hospital level should be avoided.Copyright © 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

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