title: Economic evaluation and the Jordan Rational Drug List: an exploratory study of national-level priority setting.
abstract: OBJECTIVE
  To explore the extent of and barriers to the use of economic evaluation in compiling the Jordan Rational Drug List in the health care system of Jordan.
  
  
  METHODS
  The research reported in this article involved a case study of the Jordan Rational Drug List. Data collection methods included semi-structured interviews with decision makers and analysis of secondary documentary sources. The case study was supplemented by additional interviews with a small number of Jordanian academics involved in the production of economic evaluation.
  
  
  RESULTS
  The research found that there was no formal requirement for cost-effectiveness information submitted as part of the decision-making process for the inclusion of new technologies on the Jordan Rational Drug List. Both decision makers and academics suggested that economic evidence was not influential in formulary decisions. This is unusual for national formulary bodies. The study identified a number of barriers that prevent substantive and routine use of economic evaluation. While some of these echo findings of previous studies, others-notably the extent to which the sectional interests of clinical groups and commercial (pharmaceutical) industry exert undue influence over decision making-more obviously result from the specific Jordanian context.
  
  
  CONCLUSIONS
  Economic evaluation was not found to be influential in the Jordan Rational Drug List. Recommendations for improvement include enhancing capacity in relation to generating, accessing, and/or applying health economic analysis to priority setting decisions. There is a further need to incentivize the use of economic evaluation, and this requires that organizational and structural impediments be removed.
authors.affiliation: Health Services Management Centre, University of Birmingham, UK.
authors.forename: Rania
authors.initials: R
authors.lastname: Lafi
authors.forename: Suzanne
authors.initials: S
authors.lastname: Robinson
authors.forename: Iestyn
authors.initials: I
authors.lastname: Williams
mesh_terms: D003362:Cost-Benefit Analysis; D003625:Data Collection; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics*; D018954:Drugs, Essential / Q000191:economics*; D005569:Formularies as Topic; D006801:Humans; D007597:Jordan
chemical_list: D018954:Drugs, Essential