Inefficient and irrational use of medicines is a widespread problem at all levels of health
care (Hogerzeil 1995). Per capita wastage from inefficiencies and irrational use tends to
be greatest in hospitals; this is particularly worrisome since resources are scarce and
prescribers in communities often copy hospital prescribers. Many of these sources of wastage
could be reduced if some simple principles of drug management and use were followed.
However, it is difficult to implement these principles because staff from many different
disciplines are involved in different aspects of drug management and use. Often there is
no forum for these different disciplines to work together in developing and implementing
appropriate drug policies.
In hospital settings, a drug and therapeutics committee (DTC) provides a forum to bring
together all the relevant people to work jointly to improve health-care delivery. As such,
a DTC may be regarded as a tool for promoting more efficient and rational use of medicines.
In many developed countries, a well-functioning DTC has been shown to be one of the
most effective structures in hospitals able to address drug use problems (Weekes and
Brookes 1996). However, in many developing countries DTCs do not exist and in others
they do not function effectively.