Figure 1

Routes to include a drug in the clinical practice of Chilean public hospitals.Three routes are available for doctors to prescribe a drug not included in the formulary of Chilean hospitals. (1) Doctors can apply to the PTC for a drug through the pharmacy office. (2) They can request the exceptional purchase of a medicine. (3) If they think the patient can afford the drug, they can ask them to buy the drug privately to be used in the hospital. The number of requests for exceptional purchases grew gradually over time for some drugs; to avoid the paperwork associated with processing too many requests, the pharmacy office asks the PTC for the inclusion of this drug into the formulary (4).