Background The X healthcare system is facing unprecedented challenges to healthcare expenditure that warrants healthcare reform and cost cutting. The pharmacy therapeutic committees (PTC) in hospitals play a pivotal role in a hospital formulary management system to ensure cost containment and to improve quality of care.

Purpose Our study investigates the current PTCs’ structures, activities, variations and potential factors that might influence the decision-making of these committees within Saudi Arabian hospitals.

Material and methods The study was conducted in governmental and private hospitals in X from May to July 2018 using a mixed-methods approach consisting of a quantitative, questionnaire-based study followed by a qualitative study with a triangulation technique for data collection that involved observations as well as in-depth semi-structured interviews to generate more robust findings. Ethical approval for the study was obtained from the participating hospitals.

Results One hundred and nine members were invited from seven institutions for the questionnaire: 51.47% responded. For the qualitative interview, 25 members were required to reach data saturation. All PTCs had policies and procedures outlining the committee’s activities, and an approved committee formation order. Most of the PTCs (45, 88.2%) conduct their meetings every month, and all their activities complied with CBAHI’s accreditation minimum requirements. The greatest challenges reported, were time restraints on PTC activities (seven, 28%), lack of awareness of their function in committee, evidence-based evaluation and budget restraints (five, 20%), and the stock monitoring system and lack of expertise in pharmacoeconomics (three, 12%).

Conclusion Based on our study findings, PTCs in the X health sector need to invest in standardising the functions and processes of PTCs, developing training programmes to support PTCs members in specialised aspects of formulary management, setting minimum standards for committee members’ selection and investing in stock monitoring IT solutions. Such changes may improve PTCs’ efficiency and cost cuts to align with the vision.

Reference and/or acknowledgements World Health Organization 2003. Available from: http://apps.who.int/medicinedocs/pdf/s4882e/s4882e.pdf (Accessed: 1 January 2018).

No conflict of interest.