Maintaining the formulary system

Dr Chang begins describing the details of formulary maintenance, focusing on how the pharmacists carry out new product evaluation, therapeutic class review, and formulary changes.

Key points

Formulary maintenance is an ongoing process including:

• New product evaluation

• Therapeutic class review

• Formulary changes

• Non-formulary drug use review

Pharmacists must develop a standard format for reviewing new drugs is useful in facilitating PTC discussions.

Standard elements include:

• Indications for use

• Pharmacokinetics

• Safety and cost

• Drug storage

• Mode of administration

• Special consideration and drug dispensing issues

• Etc.

Occasionally, new drugs are added to the formulary for 3-6 months as trial periods, as information on new drugs is limited.

Regularly reviewing therapeutic drug classes is useful in assuring that optimal drug options are available. Reviews should not be too broad or all-inclusive. Review criteria might include new medical information, adverse events profiles, purchase or use data, and cost.

The formulary must be constantly updated. The process involves the submission of a request for change from the pharmacy or medical staff. This request should contain specific information such as the agent to be considered for addition or deletion, the rationale for the request, and alternative agents currently on the formulary.

At TVGH:

When reviewing new drugs, the PTC list all related drugs from the same category and review the entry date, reimburse price, daily cost, monthly consumption, and manufacturer, etc. There is also a standardized working sheet and checking list for formulary management. Whenever a new drug is approved, the PTC informs the pharmacy department to key essential information into the pharmacy management system.

Share and learn:

How often is your hospital formulary reviewed?

How are pharmacists involved in this process?