Skip main navigation

Maintaining the formulary system

video
14.7
The followings we will talk about the details of formulary maintenance. It is an ongoing process including new product evaluation, Therapeutic Class Review, Formulary Changes and Non-formulary Drug Use Review
35.6
In the new product evaluation, Pharmacists have the opportunities to assume a leadership role in the selection of agent to the formulary. Development of a Standard format for reviewing new drugs is useful in facilitating PTC discussions. Standard elements include considering the indications for use, pharmacokinetics, safety and cost. Considerations to drug storage, mode of administration, special consideration and drug dispensing issues should be included in the evaluation. For example, pharmacist need to consider if the new agent with the same package appearance may cause dispensing errors. In the reviewing process, Some health system add new agents to the formulary for a limited or trial period such as 3 to 6 months.
106.8
The conditional approval allows the PTC to further assess the use and safety for the product before final formulary addition. A wait and see attitude often serves a PT committee well when deciding to add a new drug. Many new drugs on the market can have insufficient evidence for safety because they only need to be tested on a limited number of patients prior to authorities of government approval. In addition, the utility pattern of the new drug by physician will also be unclear.
157.3
The regular review of drug class by the PTC is useful in assuring that optimal drug therapeutic options are available. Therapeutic class reviews should not be so broad or all inclusive. The committee set forth criteria for these review. Such criteria might include new medical information, adverse events profiles, purchase or use data and cost. Some PT committee including our hospital conduct a therapeutic review with each consideration for formulary addition. The objective is to have the optimal agents within a therapeutic class in terms of efficacy, safety and cost. The end result of a therapeutic class review may be formulary modifications, implementation of a drug use review or the development of therapeutic guidelines.
232.7
Here I show you an example of how we list all related drug in the same category as a new drug in the review process. We will consider the entry date, reimburse price, daily cost, monthly consumption and manufacturer, etc.. It will facilitate the review process. A process to continually update the formulary must be established. Such a process should include a method for making additions and deletions to the formulary. This process typically involves the submission of a request for formulary addition or deletion from the pharmacy or medical staff. The request maybe written or verbal.
290.4
Requests generally require specific information includes: agent to be considered for addition or deletion, rationale for request, and alternative agents currently on the formulary.
309.4
This is the working sheet and checking list for formulary management in Taipei Veterans General Hospital. For example, as a new drug is approved to add on the formulary, the PT committee will inform the pharmacy department. The staff pharmacists will built up the essential information into the pharmacy management system. As you can see the stamps here, it revealed every formulary change need more than 15 steps to build up the monograph for a specific agent in the 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?

This article is from the free online

Good Pharmacy Practice: Medication Management

Created by
FutureLearn - Learning For Life

Our purpose is to transform access to education.

We offer a diverse selection of courses from leading universities and cultural institutions from around the world. These are delivered one step at a time, and are accessible on mobile, tablet and desktop, so you can fit learning around your life.

We believe learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.
You can unlock new opportunities with unlimited access to hundreds of online short courses for a year by subscribing to our Unlimited package. Build your knowledge with top universities and organisations.

Learn more about how FutureLearn is transforming access to education