Title 7. HOSPITAL FORMULARY.pdf ✅

PHARMD GURU Page 1 DEFINITION: The hospital formulary is a continuously revised compilation of pharmaceutical dosage agent and their forms etc. which reflects the current clinical judgment of the medical staff. HOSPITAL FORMULARY SYSTEM: The hospital formulary system is a method where by the medical staff of a hospital with the help of pharmacy and therapeutic committee , selects and evaluates medicinal agents and their dosage forms which are considered to be most useful in the patient care. Hospital formulary provides information for  Procuring.  Prescribing.  Dispensing.  Administration of drugs. ORIGIN OF HOSPITAL FORMULARY:  The first hospital formulary in India was published in 1968 by the Department of Pharmacy, CMC, Vellore.  The first hospital formulary for the development of government hospital teachings was published in 1997 at Government Medical College, Trivendrem, Kerala ADVANTAGES OF HOSPITAL FORMULARY:  Most effective methods for ensuring rational drug therapy and controlling drug cost.  They can offer simple and cost-effective solutions for many medicines.  Formulary is a continually revised compilation of pharmaceuticals and some important ancillary information that reflects the current clinical judgement of medical staff. HOSPITAL FORMULARY
PHARMD GURU Page 2  Set standards for best practice, promoting high quality,evidence based prescribing  Reduces the variation in the level of treatment provided to the patients and controlling drug cost.  Hospital formulary is the vehicle by which the medical, pharmacy and nursing staffs make use of the system.  It is complete, concise, updated and easy to use.  The implementation of the formulary will have significant impact on clinical practice of health care professionals.  It helps physicians to know about the available drugs in the hospital pharmacy and also helps in better inventory control.  This review gives the complete information about the importance, preparation and benefits of the formulary.  Quality of care will be further improved if medicine selection is based on evidence based treatment guidelines.  It is made so precise that it is very handy for use by the physician and nursing staff. DISADVANTAGES OF HOSPITAL FORMULARY:  The hospital formulary system deprives the physician of his right and prerogative to prescribing and obtained the brand of his choice.  The hospital formulary system in many instances, permit he pharmacist to act as the sole judge of which brands of drugs are to purchased and dispensed.  The system allow for the purchase of inferior quality of drugs particularly in institutions where there is no staff pharmacist.  The system does not reduce the cost of drug to the patient or the third party payer because most institution purchase large volume of drug at reduce rate do not pass on the patient any reduction in their cost.
PHARMD GURU Page 3 TYPES OF HOSPITAL FORMULARY: There are three basic types of formularies: 1. Open formulary. 2. Closed or restricted formulary. 3. Incentive based formulary. OPEN FORMULARY: An open formulary serves merely as a guide; a physician may prescribe any drug, but is encouraged to use the formulary list in prescribing decisions. CLOSED OR RESTRICTED FORMULARY: In contrast, a closed or restricted formulary lists the drugs that will be reimbursed by the health care provider; non-formulary drugs will be reimbursed only if they are authorized prior to prescribing. INCENTIVE BASED FORMULARY: An incentive-based formulary represents a hybrid between the open and closed formularies; patients pay a higher price for non formulary drugs. MEMBERS INVOLVED IN THE PREPARATION OF HOSPITAL FORMULARY:  The most important function of Drugs and Therapeutics Committee (DTC) is to prepare and implement a formulary for the hospital.  The committee should have sufficient members to represent all stakeholders, including the major clinical departments, the administration and the pharmacy.  Members should be selected with reference to their positions and responsibilities.
PHARMD GURU Page 4 In most hospitals, the membership includes:  A representative clinician from each major specialty, including surgery, obstetrics and gynecology, internal medicine, pediatrics, infectious diseases, and general practice (to represent the community).  A clinical pharmacologist, if available.  A nurse, usually the senior infection control nurse, or sometimes the matron.  A pharmacist (usually the chief or deputy chief pharmacist),or a pharmacy technician where there is no pharmacist.  An administrator, representing the hospital administration and finance department.  A clinical microbiologist or a laboratory technician where there is no microbiologist.  A member of the hospital records department. CRITERIA IN MEDICINE SELECTION : Selection of drugs depends on many factors, such as the  Pattern of prevalent diseases.  Treatment facilities.  Training and experience of available personnel.  Financial resources.  Genetic.  Demographic and environmental factors. WHO (1999) has developed the following selection criteria:  Only those medicines should be selected for which sound and adequate data on efficacy and safety are available from clinical studies, and for which evidence of performance in general use in a variety of medical settings has been obtained.