Hospital Formulary.ppt

Hospital Formulary-
Definition, contents of hospital formulary, Differentiation of hospital formulary and Drug list
Preparation and revision, and addition and deletion of drug from hospital formulary.

1. Hospital
Formulary
Ravinandan A P
Assistant Professor
Sree Siddaganga College of Pharmacy
Tumkur-02

2. Definition
•Formularyisacontinuallyrevised
compilationofpharmaceuticals
thatreflectsthecurrentclinical
judgmentofthemedicalstaff

3. Potential benefits / Advantages
•Therapeutic benefits
•Economical benefits
•Educational benefits

4. Disadvantages
•Deprivethephysicianofhisright&
privilegetoprescribe&obtainthebrand
ofhischoice.
•Permitsthepharmacisttoactasthesole
judgeofwhichbrandsofdrugsaretobe
purchased&dispensed.

5. Guiding principles to prepare Formulary
•AppointmentofPTC
•Setupofformularysystemrecommendationsby
PTC
•Adoptingthewrittenpoliciesandprocedures
governingtheformulary
•Inclusionofdrugsbytheirnonproprietarynames
•Restrictionofnumberofsimilarentitiesinthe
formulary
•Informationtomedicalandnursingstaff
•Appraisalofnewdrugsforentryintothe
formulary
•AllformularydrugsshouldmeetPTC
recommendations.

6. Hospital Formulary content
•Drugs approved for formulary inclusion
•Therapeutic and clinical information
•Hospital policies and procedures governing the
use of drugs
•Special information
Drug dosing rules
Nomograms
Hospital approved abbreviations
Sodium content

7. BMI Categories:
Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater

8. Parts of Hospital Formulary
Hospital Policies and Procedures
Drug product listing
Special information

9. Hospital Policies and Procedures
•Formularypoliciesandprocedures
•BriefdescriptionofhospitalPTC
•Hospitalregulationsgoverningthe
prescribing,dispensingandadministration
ofdrugs.
•Pharmacyoperatingprocedures
•Informationaboutthetechniquetousethe
formulary

10. Drug product listing
Heart of the formulary
•Consistofoneormoredescriptiveentries
•Oneormoreindex
•Formularyitementries:Alphabeticallyby
genericname Alphabeticallywithin
therapeuticclass
•Typeofinformation:Dosageform,strength,
packaging Active ingredients
Adult/paediatric dose Route of
administration,Cost
•Indexestothedrugproductslisting:Generic
name/brand name Therapeutic
/pharmacologicalindex

11. Entries
•Alphabeticallybygenericnamewith
synonymsandbrandnames
•Alphabeticallywithinthetherapeuticclass
•Acombinationoftheboth

12. Type of information
•Genericnameofthebasicdrugentity
•Combinationproducts
•Generic,commonortradename
•Synonyms
•Directionsforuse
•Dose,dosageform,strength,packagingandsize
•Formulationofcombinationproductandcategory
•Numberofformulation.

13. Additional information
•Usualadultorpediatricdosagerange
•Specialprecautions
“DonotadministerthroughIV”or
“Refrigerate”
•Controlsubstancessymbol
•Costinformation

14. Special Information
•Nutritional products listing
•Tables of equivalent dosages and similar drugs
•List of hospital abbreviations
•Rules for calculating pediatric dosage forms
•Table of sodium content in antacids
•List of sugar free drug products

15. Format & Appearance
Visuallyattractive,easilyreadableandprofessionalin
appearance.Atypicalformularymusthavethefollowing
composition;
•Titlepage
•NamesandTitlesofthePTCmembers
•Tableofcontents
•Informationonhospitalpoliciesandprocedures
PTCofXYZhospital
Objectivesandoperationofthehospitalformulary
system
hospitalregulations&proceduresforprescribing&
dispensingthedrugs
Hospitalpharmacyservicesandprocedures
Howtouseformulary

16. •Differentcolorpapersfordifferentsections
•Usinganedgeindex
•Makingtheformularyofpocketsize.
•Printingthegenericnameheadinginbold
•Listofitemsavailablefromcentralsupply
•Listofcontentsofemergencycarts
•Listofdialyzablepoisons

17. •Pharmacokineticdosingandmonitoring
information
•Metricconversionscalesandtables
•ExamplesofblankprescriptionandADRforms
•Tablesofdruginteractionsanddrug
incompatibilities
•Poisoncontrolinformation

18. FORMULARY vs DRUG LIST FORMULARY
DRUG LIST
FORMULARY
•Listingofdrugsbytheir
genericnamesfollowedby
informationonstrength,
form,posology,toxicology,
use & recommended
quantitytobedispensed.
•Preparedlocallybyitsown
clinicalstaff.
•Informationprovidedis
subjecttolocalneedsand
desires.Genericnames
followedbydataonstrength
&form.
DRUG LIST
FORMULARY
•Genericnamefollowedby
strength&form
•Preparedbycountry’s
outstanding clinicians,
pharmacologists and
pharmacists.
•According to their
pharmacologicalactions/
properties.

19. Addition And Deletion Of Drug From Hospital
Formulary.
Formulary Additions
• The assessment of new medicines is critical to managing a
formulary list, which involves adding new medicines and
old ones.
Drugs should be evaluated and compared on the basis of:
• efficacy, comparative efficacy
• effectiveness, comparative effectiveness
• safety, comparative safety
• cost of use
• quality. Efficacy, effectiveness and safety can be evaluated from a
critical assessment of the literature.
• A request for inclusion of a drug in the hospital formulary
be made by submitting a Formulary Addition Request along with
supporting literature and a signed disclosure of dual interest to
the Pharmacy and Therapeutics (P&T Committee).
• The committee will make one of the following decisions
regarding the request:
•approval (with or without restriction)
•denial
•deferment (until pertinent information becomes available)

20. Deletion of a Drug from formulary
•Suggestionsfordeletionofdrugsfromthe
formularymaybesubmittedtotheP&TCommittee
byanymemberofthemedical,pharmacy,or
nursingstaff.
•Inordertocontrolgrowthofthehospitalformulary,
someadditionswillbalancedbydeletionsof
anotherdrug.
•PTCshallperiodicallyreviewitsstocksand
varioustherapeuticclassesonanongoingbasisto
effectdeletionofduplicatedrugswhoseusageis
loworthosewhichcanreadilybereplacedbyless
costlybutequally

21. THANK YOU