Hospital formulary

Prepared by: Dr. Zumar Rizvi

 DEFINITION
A formulary is a continually revised list of drug products, which reflects the
current clinical judgment of the medical staff.
HOSPITAL FORMULARY SYSTEM
•The formulary system is an ongoing process whereby an Organization’s
pharmacy and medical staffs, working through a pharmacy and therapeutics
(P&T) committee evaluate and select the drug products that are considered to be
most useful in patient care.
•These products then are routinely available for use within the organization.
•Provides information on procuring, dispensing, and administration of drugs
under brand/generic names.
 OBJECTIVES OF A FORMULARY

• The primary objectives of the formulary are to provide

1. Information on the approved drug products.
2. Basic therapeutic information about each item.
3. Information on organizational policies and procedures governing the use of drugs.
4. Special information, such as dosing guidelines and monographs, abbreviations
approved for prescribing.
 TYPES OF FORMULARY

NATIONAL FORMULARY
National formulary is a compilation of all drugs available in a country. In Pakistan, national
formulary is under preparation
LOCAL OR PRIVATE FORMULARY
This formulary is also called a hospital owned formulary and is a compilation of drugs used
in an institution.
SPECIALIZED FORMULARY
Provides information on very particular specialty products is the specialty formulary. E.g
enteral nutrition products requires specialty formulary for use of the medical and dietetic
staffed.
 FORMULARY MANAGEMENT SYSTEMS
The formulation management system constitutes the
1) Production
2) Distribution
3) Updating of the formulary of drugs.
1) PRODUCTION
•Technical, complex and time-consuming task
•Accomplished by experts in particular fields
•Under the advice of pharmacy and therapeutics committee.
 FORMULARY MANAGEMENT SYSTEMS

2) DISTRIBUTION
On the completion, the copies of drug formulary are to be distributed among all the
prescribers, nurses, medical staff.
 FORMULARY MANAGEMENT SYSTEMS

3) FORMULARY UPDATING
Formulary goes outdated due to the:
• Introduction of new drug
• Removal of existing drugs from marketplace.
Change in hospital policies and procedures.
• Changing data on adverse reaction profiles as provided by post-marketing surveillance.
• Demand for inclusion/exclusion of new/existing drugs from.
 SIZE OF FORMULARY

• No specific size can be recommended; however, a formulary that is sufficiently small and
handy in size will, in all probability, enjoy widespread acceptability and use in an
institution.
 CRITERIA FOR APPROVAL / DELETING
DRUGS FROM FORMULARY

The P&T committee will take into consideration

• Availability of a substitute.
• Volume of usage in hospital
• Cost effectiveness
• Inventory considerations at pharmacy
The committee will review and reprint the formulary once in two years
 FORMULARY CHANGES

• To add or delete a drug from formulary drug list:

A consultant must submit a request form to pharmacy & therapeutic committee.
USE OF NON-FORMULARY DRUGS
• A formulary cannot cover all possible situations and thus a patient can receive
treatment out from a formulary's recommendations.
• A non-formulary drug in many institutions is dispensed only to inpatients on a
physician’s order by the use of a non-formulary' drug request form.