Addition of a Drug to the Hospital Formulary:
Proposal:
A drug can be proposed for addition by any healthcare professional but often comes from pharmacists or physicians.
The proposer will typically submit supporting evidence such as clinical studies, cost-effectiveness analyses, and therapeutic needs.
Review by the P&T Committee:
The Pharmacy and Therapeutics (P&T) Committee reviews the proposed drug, considering factors like efficacy, safety, cost, therapeutic gap in the current formulary, and comparison to existing alternatives.
Decision:
Based on evidence and discussion, the committee decides whether to add the drug.
If approved, guidelines regarding its use, dosing, side effects, contraindications, and monitoring may be included.
Communication:
Once added, the inclusion is communicated to all relevant stakeholders within the institution, ensuring everyone is aware of the new therapeutic option and its proper usage.
Deletion of a Drug from the Hospital Formulary:
Initiation:
The process can be initiated due to various reasons like safety concerns, obsolescence, unavailability, or the presence of a more effective or cost-effective alternative.
Review by the P&T Committee:
The committee assesses the reason for the proposed deletion, taking into account patient outcomes, adverse events, cost implications, and therapeutic alternatives available.
Decision:
If the committee decides the drug should be removed, it is then deleted from the formulary.
Transition Plan:
In cases where patients are already on the medication, a transition plan may be necessary.
This can involve switching to a therapeutic alternative, gradual tapering, or special arrangements for select patients.
Communication:
The deletion and any related recommendations or transition plans are communicated to all stakeholders to ensure patient safety and continuity of care.
For both addition and deletion, the overarching goal is to maintain a formulary that ensures the best possible patient outcomes while considering safety, efficacy, and cost-effectiveness.
