Dr. Srikanth. M Pharm,. Ph.D.
Department of Pharmaceutics.
[Link] of pharmacy, Raichur.
Mob No-9160348410
SRIKANTHYERIGERI@[Link]
HOSPITAL FORMULARY
DEFINITION:
Hospital formulary system is a method by which hospital staff in consultation with P&T
committee evaluates and select drugs in drug market which are considered most useful in
patient care.
It is a book listing recommended medicines which are to be kept in the hospital.
Drugs are usually selected on the basis of efficacy, safety, acceptability and cost.
Medicines listed in the formulary should be readily available.
OBJECTIVES:
The primary objectives of hospital formulary are
1) To provide hospital staff information of drugs which have been selected for the use in
the hospital by the committee.
2) To give brief monograph of each selected drug.
3) To give information on hospital policies and procedures regarding medicines.
4) To give information about medicines, dosing schedules, pictograms (icons), hospital
approved abbreviations etc.
ADVANTAGES:
1) It promotes rational and cost effective prescribing.
2) It gives guidance on selection of drugs and even provides price comparisons.
3) It may reduce the incidence of drug related problems like interactions, medication errors
etc.
4) In long term it may encourage the manufacturers to direct research towards therapeutic
needs rather than commercial aspects.
5) It improves relationship between prescribers and pharmacists.
PREPERATION OF FORMULARY:
Hospital pharmacists, community pharmacists along with PTC members prepare hospital
formulary.
The basic ways of producing formulary is either to prepare an independent one or modify
the existing one by adapting any formularies (BNF).
It should be presented as a document and it should be pocket sized.
It should be compatible with other hospital formularies.
1
CONTENTS OF FORMULARY:
The primary objective of formulary is to provide hospital staff with information of drugs that are
to be approved by the PTC with their monographs. The contents are
PART 1: Information on hospital policies and procedures related to drugs including composition
of P&T committee.
PART 2: Products accepted for use in hospital.
PART 3: Generic brands, therapeutic index, cost of drugs along with drugs that are deleted in
previous edition.
A subject index may also be included at the end of formulary for easy identification of drugs.
SELECTION OF DRUGS:
A formulary for use in hospital and general practice should aim to include enough drugs to
treat 80 – 90% of all common ailments.
It should include medicines that cover maximum patients either in hospital or general practice.
The factors that influence are
1) Efficacy and indications.
2) Interaction profile.
3) Side effects and contraindications
4) Pharmacokinetic profile
5) Cost
6) Formulations, palatability etc.
OPERATIONAL PROCEDURE:
The governing council along with PTC formulate the principles and procedures for the
preparation of formulary as per the needs of the hospital.
The medical staff and others shall adapt these policies and implement them correctly.
Nursing staff should be well trained for implementation of formulary system.
Any chance in working of hospital formulary system should be known to all the healthcare
providers of the hospital.
The quality, quantity of the source supply of all the pharmaceutical products should be evaluated
bt the pharmacist in consultation with PTC.
There should not be any compromise for economic reasons.
The guidelines may be issued by the PTC regarding the labelling of proprietary and non –
proprietary drugs.
LEGAL ASPECTS OF FORMULARY SYSTEM:
For the compliance of hospital formulary system is to encourage physicians to follow basic
policies and procedures of the hospital. This includes
1) Generic names within the prescriptions.
2) Dispense in accordance with the hospital formulary.
DISTRIBUTION OF FORMULARY:
It should be placed at each patient care areas including clinics, op’s, emergency rooms etc.
Each pharmacist should receive about it.
2
Annual revisions should be made and information’s regarding this should be provided to
everyone.
ROLE OF HOSPITAL PHARMACY DEPARTMENT IN RELATION TO OTHER
DEPARTMENTS IN HOSPITAL
1) With respect to P&T committee.
2) With respect to formulary
3) With respect to ethics committee.
4) With respect to infection control committee.
5) With respect to procurement and ware house departments.
6) With respect to clinical doctors – ADR’S, medication errors
7) With respect to nursing staff
8) With respect to IP, OP and direct patient care.
9) With respect to radiology department.
10) With respect to super specialities (cardiology, urology, nephrology etc).