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Principles of a Sound Drug Formulary System

National organizations representing government, health care professionals and business leaders formed a coalition in 1999. It set out to provide a set of principles that would enable health care facilities to develop sound drug policies. These policies aim to keep patients safe while promoting a cost-effective drug therapy regimen.

  1. The Formulary

    • A formulary is a list of commonly used drugs within an particular institution, medical facility, organization, even a state such as Florida. Such a list enables clinicians to become more familiar with the drugs. Certain limitations and standards are put into place regarding the medicines, allowing for easy review. By using specific medications for similar ailments, nurses and doctors become more familiar with how best to treat patients and follow up regarding the effectiveness of the drug therapies. The formulary remains ever-evolving, meaning drugs can be removed or replaced depending on changes in the needs of patients and current drug theory.

    Economic Considerations

    • By creating a comprehensive formulary, medical facilities save money on medications not only by buying in bulk but also by reducing waste. Keeping multiple drugs with the same use lets some of the drugs expire, requiring them to be discarded. The formulary can also be adjusted based on current market costs of medications. This may mean relying on generics to keep costs down for both hospital and patients.

    Consistent Evaluation

    • Clinicians and patients constantly evaluate the drug formulary. Factors such as effectiveness of medication, cost of medication, overall effects of the drug, side effects and ease of treatment should be looked at often to determine if the current list is the most effective drug combination. Ease of dispensing is also important. This helps keep down medication errors. The easier the drug mixes with others or distinguishes a variety of dosages, the more secure clinicians can be in dispensing the medication.

      A formulary change occurred nationwide in 2009 after the packaging of Heparin, a blood thinner, caused problems in many hospitals. The similar packaging of different dosages caused some nurses and pharmacists to mislabel the drug. The results were sometimes fatal. The company producing Heparin accepted the need to change based on multiple evaluations from different formularies across the country.

    Committee Decisions

    • Formularies require forming a committee to determine which drugs will be included as standard on the formulary. This helps reduce drug company influence on which medications are listed. Instead of individual doctors being wooed with free trips and free products, a committee reviews the literature, peer reviews of medications and personal experience to develop a well-rounded formulary. While doctors and patients always have the right to request a different medication, common practice is to stick with the formulary whenever possible.

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