HOSPITAL FORMULARY.

HOSPITAL FORMULARY

            “The hospital formulary is a continually revised compilation of pharmaceuticals, which reflects the current clinical judgment of the medical staffs including physicians, pharmacist and nurses and other experts in the diagnosis, prophylaxis, or treatment of disease and promotion of health”.

Hospital formularies originally started life in hospitals as collection of commonly prescribed pharmaceutical preparations, produced mainly for reference purpose. As time went on, the hospital formulary was adapted to the detailed information on the increasing number and diversity of medicines. However, these new and expensive preparations required ever increasing funds, and the formulary rapidly turned into a list of restricted medicines. When a hospital formulary is used effectively, it becomes the cornerstone of a formulary system, which can be one of the most effective methods of ensuring rational drug therapy and controlling the drug cost.It promotes high quality, evidence based prescribing and reduces variation in the levels of treatment provided to patients and can be used as a tool to rationalize the medicines used in standard practice.The healthcare professionals make use of the system hence it is important that it should be complete, concise, updated and easy to use.The World Health Organization (WHO) released the first edition of the WHO model list of essential drugs in 2002.The heart of the Formulary System is the Pharmacy & Therapeutics Committee (PTC).Membership will be comprised of representatives of the professional departments/services, pharmacy, house staff, nursing, administration and other interested parties.The PTC reviews the formulary one or more times in a year, for the addition and deletion of drugs.

The Need of Hospital Formulary

At present many of the pharmaceuticals on the world market represent duplicate, “me-too,” or nonessential products. Many are minor variations of a prototype drug and offer no therapeutic advantage over other drugs that are already available. Other drugs show high toxicity relative to their therapeutic benefit. In some cases drugs are newly released with insufficient information on efficacy or toxicity. Finally, many new products are for therapeutic indications not relevant to the basic needs of the population. They are nearly always more expensive than existing drugs. The formulary system is a mechanism by which professional staff can solve these.A number of other problems known to exist in most pharmaceutical system are limited drug budgets, increasing numbers of therapeutic alternatives, improper prescribing and use of medications, presence of unsafe and non-efficacious drugs, lack of unbiased drug information, high costs of handling large numbers of drugs, drugs of questionable quality on the market.

Information to be presented for individual drugs in a formulary

Basic information	Supplementary information
Generic name	Common brand name(s)
Dosage form and strength	Price
Main indication	Level of use or distribution code
Pharmacology/pharmacokinetics	Prescription category
Contraindications	Patient information
Precautions	Labelling information
Dosage schedule	Storage instructions and stability
Adverse effects	Essential drug list number
Drug and food interactions	Main supplier catalogue number
Instructions, warnings	Procurement priority code (VEN) Re-imbursement scheme code

Divya  Raj

Second year M-Pharm, Dept of pharmacy practice,

Al -shifa college of pharmacy.