WHAT IS A FORMULARY? It is a continually revised list of pharmaceuticals reflecting the current clinical judgment of the medical staff. Physicians, working with the Therapeutics Committee, select the drugs they consider most useful to ensure the quality of drug use in patient care while considering cost-effectiveness.
WHY HAVE A FORMULARY? The formulary is used to enhance patient care, to educate, to improve quality and to contain costs. It allows everyone to become familiar with the medications used and their appropriate routes, dosages, side effects and monitoring. This helps to prevent medication errors and improve the standard of patient care.
WHAT IS THE FORMULARY PROCESS? When a physician requests a new drug for addition to the formulary, a literature review is performed by a pharmacist. A written evaluation is submitted to the Therapeutics Committee for approval. If accepted, the proposal is sent to the Medical Board. If approved by the Medical Board, it is added to the formulary and information about the medication is published in the Therapeutics Newsletter. Class reviews follow a similar process.
WHAT IS THE ROLE OF THE THERAPEUTICS COMMITTEE? Its role is to objectively evaluate and select drugs for use at Presbyterian Hospitals. It also considers issues related to Cardiopulmonary, Diabetes, Food and Nutrition, Pharmacy and Rehabilitation Services such as treatment protocols and enteral formularies. The committee's purpose is to advise and educate. It does not dictate drug therapy, but provides physicians with the knowledge to meet clinical needs without unnecessary duplications.
WHAT IS GENERIC SUBSTITUTION? The formulary process incorporates not only the addition or deletion of drugs but also addresses generic and therapeutic substitutions. Generic substitution involves interchanges among nonproprietary and proprietary drugs having the same active chemical entity although inert ingredients may vary. The committee also provides a list of drugs that will not be generically substituted.
WHAT IS THERAPEUTIC SUBSTITUTION? Therapeutic substitution is the selection of a chemically different drug that is considered to be a therapeutic alternative with a comparable therapeutic effect.
HOW CAN I OVERRIDE A THERAPEUTIC SUBSTITUTION? A physician may override an automatic therapeutic substitution at any time by writing either "Do not substitute" or "Dispense as written", and by "checking" the appropriate column on the physician's order sheet as a part of the specific medication order. A delay in starting therapy may result, as nonformulary drugs are not stocked in the pharmacy. The drug will be purchased from outside sources, using regular ordering channels (unless it is an emergency situation). This can usually be handled within 24 hours.
WHO CAN I CONTACT IF I HAVE A QUESTION? The Pharmacy Resource Center (located ******) is open (DAYS), (TIME)and can be reached at (phone)to request a new drug for formulary review or request additional information on formulary issues. The pharmacy department is also open (hours)hours a day, (days) days a week at (phone).