Pharmacy

1. Pharmacy and Therapeutic Committee
(PTC)
The PTC is a group of persons which formulate
policies regarding therapeutic use of drugs. This
committee is composed of physicians, pharmacists
& other health professionals with the inclusion of
the medical staff. It serves as the communication line
between the medical staff & pharmacy department.
Other names are Pharmacy Committee, Formulary
Committee, Therapeutic committee & PTC

2. Purposes of PTC
(1) Advisory; The PTC recommends or assists in
the formulation of policies regarding evaluation,
selection and therapeutic use of drugs in hospitals.
(2) Educational; The committee recommends or
or assists in various functions designed to meet
the needs of the professional staff, the physicians,
nurses, pharmacists and other health care
personnel for the complete current knowledge of
the matters pertaining to drugs.

3. Membership of PTC
The PTC should be composed of
►at least 3 physicians,
► a pharmacist,
►a nurse, and
►administrator.
Committee members are appointed by
governing unit or elected medical staff.
A representative of physicians will act as
chairman of committee & Pharmacist will be
considered as secretary of the committee.

4. Functions of PTC
(1)To serve as an advisory council to medical staff
& hospital administration in all matters related to the
use of drugs.
(2) To develop & compile a formulary of drugs and
prescriptions accepted for use in various hospitals.
The items are selected on their therapeutic use,
safety, cost etc
(3) The committee recommends written policies &
procedures for selection, procurement, storage,
distribution & use of drugs

5. (4) To establish or plan suitable educational schemes
for the hospital professional staff relating to drug use.
(5) To study problems related to the distribution and
administration of medications.
(6) To make recommendations concerning drugs to
be stocked in Wards & Emergency.
(7) To advise the pharmacy in the implementation of
effective drug distribution and control procedures.

6. Hospital Formulary
Hospital formulary is a continually revised
compilation of pharmaceuticals that reflects the
clinical judgment of the medical staff.
Hospital formulary system is a method where the
medical staff working through the P&T committee,
evaluates, appraises, and selects from the numerous
available drug products those considered most
useful in patient care.
The selection is made on the basis of its toxicity,
untoward reactions, quality, efficacy &
bioequivalence.

7. Guiding Principles to Hospital Formulary System
Following principles serves as guidelines for physicians,
pharmacist and administrator in the hospital for their
professional judgment.
(1) The medical staff shall appoint a multidisciplinary
PTC and outline its purposes, organization,
function & scope.
(2) The formulary system shall be sponsored by the
medical staff based upon the recommendations
of the PTC

8. (3) The medical staff shall adopt written policies and
procedures governing the formulary system as
developed by the PTC.
(4) Drugs should be included in the formulary by their
nonproprietary names. Prescribers should be strongly
encouraged to prescribe drugs by their nonproprietary
names.
(5) Limited no. of drug product should be included in the
formulary for the consideration of financial benefits.
For this purpose generic equivalents and therapeutic
equivalent should be considered.

9. (6) The institution must assure that its medical and
nursing staffs are informed about the existence of
the formulary system, the governing procedures, its
operation and any changes in those procedures.
(7) Provision shall be made for the appraisal and use of
drugs not included in the formulary.
(8) The pharmacist shall be responsible for specifications
as quality, quantity and source of supply of all drugs,
chemicals, biologicals and pharmaceuticals.

10. Legal Basis of Hospital Formulary System
A written or signed prescription or a written and
signed medication order is the only legal permit to
dispense or administer a prescription legend drug.
If the physician use chemical or generic name of the
drug, the pharmacist may dispense the brand in his
professional judgment.
Problems usually arise when prescribers continues
to use the propriety name for the drug desired. To
avoid such situations hospitals should devise many
ways--

11. (1)One common method is the use of a suitably
worded imprint on the prescription form. For
example, “Generic Equivalent Permitted” or
“Dispensed in accord with the hospital formulary
system”.
(2) The 2nd method is obtaining the prior medical consent
to the operation of a hospital formulary system. In this
case the physician is bound to accept the rules and
regulations of hospital formulary system.
(3) The 3rd method is to obtain the medical consent to the
operation of hospital formulary in a separate
documents and all physicians are requested to sign it.

12. Principles for Admission or Deletion of Drugs/
(Revision of Formulary)
Inclusion or exclusion of a new drug in the formulary
is a very complex process. The PTC frames certain
policies and procedure for inclusion and deletion of
drugs. The criteria followed for inclusion / deletion are
as follows—
► The 1st criteria to be established is whether or not
the local general and specialty staff consider the drug
to be of proven clinical value based upon their
experience with it.

13. ► The 2nd may be that the drug must be recognized by
the USP/ NF or supplements.
► The 3rd may be the manufacturer of the drug product
must have proven integrity & dependability as well
as having the reputation of initiating and supportive
research activities of merit.
► The 4th criteria may be that no preparation of secret
composition will be considered or admitted to the
formulary.
► The 5th may be that the single agent may replace
the combination therapy.
During revision of formulary cost effectiveness or cost
benefit analysis methods are often used.

14. Formulary needs to be revised annually because
addition, deletion, changes in the products, removal
of drugs from the market, changes in hospital policies
& procedure.
After each revision the supplement sheets could be
attached to the back cover of formulary books. The 2nd
way is to use different color in each edition.