This document provides information about hospital formularies, including their definition, contents, preparation, and revision. It begins by defining a hospital formulary as a list of the most useful and safe medicines for patients in that hospital. It describes the contents of formularies, such as drug information, policies, and indices. It explains that formularies are prepared and revised by a pharmacy and therapeutics committee with input from pharmacists. Drugs are added or removed based on various criteria to ensure efficacy, safety, and cost-effectiveness. Formularies help standardize drug use in hospitals.

1. UNIT II- CHAPTER 2
HOSPITAL FORMULARY
Mrs Chanda Ranjan
Department of Pharm Chemistry
The Oxford College of Pharmacy, Bangalore

2. Syllabus
Hospital formulary (1)
Definition, contents of hospital formulary, Differentiation of hospital formulary and
Drug list, preparation and revision, and addition and deletion of drug from hospital
formulary.

3. INTRODUCTION
Hospital Formulary is the list of the medicines which are considered most useful and safe in the
patient-care by a hospital.
The selection of these drugs is based on the evaluation of medicines against the needs of the patients
from among numerous available medicinal agents.
The hospital formulary also consists of information related to toxicity, untoward side effects and the
beneficial effects of various drugs.
The hospital formulary helps in obtaining, prescribing, dispensing and administering of appropriate
medicines.

4. SALIENT FEATURE OF THE HOSPITAL FORMULARY SYSTEM
1. Any drug is selected for inclusion in the formulary based upon its efficacy and safety.
2. Various drugs are included in the formulary after proper study of their pharmacokinetics, drug and
food interactions and their poisoning.
3. The non-properiteay (Generic) names of the drugs are used in the hospital formulary.
4. The hospital staff uses only those drugs, chemicals, biological and pharmaceutical preparations which
are included in the hospital formulary.
5. The substituted for any particular drug need not be specified in the hospital formulary. Only those
drugs which are specified in the hospital formulary should be used.
6. Changes are made in the list of drugs in the hospital formulary only after the approval by the
Pharmacy and Therapeutic committee.
7. The formulary also consists of name of the manufacturer or supplier, proprietary name of the drug and
other necessary information.
8. It maintains the responsibility and rights of the physician in the selection of proper drugs.
9. It provides for the study, selection, procurement, storage, distribution, use and safety procedures
related to the drugs in the hospital.
10. Any changes in the formulary are made known to the hospital staff.

5. HOSPITAL FORMULARY SYSTEM
Merits:
1. Provision of drugs at low cost to the hospital.
2. Prevention of physician form prescribing brands based on personal inclination.
3. Involvement of pharmacist in the selection of right medicines who has sound knowledge of
properties of various drugs.
4. Use of hospital formulary as a good measure for inventory control.
5. Facilitation of improved drug therapy.
6. The hospital formulary is made so precise that it is very handy for use by the physicians and
nursing staff.
Demerits:
1. It may lead to purchase of drugs which are inferior in quality, incase of no involvement of the pharmacist
in the preparation of formulary.
2. The physician is deprived of prescribing drugs of his choice.
3. In some hospitals, commercialization may be practiced by including only costly drugs which are not
feasible by the patients.

6. ROLE OF PHARMACIST IN THE PREPARATION OF
HOSPITAL FORMULARY
1. The pharmacist collects information on various drugs to be included in the formulary from
different pharmacopoeias.
2. He/she evaluates various drugs as per the guidelines of the PTC.
3. He/she procures the formulary drugs in required quantity from the right source.
4. He is mainly involved in the selection of text and indexing of the formulary i.e., preparation of the
formulary under the guidance of PTC.
5. He/she is responsible for annual revision of the formulary.
6. He/she has to communicate the changes in the working (or contents) of the formulary to the
hospital staff.

7. COMPOSITION OF HOSPITAL FORMULARY
The contents depend upon the requirement of a particular hospital.
They are decided by the PTC. The general contents are as follows:
1. Information on drugs to be used in the hospital.
2. The details of prescription writing.
3. Information on hospital policies and list of abbreviations used in the
hospital.
4. Special information.

8. 1. Information on drugs to be used in the hospital.
a. Generic name of the drug.
b. Common name
c. Different dosage forms available and their strength and route of administration.
d. Category of the drug.
2. The details of prescription writing.
a. Name, age, sex, and address of the patient
b. Date of prescribing
c. Name and potency of the drug
d. Quantity to be dispensed
e. Instructions to the patient
f. Redispense instructions (to the pharmacist) if necessary
g. Signature to the physician

9. 3. Information on hospital policies and list of abbreviations used in the hospital.
a. The constitution and responsibilities of PTC.
b. Details of activities of the hospital such as working hours, prescription policy towards out-patients,
labelling and packing, drug distribution system to in-patients, patient education programme etc.
4. Special Information
a. The essential of narcotic preparations.
b. Tables of posology
c. Commonly used diagnostic and pathological reagents.
d. Poisons and their antidotes.
e. Normal clinical laboratory values.
f. First-aid treatment.
g. Tips for intravenous admixtures.
h. Number of available items in emergency boxes.
i. List of nutritional products for different patients.

10. PREPARATION OF HOSPITAL FORMULARY
The composition of the formulary is as follows:
1. Title page
2. Names and titles of the members of PTC.
3. Table of contents.
4. Information on hospital policies and procedures concerned with drugs. These include:
a. The Pharmacy and Therapeutic Committee of hospital
b. Objective and operation of the formulary systems.
c. Drug prescribing and dispensing regulations.
d. Mode of use of formulary.
e. Mode of use of formulary.
5. a. General index
b. Pharmacological index
The chief pharmacist is mainly vested with the responsibility of developing the hospital formulary.
He is guided by the PTC.

11. PREPARATION OF HOSPITAL FORMULARY
Size:
It should be small enough to facilitate easy carrying by the pharmacist, doctors, nurses, wherever necessary.
Format:
a. The hospital formulary can be made as a bounded book or in the form of loose leaves.
b. Bounded book offers protection to the pages and loose leaf form permits easy update of the formulary.
c. The formulary can be a printed book or a Xerox copy of the original formulary.
d. The printed formulary is attractive and has the look of a valuable record. Only black ink should be used
in the printing.
Contents:
The information on a drug must not be too much or less than required and it should serve the actual purpose of
the formulary.

12. PREPARATION OF HOSPITAL FORMULARY
Index:
Proper index should be prepared with good efforts. This facilitates easy location of any drug in the formulary
and saves time. The two widely used indices are:
a. General Index:
This consists of drugs arranged in the alphabetical order of their generic names, followed by their
page number. This is useful to locate a drug easily when only generic name is known.
b. Pharmacological Index
The drugs are arranged according to their therapeutic category in alphabetical order along with their page number.
After final publication of the formulary copies of the same should be submitted to Director General of Health
Services (DGHS), Government of India, Pharmacy Council of India, Central Drugs Standard Organization and
Association of Indian Hospital Pharmacists.

13. DIFFERENTIATION OF HOSPITAL FORMULARY AND DRUG LIST
There is a common tendency to use the terms “formulary and drug list” synonymously or
interchangeably. This is not correct, because there exists a vast difference in the scope and
preparation of a formulary over a drug list.
A formulary usually consists of a listing of therapeutic agents by their generic names followed by
information on strength, form, posology, toxicology, uses and recommended quantity to be dispensed.
A drug list on the other hand usually consists of listing of therapeutic agents by their generic names
followed by data on strength and form.
There may or may not be any additional information although some drug lists may provide the
prescriber with recommended quantities to be dispensed.
Thus it will be observed that a formulary is more informative publication.

14. REVISION OF FORMULARY
1. The PTC holds meetings to discuss about the revision of the formulary.
2. The annual revision is necessary because of the changes in the drug products, removal of certain
drugs from the market and changes in the hospital policies.
3. The addition of details of a drug is done by attaching the supplement sheets at the back of the
formulary.
4. The addition of any drugsto the formulary is a complex decision.
5. Deletion of a drug is requiredwhen a drug product has been removed from the market or when
improved product is made available.
6. The guidelines of the PTC must be followed during the revision of the formulary.
7. All steps prior to addition or deletion of a drug must be reported to the medical staff.
8. Before revision cost-benefit analysis of new drugs should be made.

15. CRITERIA FOR ADDITION or DELETION of DRUGS
1. The subject drug must be present in the Pharmacopoeia or National Formulary of India.
2. The drug product is to be manufactured by a licensed company with a good record.
3. The preparation of known composition can only be added to the formulary.
4. The subject drug product should receive approval for its clinical value by the local physicians.
5. The drugs of established therapeutic-efficacy can only be added to the formulary.
6. A product of multiple ingredients should not be included if the same therapeutic action is shown
by any single drug.

16. •Thank You