Hospital Formulary- Definition, contents of hospital formulary, Differentiation of hospital formulary and Drug list Preparation and revision, and addition and deletion of drug from hospital formulary.

1. Hospital
Formulary
Ravinandan A P
Assistant Professor
Sree Siddaganga College of Pharmacy
Tumkur-02

2. Definition
•Formulary is a continually revised
compilation of pharmaceuticals
that reflects the current clinical
judgment of the medical staff

3. Potential benefits / Advantages
•Therapeutic benefits
•Economical benefits
•Educational benefits

4. Disadvantages
•Deprive the physician of his right &
privilege to prescribe & obtain the brand
of his choice.
•Permits the pharmacist to act as the sole
judge of which brands of drugs are to be
purchased & dispensed.

5. Guiding principles to prepare Formulary
•Appointment of PTC
•Set up of formulary system recommendations by
PTC
•Adopting the written policies and procedures
governing the formulary
•Inclusion of drugs by their non proprietary names
•Restriction of number of similar entities in the
formulary
•Information to medical and nursing staff
•Appraisal of new drugs for entry in to the
formulary
•All formulary drugs should meet PTC
recommendations.

6. Hospital Formulary content
•Drugs approved for formulary inclusion
•Therapeutic and clinical information
•Hospital policies and procedures governing the
use of drugs
•Special information
Drug dosing rules
Nomograms
Hospital approved abbreviations
Sodium content

7. BMI Categories:
Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater

8. Parts of Hospital Formulary
Hospital Policies and Procedures
Drug product listing
Special information

9. Hospital Policies and Procedures
•Formulary policies and procedures
•Brief description of hospital PTC
•Hospital regulations governing the
prescribing, dispensing and administration
of drugs.
•Pharmacy operating procedures
•Information about the technique to use the
formulary

10. Drug product listing
Heart of the formulary
•Consist of one or more descriptive entries
•One or more index
•Formulary item entries: Alphabetically by
generic name Alphabetically within
therapeutic class
•Type of information: Dosage form, strength,
packaging Active ingredients
Adult/paediatric dose Route of
administration, Cost
•Indexes to the drug products listing: Generic
name/brand name Therapeutic
/pharmacological index

11. Entries
•Alphabetically by generic name with
synonyms and brand names
•Alphabetically within the therapeutic class
•A combination of the both

12. Type of information
•Generic name of the basic drug entity
•Combination products
•Generic, common or trade name
•Synonyms
•Directions for use
•Dose, dosage form, strength, packaging and size
•Formulation of combination product and category
•Number of formulation.

13. Additional information
•Usual adult or pediatric dosage range
•Special precautions
“Do not administer through IV” or
“Refrigerate”
•Control substances symbol
•Cost information

14. Special Information
•Nutritional products listing
•Tables of equivalent dosages and similar drugs
•List of hospital abbreviations
•Rules for calculating pediatric dosage forms
•Table of sodium content in antacids
•List of sugar free drug products

15. Format & Appearance
Visually attractive, easily readable and professional in
appearance. A typical formulary must have the following
composition;
•Title page
•Names and Titles of the PTC members
•Table of contents
•Information on hospital policies and procedures
PTC of XYZ hospital
Objectives and operation of the hospital formulary
system
hospital regulations & procedures for prescribing &
dispensing the drugs
Hospital pharmacy services and procedures
How to use formulary

16. •Different color papers for different sections
•Using an edge index
•Making the formulary of pocket size.
•Printing the generic name heading in bold
•List of items available from central supply
•List of contents of emergency carts
•List of dialyzable poisons

17. •Pharmacokinetic dosing and monitoring
information
•Metric conversion scales and tables
•Examples of blank prescription and ADR forms
•Tables of drug interactions and drug
incompatibilities
•Poison control information

18. FORMULARY vs DRUG LIST FORMULARY
DRUG LIST
FORMULARY
• Listing of drugs by their
generic names followed by
information on strength,
form, posology, toxicology,
use & recommended
quantity to be dispensed.
• Prepared locally by its own
clinical staff.
• Information provided is
subject to local needs and
desires. Generic names
followed by data on strength
& form.
DRUG LIST
FORMULARY
• Generic name followed by
strength & form
• Prepared by country’s
outstanding clinicians,
pharmacologists and
pharmacists.
• According to their
pharmacological actions /
properties.

19. Addition And Deletion Of Drug From Hospital
Formulary.
Formulary Additions
• The assessment of new medicines is critical to managing a
formulary list, which involves adding new medicines and
old ones.
Drugs should be evaluated and compared on the basis of:
• efficacy, comparative efficacy
• effectiveness, comparative effectiveness
• safety, comparative safety
• cost of use
• quality. Efficacy, effectiveness and safety can be evaluated from a
critical assessment of the literature.
• A request for inclusion of a drug in the hospital formulary
be made by submitting a Formulary Addition Request along with
supporting literature and a signed disclosure of dual interest to
the Pharmacy and Therapeutics (P&T Committee).
• The committee will make one of the following decisions
regarding the request:
• approval (with or without restriction)
• denial
• deferment (until pertinent information becomes available)

20. Deletion of a Drug from formulary
• Suggestions for deletion of drugs from the
formulary may be submitted to the P&T Committee
by any member of the medical, pharmacy, or
nursing staff.
• In order to control growth of the hospital formulary,
some additions will balanced by deletions of
another drug.
• PTC shall periodically review its stocks and
various therapeutic classes on an ongoing basis to
effect deletion of duplicate drugs whose usage is
low or those which can readily be replaced by less
costly but equally

21. THANK YOU