Pharmacy & Therapeutic Committee

1. THE DRUG AND THERAPEUTICS
COMMITTEE(DTC/PTC)

2. Hospital Drug Policy
Many countries-20-40%-Health care budgets- Drugs
When drug is required:
 Appropriate drug has to be chosen
 Must be available at right time & right price.
 Must be dispensed correctly
 Must be delivered in a right dose, at the right intervals and
for a right period of time.
In order to ensure that hospitals use drugs judiciously
Right procurement, storage, distribution, QA, inventory
control – Safe use of drugs.

3. To promote safe use of drugs – A set of drug policies
1. DTC/ PTC
2. Infection control committee/ Antibiotic policy committee
3. Drug utilization review committee (DUR)
4. Research and ethics committee
5. Rational drug use committee
6. Drug exchange and drug donation committee

4. INTRODUCTION
DTCs can provide the leadership and structure to select
appropriate drugs for the formulary, promote rational drug
use, and help reduce drug costs to acceptable level
Many countries will spend 20 to 40 percent of their health
care budgets on drugs and much of that money is wasted
on irrational drug use and inefficiencies in procurement
of drugs.
Other serious problems that health care organizations face
are the over use of antibiotics, increasing antimicrobial
resistance, increasing adverse drug reactions, and
considerably higher costs associated with drug use

5. The pharmacy and therapeutics committee is a
policy faming and recommending body to the
medical staff and the administration of hospital
on matters related to therapeutic use of drugs.

6. OBJECTIVE
The pharmacy and therapeutics have three major roles to
play. These are:
ADVISORY
EDUCATIONAL
DRUG SAFETY AND ADR MONITIORING

7. FUNCTIONS
1. Advising medical, administrative, and pharmacy
departments on drug related issues
2. To formulate & implement policies for selection & use
of drugs
3. To develop essential drug list (ABC Analysis)
4. To develop standard treatment guidelines (STG)
5. To monitor medication errors & ADR
6. Drug information service to prescribers
7. To carry out utilization review (DUR)

8. COMPOSITION
Composition of pharmacy and therapeutics committee
(PTC) might vary from hospital to hospital. The PTC may
be composed of:
 At least three physicians from the medical staff (one
of the physicians may be appointed as the chairman of
PTC by hospital executive board)
 A pharmacist (Chief pharmacist- Secretary)
 A representative of the nursing staff
 An hospital administrator (Ex‐officio member of the
committee)
Quality assurance coordinator
Consumer (Optional)

9. OPERATION OF PHARMACY AND
THERAPEUTICS COMMITTEE
This committee should meet regularly at least six times in an
year and also when necessary.
 The agenda and the supplementary materials should be
prepared by the secretary and furnished to the committee
members well in advance so that the members can study them
properly before meeting

10. ROLE OF PHARMACY AND THERAPEUTICS
COMMITTEE (PTC) IN DRUG SAFETY
Drug safety is the moral, legal and professional obligation of
pharmacist.
 It includes responsibility from dispensing of drugs to drug
administration.
 Following guidelines may sub serve the committee in
ascertaining the adequate safety factor of hospital pharmacy:
The hospital must employ a qualified, at least, a registered
pharmacist with at least B. Pharm degree as ‘Chief Pharmacist’
and the rest are may be at least Diploma holders in pharmacist.

11. Should not permit non‐pharmacist personnel to
dispense drugs and allied materials.
Must employ a sufficient members of qualified
considering the work load of a pharmacist and allow
for adequate coverage(7days/week).
Must provide adequate safe, work space, and storage
facilities.

12. Should have equipment necessary to safely and
adequately carry out the modern practice of
pharmacy.
Must have an automatic stop order regulation for
dangerous drugs. eg: narcotics, anticoagulants etc.
Should have a drug formulary which periodically
revised and kept up to date.

13. The poisonous materials are separated from
non-poisonous materials in the pharmacy.
The external use preparations should be separated from
internal used medications.
Must have adequate quality control measures and follow
good manufacturing practices (GMP)
Should provide a teaching program to teach students,
nurses the basic course of pharmaceutical mathematics
and pharmacology.

14. Should be periodically inspected in order to remove
deteriorated and outdated drugs as well as to check all
labels for legibility.
Should have an adequate reference library which
contains texts on pharmacology, toxicology, posology,
and journals containing information on newer
developments in the pharmaceutical world

15. ROLE OF PTC IN ADVERSE DRUG REACTION
MONITORING PROGRAMME:
An adverse drug reaction is defined as any usual of
unexpected harmful reaction including acute poisonings
by narcotics, barbiturates, and amphetamines as well as
industrial poisonings.
There is a proportionate increase in the drug reactions.
In order to gain an understanding of these problems and
to formulate competent opinions, prevention and
treatment, the PTC must assume the responsibility for
the developing and instituting a procedure for the
purpose of committee.

16. ROLE OF PTC IN “EMERGENCY
DRUG LISTS”
The Time Factor is necessary for the PTC of a hospital
to get prepared boxes containing emergency drugs
which should be always available readily for use at the
bed-side.
OP list & IP list‐ Wards- Surgical, medical, pediatric,
maternity & emergency.
List of such drugs and other supplies should compiled
by Committee, and it should find their place in
“Emergency Kits”

17. After the emergency boxes have been placed in the
wards, it is very essential and compulsory that a system
is developed whereby they are checked daily either by
the hospital pharmacists or by nursing supervisor
responsible for the ward.

18. ROLE OF PHARMACY AND THERAPEUTIC
COMMITTEE IN DRUG PRODUCT DEFECT
REPORTING PROGRAMME
The drugs purchased by hospital may be defective in
quality.
 It is for the committee to get information about the
defective drug products and to inform it first to the
manufacturer for appropriate action.
 If satisfactory answer is not obtained from the
manufacturer , it should be reported to the Food and
Drug Control Administration.

19. ROLE OF PHARMACY AND THERAPEUTICS
COMMITTEE IN DRUG UTILISATION REVIEW
Drug utilization includes prescribing, dispensing,
administering and ingesting of prescription of drugs.
Hospital pharmacist should take medication history
that should include following information:
Medication being taken at the time of admission,
during admission, home remedies
Drug allergies and idiosyncrasy towards food products
etc.

20. Patent medication profile to be maintained for each
patient. This will serve the following purposes:
 To help improved drug prescribing practices by
promoting the safe and rational use of drugs.
 To detect and help prevent drug‐interactions.
 To detect and prevent ADR in sensitive patients.
 To detect and prevents IV additive incompatibilities.
To detect drug‐induced diseases.
 To help detect and potential drug‐toxicities.

21. ETHICAL CONCERNS OF THE DTC
The committee needs to operate in a manner that
ensures transparency and avoids conflicts of
interest with manufacturers and distributors of drugs
or medical supplies.
In order for the committee to maintain objectivity and
credibility, it is necessary that a strict ethics policy be
provided and rigorously enforced.
There can be no relationships with the
pharmaceutical companies other than a purely
professional one that encourages the flow of
unbiased information about their drug products.