Considerations in Deciding Which Drugs Should Be in a Formulary

Abstract

The formulary is a compendium of pharmaceuticals, along with important drug information, that reflects the current clinical judgment of the medical and pharmacy staffs of an organization. Sound formularies have been shown to have a positive effect on prescribing. Poor formularies, those with too many marginal, obsolete, or redundant drugs, may contribute to less than ideal therapy in some patients, and probably at more expense. At the core of a sound formulary is having sound criteria and procedures for adding drugs. Such criteria should be general and specific. Should there be separate criteria for adding new drugs? For antibiotics? For biotechnology drugs? Criteria for maintaining and deleting drugs should also be in place. This keeps the formulary up-to-date and viable. Even with sound criteria, the process of adding, maintaining, and deleting drugs can be flawed by pressures, outside and inside organizations. However, such barriers can be overcome. The process of evaluating drugs for formulary status has been changing. New techniques are being developed to make the process more objective, more scientific, and more patient-outcome-driven.