HOSPITAL FORMULARY

1
AND THE GUIDELINES
VISHWANATH GOUDA
1ST M PHARM
PHARMACY PRACTICE
NGSMIPS
NITTE UNIVERSITY
CLASSIFICATION 2

 International formulary

 National formulary

 General formulary

 State formulary

 Joint formulary

 Hospital formulary
 FORMULARY :
Formulary is an official or authorised publication of an 3
approved list of medicines for use in a hospital, a group
of hospitals a society a state or a region a country or a
number of countries.

 HOSPITAL FORMULARY :
Hospital Formulary is a continually revised compilation
of pharmaceuticals dosage agents and their forms that
reflects the current clinical view of the medical staff.
Hospital formulary is the list of the medicines
including important 4

 Ancillary information related to

toxicity
 Unwanted side effects
 Beneficial effects of some drugs which
are considered most useful and safe in
patient-care by a hospital.
THE NEED FOR HOSPITAL FORMULARY:
5
THE NEED FOR HOSPITAL FORMULARY:
6
 The increasing no. of new drugs manufactured and
marketed by drug companies.
 Increasing complexity of untoward effects of modern
potent drugs.
 Newer sales promotion strategies of pharmaceutical
industry.
 The public interest in getting possible health care at
lowest possible cost.
GUIDING PRINCIPLES 7

 The governing body of the hospital shall appoint pharmacy

and therapeutics committee (PTC) composed of physicians
and pharmacists which will prepare the hospital formulary
system.
GUIDING PRINCIPLES 8

 The PTC shall develop policies and procedures governing the

hospital formulary and the medical staff shall adopt these to
administrative approval.
GUIDING PRINCIPLES 9

 The policies and procedures shall afford guidance in the

appraisal, selection, procurement, storage, distribution, use,
safety procedures and other matters relating to drugs in the
hospital and shall be published in the hospital’s formulary or
other media available to the members of the medical staff.
 GUIDING PRINCIPLES (Cont…) 10

 The medical staff shall adopt the policy of including the

drugs by their non-proprietary names.
 GUIDING PRINCIPLES (Cont…) 11

 In the absence of written policies approved by the

medical staff, the pharmacist shall dispense the brands
prescribed.
 GUIDING PRINCIPLES (Cont…) 12

 The hospital shall make it certain that the nursing personnel

must be informed in writing about the hospital formulary
system existing in the hospital for its effective usage.
 GUIDING PRINCIPLES (Cont…) 13

 In the formulation of policies and procedures the terms

“substitute” or “substitution” should be avoided because
these terms can be used for dispensing entirely different
drugs.
 GUIDING PRINCIPLES (Cont…) 14

 If there is any change in hospital system or in the contents, it

must be informed to the medical staff.
GUIDING PRINCIPLES (Cont…) 15

The labelling of medicine with non-proprietary names should

always be done in a proper manner. The format is as follows:

 Name of drug (non-proprietary names).

 Name of manufacturer or distributor.
 Prescription or order by the proprietary name.
 Dispensing is done according to the formulary policy.
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 PARTS OF HOSPITAL FORMULARY 17

 Introduction
 Basic information on each drug
 Supplementary information on each drug
 Prescribing and dispensing guidelines
 General drug use and advice
 Miscellaneous section
PREPARATION OF FORMULARY 18

 A typical formulary will have the composition in the

following manner.
 Title page.
 Names and titles of the member of pharmacy and
therapeutic committee.
 Table of contents.
 Information on hospital policies and procedure
concerning drugs.
 Size.
PREPARATION OF FORMULARY 19

 Format
Loose leaf or Bound
Printed or Mimeographed
 Indexing and assigning categories
General index
Pharmacological index
 REVISION OF FORMULARY 20

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 drug to the formulary is a complex decision.
5) All steps prior to the addition or deletion of a drug must be
reported to the medical staff.
 CRITERIA FOR ADDITION OR DELETION OF
DRUGS 21

 The subject drug must be present in the pharmacopoeia or NFI.

 The drug product is to be manufactured by a licensed company
with a good record.
 The preparation of known composition can only be added to the
formulary.
 The subject drug product should receive approval for its clinical
value by the local physicians
 The drugs of established therapeutic efficacy can only be added
to the formulary
ROLE OF PHARMACIST IN THE PREPARATION
OF HOSPITAL FORMULARY 22

 The pharmacist collects information on various drugs to be

included in the formulary from different pharmacopoeias.
 Valuates various drugs as per the guidelines of the PTC.
 He is mainly involved in the preparation of the formulary under
the guidance of pharmacy and therapeutics committee.
 He is responsible for annual revision of the formulary.
ADVANTAGES OF HOSPITAL FORMULARY
SYSTEM 23

 Cost containment
 Rational prescriptions
 Evidence based practice
 Cost effective prescribing
 Efficient procurement and storage
 Safetey and continuous care
 Educational value
DISADVANTAGES 24

 The physician is deprived of prescribing drugs of his choice.

 It may lead to purchase of drugs which are inferior in quality, in
case of no involvement of the pharmacist in the preparation of
formulary.
 REFERENCES 25

1) Ramesh K. Goyal, R.K. Parikh, Text book of Hospital Pharmacy, 12th

edition, pg.no:40-53.
2) Anees A. Siddiqui, Imran Parvez, Seemi Siddiqui Text book of Hospital
and clinical pharmacy, pg.no:28-37.
3) Revikumar K G , miglani B D, Textbook of pharmacy practice, career
publications, pg no;82-94
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