New tool aims to guide formulary role in drug prescribing
Research Activities, August 2012, No. 384
A new tool is designed to help drug formulary committees at hospitals, health systems, and insurance companies make decisions based on a deliberative evaluation of drug evidence, efficacy, and therapeutic alternatives. Researchers from the University of Illinois Center for Education and Research on Therapeutics (CERT) note that while formularies have received much attention regarding cost containment, their role in guiding rational drug use remains underdeveloped. Their role could be enhanced by a more standardized critical evaluation of drugs proposed for formulary placement.
The new tool, funded by the Agency for Healthcare Research and Quality and used at two U.S. teaching hospitals, consists of a checklist of questions for evaluating drugs. The tool poses 48 questions related to six domains: evidence of need (7 questions), efficacy (6), medication safety (6), misuse potential (7), cost issues (10), and decisionmaking process (12).
According to the CERT researchers, who derived and applied the tool in the formulary of several hospitals and systems, the checklist can facilitate more standardized and critical scrutiny of the evidence and therapeutic alternatives. Potential uses the authors propose for the tool include (1) education of new pharmacy and therapeutics committee members related to questions to be asked for new drug applications, (2) guidance of committee discussions of drugs proposed for formulary addition, and (3) evaluation of quality of committee decisionmaking to assess whether key questions were raised and addressed.
The checklist is available in the article, "A Prescription for Improving Drug Formulary Decision Making," which was published in PLoS Medicine on May 22, 2012.