Lecture 25 - formularies Flashcards
what are formularies ?
A list of medicines for use in the health board that has been agreed by health boards in consultation with local clinical experts.
Offers a choice of medicines for healthcare professionals to prescribe for common medical conditions.
Consists of a list of medicines arranged by approved (generic) name of the medicine, rather than the brand name of the product
Products will have brand names specified where this is clinically relevant.
This formulary is a list of the medicines that are preferred for use for patients in a particular area taking into account national and local guidelines
what is the SMC
Considers newly licensed medicines and advises health boards in Scotland whether they should be available In Scotland, a newly licensed medicine is routinely available in a health board only after it has been:
accepted for use in NHSScotland by the Scottish Medicines Consortium (SMC), AND
accepted for use by the health board’s Area Drug and Therapeutics Committee (ADTC).
what does the SMC look for when a new medicine is considered for NHS Scotland?
how well the medicine works,
which patients might benefit from it ,
whether it is as good or better than medicines the NHS already uses to treat the medical condition, and
whether it is good value for money
when are medicine accepted by SMC routines available
All medicines accepted by SMC are available in Scotland but may not be considered ‘routinely available’ within health board because of available services and preferences for alternative medicines.
‘Routinely available’ means that a medicine can be prescribed by the appropriately qualified person within a health board.
what is the Area Drug and Therapeutic Commitee?
ADTC - responsible for advising the health board on all aspects of the use of medicines.
Medicines routinely available within a health board are usually included in the local formulary.
what do the ADTC do and who are why comprise dof?
Comprised of physicians, specialists, and pharmacists, and lay members
Meets regularly to review newly available drug therapies/ treatment options
Stays abreast of developments in the pharmacy market including new drugs, new warnings, recalls, etc.
Develops, manages, updates, and administers the formulary
May also be involved in quality/cost initiatives
what re CORE function of ADTC
promote the safe, effective and efficient use of medicines to maximise health gain;
develop co-ordinated policies and treatment guidelines for the optimal use of medicines;
advise on the introduction of new medicines and monitor their utilisation;
develop and maintain the Formularies and Therapeutics Handbook;
liaise with Managed Clinical Networks and other specialist clinical interest groups to influence
Manage prescribing across the primary care-secondary care interface
monitor critical incidents relating to medicines and disseminate knowledge gained from lessons learned;
review and monitor safe medication practices and promote implementation to improve patient safety;
encourage participation in the ‘Yellow Card’ scheme for reporting of adverse drug reactions;
provide timely communication of ADTC policy and decisions to health professionals, patients and the
what do other stakeholders do?
Consider national and local guidance before deciding whether to make a new medicine routinely available.
Healthcare Improvement Scotland issues alerts to advise if National Institute for Health and Care Excellence Multiple Technology Appraisals (NICE MTAs) are applicable in Scotland.
Advice from local clinical experts who would be expected to prescribe a particular medicine, where that service is available in a health board
what is a Non-formulary drug?
If medicine is not routinely available and not included in formulary and there are no suitable alternatives, a healthcare professional can request to prescribe a medicine
procedures in place to consider requests when a healthcare professional feels a medicine that is not on the formulary would be right for a particular patient.
Usually need to make a case
what are Cross sector formularies?
Approved medicines and treatments delivered in secondary care, are suitable for primary care prescribing by GPs
Allows continuity of prescribing in primary care after a patient is discharged from secondary care.
In other cases, the formulary may be confined to secondary or tertiary care settings; a recommendation to continue appropriate treatment is provided, on discharge, to the patient’s GP who will make a separate clinical decision about which medicine(s) to prescribe to continue treatment.
what are the benefits of formularies?
Formularies improve:
patient outcomes by optimising the use of medicines
local care pathways
collaboration between clinicians and commissioners
quality by reducing inappropriate variations in clinical care and facilitating access to cost-effective medicines
