Penny (Local drug formularies)

Question 1

What is a formulary?

Answer 1

A formulary is the product of an evaluative process, the formulary system, conducted by an expert panel that both sanctions and guides the selection, prescription, administration, and monitoring of pharmaceuticals and related items for a given environment.
May include drugs, formulations, vaccines, wound care products, and appliances.

Question 2

Benefits of a formulary

Answer 2

Improving local care pathways in relation to medicines and prescribing improving collaboration with clinicians and commissioners improving quality by reducing variations in clinical care improving quality through rapid access to cost effective medicines supporting the supply arrangements of medicines across a local health economy supporting financial management and expenditure on medicines across health communities

Question 3

How are formularies developed?

Answer 3

• Medicines should be selected based on the needs of the community.
• Medicines selected for the formulary are “medicines of choice.”
• The formulary list should have a limited number of medicines; duplication of agents that have therapeutic equivalence should not occur.
• International non-proprietary names (INN) (i.e., generic names) should be used. (BANs are not permitted)
• Combination (fixed-dose) products should be used only in specific proven conditions (e.g., to treat tuberculosis).
• Medicines need to be selected based on explicit criteria that include proven efficacy, safety, quality, and cost.
• The formulary must be consistent with any national or regional formulary or approved standard treatment guidelines.
• Medicines should be restricted to appropriate practitioners

Question 4

Who is involved in creating a local formulary?

Answer 4

• Primary care
  
  • Prescribing lead (GP)
  • Head of Medicines optimisation (ph/GP)
• Secondary care
  
  • Clinical director
• Professional representative
• Local authority
• Lay representative

Question 5

What happens when a product is unavailable and cannot be dispensed?

Answer 5

Look on SSP (serious shortage protocols), check what is recommended for it to be replaced by. Endorse it and the pharmacy gets paid extra for swapping it.

Question 6

Shared care

Answer 6

• Local guidelines
• Lists responsibilities
• High cost medicines- drug tariff
• ‘Shared care guidelines will endure that the GP has sufficient information available to undertake the prescribing for a specialist treatment if s/he so wishes’
• Any doctor who does not wish to prescribe that drug is under no obligation to do so
• Example- methotrexate