Microsoft word - medication formulary april 2011.doc
Dear Prescribers, April 2011
Welcome to the Saint Vincent Healthcare Medication Formulary. This formulary was designed to provide
you with the most current information possible pertaining to Formulary listings and drug-related policies. Please
review this booklet at your leisure so you are familiar with which drugs are approved for use at Saint Vincent
HOW TO USE THIS BOOKLET Drug Listings
The drugs are listed using the American Hospital Formulary Service (AHFS) classification system. Each drug
entry lists the generic name, strengths and formulations available, and common brand names.
Drug-Related Policies
Selected policies have been included to assist you in ordering medications and understanding the Formulary
PLEASE NOTE
It is possible there are a few omissions due to human error which will be corrected in future versions. Please do not
panic if something common is not listed! Please call the Pharmacy with questions and concerns. If a desired item
was purposefully left off the Formulary, it can be acquired as a non-formulary drug request.
UPDATES TO THE FORMULARY
Updates to the Formulary will be distributed to the medical and hospital staff as drugs are added and deleted
from the Formulary. An electronic copy of the formulary may be found on the Communicator.
TITLE: PHARMACY & THERAPEUTICS COMMITTEE POLICY NO. 200.40.010 PURPOSE OF THE COMMITTEE 1. Policy Development: The Pharmacy and Therapeutics Committee formulates policies regarding evaluation, selection, & therapeutic use of
drugs for Saint Vincent Hospital and Health Center.
2. Advisory/Educational: The Pharmacy and Therapeutic Committee recommends & formulates programs designed to meet the needs of the
professional staff (physicians, nurses, pharmacists, and other health care practitioners) for complete current knowledge on matters related to drugs and drug use.
FUNCTIONS AND SCOPE OF THE COMMITTEE The multiplicity of drugs available and the complexities surrounding their safe and effective use make it necessary for hospitals to have an organized, sound program for maximizing rational drug use. The Pharmacy and Therapeutics Committee is the organizational keystone of this program. The Pharmacy and Therapeutics Committee is an advisory group of the Medical Staff and serves as the organizational line of communication between the Medical Staff and the Department of Pharmacy Services. The Pharmacy and Therapeutics Committee is a policy-recommending body to the Medical Staff and the Administration of the Hospital on matters related to use of drugs. The Pharmacy and Therapeutics Committee shall be responsible for the development and surveillance of all drug usage policies and practices at Saint Vincent Hospital and Health Center in order to assure optimum clinical results. The Committee will formulate professional policies regarding the evaluation, selection, procurement, storage, distribution, use, safety, and all other matters relating to drug usage. It will perform the following specific functions: 1. Serve in an advisory capacity to the Medical Staff and Hospital Administration in all matters pertaining to the use of drugs (including
2. Develop a Formulary of drugs acceptable for use in the Hospital and provide for its ongoing review and revision as indicated. The selection of
items to be of Formulary status will be based on objective evaluation of their relative therapeutic merits, safety, and cost. The Committee will minimize duplication of the same basic drug type, drug entity or drug product.
3. Establish programs and procedures that help ensure safe & effective drug therapy. 4. Establish programs adn procedures that help ensure cost-effective drug therapy. 5. Establish or plan suitable educational programs for the Hospital professional staff on matters related to drug use. 6. Participate in continuous quality improvement activities related to procurement, prescribing, distribution, administration, and monitoring of
medications. As indicated by review findings, the Committee will make recommendations to the Medical Executive Committee for appropriate action.
7. Monitor & evaluate adverse drug reactions occurring in the Hospital. 8. Initiate and/or direct medication-use review programs and studies. The Committee will review the results of such activities and make
9. Advise the Pharmacy in the implementation of effective drug distribution and control procedures. 10. Make recommendations concerning drugs to be stocked in Hospital patient-care areas. 11. Evaluate clinical data concerning new drugs or preparations requested for use in the Hospital. 12. Recommend policies regarding the safe use of investigational and hazardous drugs.
THE FORMULARY – Policy TX-100.12 Definition and Composition
The Formulary is a compilation of all drug products approved for use by the medical staff which are considered most
useful in patient care. The Formulary System is a method whereby the Medical Staff of the Hospital, working
through the Pharmacy and Therapeutics Committee, evaluates, appraises, and selects from among the numerous
available drug entities and drug products those that are considered most useful in patient care. The Formulary
System is thus an important tool for assuring the quality of drug use.
A. The Pharmacy & Therapeutics (P&T) Committee shall be responsible for the development and management of a
medication formulary for use in the hospital. Only those medications selected are routinely available from the
B. The P&T Committee whall be responsible for reviewing and approving all changes to the formulary including:
The addition and deletion of medications
The use of generic and therapeutically equivalent products
C. The Medical Executive Committee shall be responsible for the review and approval of all actions in relation to
Procedures
A. Evaluation and Approval of Medications
1.1 Evaluates & appraises selected medication(s) & medication classes for formulary inclusion.
1.2 Approves all changes to the hospital formulary.
a. Add to the formulary with no restrictions.
1.) These are medications approved for use by any member of the medical staff.
b. Add to the formulary with restrictions
1.) These are medications approved for use in specific patient care.
2.) These medications may be restricted to use by a specific service or for a specific indication of use.
1.) Includes medications in which the Committee feels that additional information is required to
2.) Provisionally approved medications are reconsidered by the Committee after 6 months of use.
1.4 Forwards formulary recommendations to the Medical Executive Committee for review & final approval.
2.1 Reviews and approves formulary recommendations.
3.1 Requests the addition of a medication not included on the formulary by submitting a completed "Request for
Formulary Addition" form. NOTE: Any member of the medical staff may make a formulary request
4.1 Schedules medications for review by the P&T Committee. Medications for review include:
a. Medications recently approved by the FDA.
b. Medications requested by members of the medical staff.
c. Medications or medication classes in which duplication is felt to exist.
4.2 Prepares a formulary evaluation of the medication(s) scheduled for review by the P&T Committee.
a. Summarizes clinical information related to a medication(s) safety & efficacy.
b. Provides cost information. NOTE: Cost will only be used as a basis for formulary selection when the
Committee feels that two or more medications are clinically equivalent.
4.3 Presents above information to the P&T Committee
4.4 Communicates information regarding formulary decisions to the medical staff.
4.5 Obtains, stores, & distributes, all medications on the formulary.
4.6 Ensures the maintenance and distribution of the printed formulary.
4.7 Publishes a printed formulary every year.
a. All patient care areas in the hospital
If the medication is given provisional approval:
4.10 Gathers & reviews any new information
4.11 Solicits information & opinions from practitioners who have had experience with the medication.
4.12 Presents above information to the P&T Committee so that a determination may be made concerning full
1.1 Contacts physician when a non-formulary medication is ordered. NOTE: If the physician determines that
the non-formulary medication is necessary for the patient then the pharmacy will obtain a supply of
the medication to meet the anticipated needs of the patient.
1.2 Notifies the prescriber and nursing unit caring for the patient if the non-formulary medication cannot be
1.3 Documents any changes to the medication order in the patient's medical record as authorized by the
GENERIC/THERAPEUTIC INTERCHANGE POLICY
To define the use of generic and therapeutically equivalent drugs within at Saint Vincent
Healthcare. Therapeutic interchange of selected drug products will be accomplished according to
drug specific guidelines as outlined in this policy. Patient safety and product quality will be the
guiding principle in the use of generic and therapeutically equivalent drugs. Medical, pharmacy,
government and industry literature will be continually scrutinized to ensure the efficacy of drug
products contained on the hospital formulary.
DEFINITIONS:
Generic Interchange: Involves the interchange among nonpropriety and propriety drugs having the same chemical
Therapeutic Interchange: Is the selection of a chemically different drug that is considered by the Pharmacy and
Therapeutics Committee to be a therapeutic alternative with a comparable effect.
PROCEDURE:
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