managing-formulary-evaluations
Managing Formulary Evaluations
Structures drug formulary reviews with efficacy, safety, cost-effectiveness, and therapeutic interchange analysis for Pharmacy and Therapeutics (P&T) Committee decision-making.
Why This Skill Exists
Hospital formularies directly impact patient outcomes, medication safety, and institutional costs. The Pharmacy and Therapeutics (P&T) Committee is the governance body responsible for evidence-based medication selection, and formulary monographs are the primary decision documents that inform their votes. ASHP guidelines mandate that formulary management be based on clinical evidence, not solely on cost. The Joint Commission and CMS require that hospitals maintain a formulary system with processes for evaluating and selecting medications.
A poorly structured formulary evaluation can lead to adoption of inferior agents, therapeutic duplication, unnecessary expenditure, or rejection of genuinely beneficial innovations. Conversely, rigorous monographs that address efficacy (with NNT), safety (with NNH), pharmacokinetic advantages, cost-effectiveness (ICER), and place in therapy relative to existing alternatives enable P&T Committees to make sound, defensible decisions. Pharmacists are the principal authors of formulary evaluations and therapeutic interchange protocols in virtually every health system.