A formulary must be made acceptable to the medical staff on its merit sound therapeutics, quickly obtained quality drugs, and economy.
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The drugs and therapeutics committee should prepare written policies and procedures governing the hospital formulary. These policies afford guidance in the evaluation, selection, procurement, use, safety procedures and other matters relating to drugs in the hospital.
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The committee may consider the policy of including drugs in the formulary by their generic (nonproprietary) names.
All nursing personnel must be informed in writing about the procedure governing the operation of the formulary system.
In forming policies and procedures, the terms “substitute” and “substitution” should be avoided, since these terms have been used to imply the unauthorized dispensing of an entirely different drug, neither of which takes place under a properly operated hospital formulary.
In the preparation of the formulary, the drugs and therapeutics committee should:
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i. Review the existing list of drugs in the hospital and include only those which are useful, necessary and cost-effective,
ii. Consult the formularies of well-known hospitals and adopt them to its own needs, and
iii. Consult the WHO list of essential drugs.
The formulary is not complete without incorporating the indications, contraindication, side effects, adverse effects, and special precautions to be taken for each type of medication. The dose, duration of full course of treatment, and cost must also be included.
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Once the formulary has been accepted, only the drugs included in the formulary should be stocked in the pharmacy.
The formulary should be printed in a style and format which is simple to refer to and understand. Simplicity of format and a convenient size are the hallmarks of a good formulary. A pocket-size and easy-to-carry hospital formulary is more frequently used by all.
The procedure for periodically updating the formulary or for additions or deletions should be laid down. Any requests for additions or deletions must come to the drugs and therapeutics committee in writing from any of the prescribers, giving valid reasons for an addition or deletion.
Additions or deletion must be affected only on their merits and in the best interest of hospital patients. A hospital formulary needs to be revised every two years.