ASHP guidelines on the pharmacy and therapeutics committee and the formulary system.

Purpose These guidelines outline the recommended processes and techniques for formulary system management and describe the pharmacist's responsibilities and roles in managing the formulary system in partnership with other health care professionals. These guidelines also provide assistance to pharmacists in the organization and operation of the pharmacy and therapeutics (P&T) committee or equivalent body, evaluation of medications for formularies, and development and implementation of strategies to manage medication use through the formulary system. A glossary of terms is provided in the appendix. A formulary is a continually updated list of medications and related information, representing the clinical judgment of physicians, pharmacists, and other experts in the diagnosis , prophylaxis, or treatment of disease and promotion of health. A formulary includes, but is not limited to, a list of medications and medication-associated products or devices, medication-use policies, important ancillary drug information , decision-support tools, and organizational guidelines. A formulary system is the ongoing process through which a health care organization establishes policies regarding the use of drugs, therapies, and drug-related products and identifies those that are most medically appropriate and cost-effective to best serve the health interests of a given patient population. 1 Formulary systems are used in many different settings, including hospitals, acute care facilities, home care settings, and long-term-care facilities, as well as by payers such as Medicare, Medicaid, insurance companies, and managed care organizations. Many organizations have policy statements on the use of formularies. 2–8 This document focuses on the use of formulary systems in hospitals and health systems. Formulary systems have evolved over time. Modern for-mularies began as rudimentary drug lists developed by the military in the 1940s and came into more widespread use during the 1950s. Pharmacists, in conjunction with their organizations , developed policies to dispense generic equivalent drugs when a specific brand-name drug was prescribed. Protests from the National Pharmaceutical Council and the American Medical Association (AMA) resulted in state laws prohibiting this activity. Community pharmacies complied, but hospital pharmacies resisted. In the late 1950s, the ASHP minimum standard for pharmacies in hospitals called for the implementation of a formulary system. 9 During the 1960s, the concept of a hospital formu-lary continued to grow. Hospitals developed policies that authorized pharmacists to make generic interchanges in an institutional formulary system based on prior consent from physicians. 10 ASHP and the American Hospital Association (AHA) issued joint statements on the legality of formu-laries. AMA and the …