New tool helps decide what drugs to include in health care formularies

A new tool that could provide a useful framework for deciding what medicines to include in drug formularies is presented in this week's PLoS Medicine by the experts from Harvard Medical School and the University of Illinois at Chicago who developed it.

The experts, led by Gordon Schiff, say: "Formularies and committees that oversee them are present in some form in virtually every US hospital and outpatient drug plan and are highly visible components of public benefits in many countries. Thus decisions made by these committees directly or indirectly impact every prescriber, , and patient."

Although considerable attention has been devoted to their role in cost containment, the authors argue that "formularies' role in guiding rational remains underdeveloped and could be improved by a more standardized critical evaluation of drugs proposed for formulary placement."

So in a joint project, the authors developed a tool consisting of checklist of 48 questions for evaluating drugs to be considered for inclusion in the formulary related to the evidence of need, efficacy, , misuse potential, cost issues, and decision-making process.

The authors say: "The checklist can facilitate more standardized and critical scrutiny of the evidence and therapeutic alternatives. It can educate new committee members, guide discussions of drugs proposed for formulary addition, and be used to evaluate the quality of committee decision making."

The authors conclude: "we offer the tool for a broader audience to use and test. We hope that it will prove useful in improving the quality of formulary decision making and stimulating debate related to critical questions that need to be asked, highlighting essential data needed to more safely prescribe drugs."

More information: Schiff GD, Galanter WL, Duhig J, Koronkowski MJ, Lodolce AE, et al. (2012) A Prescription for Improving Drug Formulary Decision Making. PLoS Med 9(5): e1001220. doi:10.1371/journal.pmed.1001220

add to favorites email to friend print save as pdf

Related Stories

Higher co-payments reduce use of antidepressants

Jun 07, 2008

As they struggle to contain skyrocketing medication costs, health plans across the U.S. have responded by implementing multi-tiered formularies requiring higher copayments for 'non-preferred' medications. New research from ...

US Medicaid drug lists cost more, deliver less

Jun 17, 2011

The U.S. Medicaid program is likely paying far more than necessary for medications and not offering patients the most effective ones available, by ignoring international evidence-based lists of safe and effective medications, ...

Recommended for you

Seniors successfully withdraw from meds

Sep 19, 2014

Elderly people have proved receptive to being de-prescribed medications, as part of a trial aimed at assessing the feasibility of withdrawal of medications among older people.

Flu vaccine for expectant moms a top priority

Sep 18, 2014

Only about half of all pregnant women in the U.S. get a flu shot each season, leaving thousands of moms-to-be and their babies at increased risk of serious illness.

Experts want restrictions on testosterone drug use (Update)

Sep 17, 2014

Federal health experts said Wednesday there is little evidence that testosterone-boosting drugs are effective for treating common signs of aging in men and that their use should be narrowed to exclude millions of Americans ...

User comments