Contemporary challenges and novel strategies for health-system formulary management

Heindel, Gregory A; McIntyre, Chelsey M.

doi:10.2146/ajhp170351

Cited by 5 publications

(4 citation statements)

References 5 publications

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“…The TDF domain environmental context and resources , which was linked to formulary and formulary processes being inadequately responsive has been discussed in the literature. Challenges associated with maintaining up-to-date formularies and their cost-effectiveness continues to be debated [ 16 , 51 – 55 ]. What is clear, however, is the strong consensus that continuous monitoring of NFD prescribing and periodic review of trends are essential parts of formulary management [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…What is clear, however, is the strong consensus that continuous monitoring of NFD prescribing and periodic review of trends are essential parts of formulary management [ 56 ]. Beyond this, recent studies have advocated for the transition to more relaxed formularies, with expansion of the number of formulary items within selected drug classes in order to avoid the increased workload burden associated with the process of prescribing NFDs [ 55 , 57 – 59 ]. However, there is likely to be considerable resistance against this approach.…”

Section: Discussionmentioning

confidence: 99%

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Investigating physicians’ views on non-formulary prescribing: a qualitative study using the theoretical domains framework

Nazar

Al-Hail

Al-Shaibi³

et al. 2023

Int J Clin Pharm

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Background Well-designed and well-maintained drug formularies serve as a reliable resource to guide prescribing decisions; they are associated with improved medicine safety and increased efficiency, while also serving as a cost-effective tool to help manage and predict medicine expenditure. Multiple studies have investigated the inappropriate prescribing of non-formulary drugs (NFDs) with statistics indicating that up to 70% of NFD usage being inappropriate or not following the ascribed NFD policies. Aim To explore physicians’ views and influences on their prescribing of non-formulary drugs. Method Data collection and analysis were underpinned using the Theoretical Domains Framework (TDF). Thirteen semi-structured interviews were conducted within Hamad Medical Corporation, the main provider of secondary and tertiary healthcare in Qatar, with physicians who had submitted a NFD request in the preceding 12 months. Results Three overarching themes were identified: providing evidence-based care for individual patients; influences of others; and formulary management issues. Subthemes were mapped to specific TDF domains: environmental context and resources; social influences; professional role and identity; beliefs about consequences; goals; intentions. Conclusion The behavioral influences identified in this study can be mapped to behavior change strategies facilitating the development of an intervention to promote appropriate prescribing of NFDs with implications for medicine safety and healthcare efficiency.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Investigating physicians’ views on non-formulary prescribing: a qualitative study using the theoretical domains framework

Nazar

Al-Hail

Al-Shaibi³

et al. 2023

Int J Clin Pharm

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“…The assessment of medication value is a logical extension of the traditional assessment of cost in the formulary management process. The increasing cost of medications has resulted in a broadening of formulary categories (Table 5) as well as creative solutions to mitigate their financial impact using different pharmacoeconomic models (eg, cost‐minimization, cost utility) as relevant to the drug/disease state 36 . Five value frameworks exist within the oncology landscape, which share a focus on safety and survival but demonstrate variability in methodology and perspective in comparing value as well as framework‐specific advantages and disadvantages 37 .…”

Section: Innovative Methods Of Formulary Managementmentioning

confidence: 99%

Formulary management challenges and opportunities: 2020 and beyond ‐ an opinion paper of the drug information practice and research network of the American College of Clinical Pharmacy

Johnson

Gosser

Kier

et al. 2020

J Am Coll Clin Pharm

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Formulary management systems in hospitals and health‐systems serve to ensure that medications are rigorously evaluated for efficacy, safety, and value. The increased complexity of these systems, along with the broadening of items for formulary inclusion, poses unique challenges and opportunities for the development of innovative formulary management processes. Pharmacists are challenged to evaluate different types of medications that are not all small molecule entities as well as deal with medication shortages that can impact patient care. The authors review unique formulary aspects of biosimilars, gene therapy, rare disease treatments, outpatient therapies, and formulary‐related challenges/opportunities with drug shortages. Core strategies for formulary management and drug shortage mitigation techniques in closed formulary settings are discussed. This information is intended to guide formulary decision‐makers and other clinicians to effectively manage health‐system formularies in 2020 and beyond.

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“…6 Pharmacoeconomic studies currently explore the economic value of treatment options, but there is a need in the United States for a way to create and distribute improved information on the clinical and economic value of medications. 7 Maintaining a formulary and creating a process for selecting medications for use within a health system is required by the Joint Commission and the National Integrated Accreditation for Healthcare Organizations for accredited hospitals. 8,9 There are minimum criteria for pharmacy & therapeutics (P&T) committees, with the key principles being unbiased review of safety and efficacy.…”

Section: What This Study Addsmentioning

confidence: 99%

Verifying the value of existing frameworks for formulary review at a large academic health system: assessing inter-rater reliability

Karas

Picone

Werner

et al. 2021

JMCP

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BACKGROUND:The value assessment framework (VAF) is one approach to assessing the evidence and value of medications. VAFs are a way to measure and communicate the value of medications and other health care technologies for decision-making purposes. Given the increasing number of high-cost medications, challenging formulary inquiries, and critiques of currently available tools, health systems need to explore a standardized way to incorporate value assessment into formulary decision making. OBJECTIVES:To (a) evaluate existing VAFs by measuring inter-rater reliability among typical clinicians completing formulary reviews and (b) explore general implications of applying these tools to formulary decision making for all medications at a large academic health system.

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Contemporary challenges and novel strategies for health-system formulary management

Cited by 5 publications

References 5 publications

Investigating physicians’ views on non-formulary prescribing: a qualitative study using the theoretical domains framework

Investigating physicians’ views on non-formulary prescribing: a qualitative study using the theoretical domains framework

Formulary management challenges and opportunities: 2020 and beyond ‐ an opinion paper of the drug information practice and research network of the American College of Clinical Pharmacy

Verifying the value of existing frameworks for formulary review at a large academic health system: assessing inter-rater reliability

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