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PurposeThese 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. Formulary and formulary systemA formulary is a continually up- ASHP Guidelines on the Pharmacy and Therapeutics Committee and the Formulary SystemDevelopeD by an aSHp expert panel on Formulary management: linDa S. tyler, Sabrina W. Cole, J. ruSSell may, mirta millareS, miCHael a. valentino, lee C. vermeulen Jr., anD anDreW l. WilSon Am J Health-Syst Pharm. 2008; 65:1272-83

Goal The goal of this program is to inform the participant of practical ways to prevent, identify, and manage the extravasation of anti-neoplastic agents. Objectives At the completion of this program the participant will be able to: List antineoplastic agents known to be vesicants or irritants. Identify the signs and symptoms of extravasation injury. Recommend a procedure for the safe administration of vesicant medications. Describe the appropriate management of antineoplastic-induced extravasation injury.

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In their article in this issue of CPT, Woodcock and Wosinska are the first to clearly outline the quality and manufacturing problems causing drug shortages of generic injectables. These authors have focused on the main issue, namely, that manufacturing problems and the lack of incentives for quality products are the primary reasons for most recent shortages of generic injectable drugs.

Shortages and sudden price increases of certain drugs may both occur emergently, with little to no warning, and they can have a dramatic impact on patient care. Little data are available linking drug shortages and price increases. Many of the same characteristics that may make medications susceptible to shortages can also place them at risk for sudden price increases. These characteristics include unapproved drugs, off-patent sole-source medications, and infrequently used medications. We reviewed drug shortage data from the University of Utah Drug Information Service to demonstrate how frequently these characteristics occurred and resulted in higher drug prices. Clinicians can use drug shortage management principles to mitigate the impact of sudden price increases for patients and health care organizations.