Literature review on the structure and operation of Pharmacy and Therapeutics Committees

Abstract

The structure and operating procedures of Hospital Pharmacy and Therapeutics Committees are similar in select Western countries. Information from clinical trials is the most influential factor in the decision-making process.

Management of Hospital Formularies in Ontario: Challenges within a Local Health Integration Network

“…The P&T committees in the HNHB LHNIN were similar in structure to others in Canada and internationally 8,11,16,17 and were active in traditional activities of assessing the clinical benefits and harms of new drugs proposed for addition to their formularies; they have also expanded their oversight to cover several risk mitigation and medication safety areas. The expertise within each committee, and therefore the quality of formulary review, differed.…”

“…Development of this questionnaire took into account domains identified from the literature. 8,9,11 The questionnaire was reviewed for clarity, comprehensiveness, and content validity by 8 study investigators, including pharmacy directors and clinicians. Part 1 of the questionnaire was an institution profile survey inquiring about (1) the institution's characteristics (number of sites, beds, and pharmacy staff), (2) its drug formulary (how clinicians access the formulary, major formulary reviews), (3) its P&T committee (membership, frequency and duration of meetings, other activities performed), (4) the submission process for formulary review (prioritization of requests, use of standardized request forms), (5) the information and evidence submitted for review (clinical, economic, or other types of information), (6) formulary decision-making (method of decision-making, approval of requests), (7) approval and utilization of nonformulary drugs, and (8) recent requests for new drugs to be added to the formulary (drugs evaluated, sharing of reviews across institutions).…”

“…7 P&T committees are mandated by hospital accreditation standards, but differ in terms of responsibilities, membership, operation, and processes for formulary decision-making. [8][9][10][11] A survey of Canadian hospitals in 2006 identified efficacy and safety of drugs as the primary review targets, with fewer than half of the committees reporting use of economic criteria. 11 In Ontario, improving formulary management across hospitals using provincial review processes and price negotiation mechanisms was part of the Transparent Drug System for Patients Act, 12 but this legislation has yet to be enacted, despite broad support from the pharmacy directors of teaching hospitals.…”

Role of the hospital pharmacy and therapeutics committee in detecting and regulating off-label drug use

“…We have read the article published by Durán-García et al [1] and would like to congratulate the authors on their work. Moreover, based on our own experience, we would also like to highlight the importance of the role of the Pharmacy and Therapeutics Committee in detecting and regulating the ''off-label'' drug use in hospitals.…”

“…In other words, ''offlabel'' drug use could be sometimes the correct treatment approach and can have positive effects on patient health, even before this use is approved by regulatory boards. On these occasions, the work carried out by the hospital Pharmacy and Therapeutics Committee becomes particularly important, as one of its main objectives is to assess the suitability of the ''off-label'' drug use [1]. If high-quality scientific evidence supporting the ''off-label'' drug use is found, the committee can decide to authorise this use in the corresponding hospitals, accepting the entailed advantages and drawbacks.…”