Imagine a new drug has hit the market. It’s supposed to “revolutionize” the care of diabetics all over America – it’s commercial said so remember!? Well, if you are the Director of Pharmacy at a large medical center, you probably wouldn’t take their word for it. So, how do you decide whether it is worth adding to the hospital’s formulary or not? Well, you have a Pharmacy and Therapeutics Committee for that. This P&T Committee is made up of clinical pharmacists, managed care pharmacists, physicians, and nurses. It is the committee’s job to create their own monograph to determine the drug’s true value and whether it should be added onto the formulary. Clinical judgement is required to assess if a drug meets efficacy standards and the needs of that hospitals demographic. After this is determined, the committee then needs to determine economic factors of the drug. Even though efficacy is the most important factor for the committee, the hospital still needs to be able to pay for the drug. Remember, each hospital has a budget for medications and cannot sacrifice other drugs that patients would need. So essentially it is up to the committee to determine if the drug in question should be added to the formulary, or if current/alternative therapies are more suitable. Like-wise, insurance providers and Office of Workers' Compensation Programs under the Department of Labor must also follow the same process. However, their agenda is to determine which drugs they are willing cover the cost of, and to what extent. Essentially, the P&T Committee is the back bone of all pharmaceutical decision making in their respective settings. They give the oversight necessary to ensure the budget is balanced, without compromise to their patients’ healthcare. Aaron Bisnath Director of P&T
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