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Despite the availability of numerous drugs to treat certain medical conditions, many institutions maintain closed formulary systems that limit the number and/or types of drugs that may be accessed by practitioners for use in the treatment of their patients. These closed formulary systems are usually maintained through oversight by a Pharmacy and Therapeutics (P&T) committee. As medication use experts, pharmacists are often asked to participate on an institution’s P&T committee to provide guidance on the appropriate selection of medications for inclusion on the formulary. In this role, pharmacists apply skills in drug literature retrieval and evaluation in order to complete a comparative review of a class of medications based on efficacy, safety, cost, availability, and other information relevant to the particular setting. The purpose of this activity is to introduce students to the process of conducting a comparative drug class review and applying the information to the selection of agents to be included on a hypothetical institution’s closed formulary.

Learning Objectives
  1. Develop an appropriate search strategy to identify relevant literature for information on a specific class of medications.

  2. Critically evaluate the methodology and results of the relevant literature sources.

  3. Make recommendations for the inclusion of specific drug agents on a hypothetical institution’s closed formulary based on a comparative review of a drug class.

  4. Develop a guideline for pharmacists to use when performing a therapeutic substitution for a nonformulary agent in a specific drug class.

  5. Deliver a concise, informative, and persuasive presentation of the formulary recommendations at a level appropriate to the audience, and defend the recommendations upon questioning.

  6. Work efficiently to complete the assignment on time, and in the appropriate format.

Foundational Knowledge Required

Pharmacotherapy and disease state guidelines related to assigned drug classes, literature retrieval, and evaluation skills

Suggested Resources
  • Aparasu RR, Bentley JP, eds. Principles of Research Design and Drug Literature Evaluation. 2nd ed. McGraw-Hill;2020.

  • Dawson B, Trapp RG. Basic & Clinical Biostatistics. 4th ed. McGraw-Hill;2004.

  • Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. McGraw-Hill;2020.

Assignment Instructions

  1. For this activity, students will work in their assigned groups. Each group will be given a copy of the Formulary Review Criteria. This document contains the assigned drug class to be evaluated, along with a specific set of criteria that the group must use to determine the final set of agents for inclusion on the closed formulary.

  2. After receiving the Formulary Review Criteria, each group should conduct a search to identify appropriate drug information sources to complete the activity. Examples of general drug information about the assigned class of medications may be obtained through the manufacturer’s approved package inserts, general drug information databases (eg, Lexicomp, Facts and Comparisons, Micromedex), or tertiary literature sources.

  3. Students will have access to a Formulary Review Reference List, which contains a selected set of disease state guidelines and primary literature articles relevant to the assigned drug class. Only publications on ...

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