Principles of a Sound Formulary Drug System

Background and an Invitation to Endorse

The "Principles of a Sound Formulary Drug System" (360KB) have been endorsed by the Academy of Managed Care Pharmacy; American Society of Health-System Pharmacists; Department of Veterans Affairs, Pharmacy Benefits Management Strategic Healthcare Group; National Business Coalition on Health; and, the U. S. Pharmacopeia. A coalition working group was formed in September 1999 in response to the widespread use of drug formularies in both inpatient and outpatient settings and the lack of understanding about formularies among the public. Proposed federal legislation that would provide a prescription drug benefit for Medicare beneficiaries also continues to focus attention on the appropriate role and management of drug formulary systems within drug benefit programs.

The endorsing organizations believe that the presence of consensus-based Formulary System Principles can assist decision-makers who must balance the health care quality and cost equation. Endorsement of the Principles by additional organizations is welcome.

Whether you choose to endorse the Principles or not, it was the hope of the Coalition that the Principles will be valuable as individual organizations hold discussions on formulary system issues with national, state, and local practitioners, health care system administrators, third party payers, patient advocates, and public policy setters. Each of these parties has a stake in designing a formulary system that ensures patients access to rational, clinically appropriate and cost-effective therapy, and that supports an affordable and sustainable drug benefit program. The Principles by design have been kept general in nature to the end goal of enabling each organization to adapt them to their specific needs, which could include adding specificity within each principle and accompanying bulleted points.

In developing the Principles, the Coalition sought and received feedback on a preliminary document from a broader constituency of health care professionals, government, and business. Those comments were carefully reviewed and considered in the development of this final version. We hope that you will find that the document reflects the Coalition's primary goal—providing clear and concise guidance to healthcare and business decision-makers in a format that will facilitate sound national and local formulary system development and implementation.

If you have questions about the Formulary Principles or the process by which they were developed, please contact any of the coalition working group members that are noted in Appendix III of the document.