The Importance of Formulary Adherence in Health Systems

Aislinn Antrim: Why is it important for prescribers to stay on formulary whenever possible?

Peter Bonis, MD: Yeah, so, there has been some debate about the net benefits, but there are 3 major reasons. So, number 1 is cost, number 2 is appropriateness, and the third is safety. So, formulary decisions have ideally been chosen carefully by multi-disciplinary teams who consider all these factors in the hope to help drive the ecosystem toward more safe, cost-effective care. So, formulary adherence is more important now than ever, particularly on the cost side. So, hospital drug spending has increased nearly 19% between 2015 and 2017, and continues to rise, and almost 30% in the ambulatory setting. On appropriateness, many studies continue to demonstrate that drug choices are not always applied optimally to specific care settings, so restricted formulary choices can help to sharpen decision making. And finally, on safety, constrained formulary helps organizations to be familiar with the existing complements of drugs, potentially helping to make sure that they’re used safely. There are more than 360,000 patients who have suffered preventable drug events in the inpatient setting each year, and even more so on the ambulatory side. So, much more needs to be done, but formulary adherence is certainly part of that solution.