The Aim of the Formulary
The aim of the Formulary is to advise clinicians on evidence based drug treatments, (which are cost and clinically effective) for the common mental disorders encountered in clinical practice.
The vast majority of prescribing for mental disorders in primary and secondary care should be covered by this Formulary, and it will be wide-ranging, in order to achieve this. netFormulary has electronic links to prescribing resources, such as NICE guidance and local guidelines/ pathways. From a cost-effectiveness and evidence-based perspective, it is important to ensure that formulary drugs are positioned appropriately, and adherence to this positioning will produce a number of benefits to the health economy. To facilitate this, formulary drugs clearly state their position in treatment for a particular indication (e.g. first line).
All drugs should be prescribed generically unless a particular preparation needs to be specified because of variations in bioavailability between different brands. It is recognised that on occasion, non-formulary items will be legitimately requested although in such circumstances pharmacists may seek a rationale from the prescribing clinician, e.g. a patient has been admitted on a particular drug and is stabilised on it. Newly introduced medicines into the UK will not be stocked by the Pharmacy, until Formulary inclusion has been agreed by the Medicines Optimisation Committee. In urgent cases, consultants can seek approval from the Chief Medical Officer and Chief Pharmacist (who have joint authority from the Committee) by completing an Individual Patient Request (IPR) for a Non Formulary or Managed Entry Medicine Medicines Used Outside Terms of or Without a Product License
It is anticipated that this Formulary will evolve through debate and suggestion and as new drugs become available. Genuine ownership of the Formulary by clinicians in South Staffordshire and Shropshire who prescribe for people with mental health problems will help to refine it and enhance its relevance to everyday clinical practice.
The Formulary includes a price banding system which identifies whether each drug is low, medium or high cost, and a traffic light system to highlight drugs that are appropriate for prescribing under a shared care arrangement (classed as amber). Essential Shared Care Agreements will be electronically linked to the appropriate parts of the Formulary.
