Add Formweb to your mobile device
Following is a P and T Committee update (from the October 25th meeting). Starting date for specific programs is 1 Nov 2016, unless otherwise noted. Please let me know if you have any questions or comments. Don’t forget to check the “New Drug Monitoring Spotlight” section of the website, which provides important monitoring information about newly approved drugs. Also, attached is the updated version of the “Not Stocked, Not Ordered” drug list with the new additions highlighted in red.
Below is the memo with links to the drug monographs, protocols, and formulary documents. Click to access the full P&T packet for this month, or here to access the P&T packet archive.
|
Drug or Drug Class |
Formulary Decision |
Comments |
| buprenorphine subdermal implant (Probuphine) | Non-Formulary | Insertion or routine removal of the implants should occur after discharge. |
| brivaracetam (Briviact) |
Formulary, Restricted Automatic IV to PO conversion |
Inpatient initiation of therapy is restricted to neurologists. Any prescriber may order to continue maintenance therapy (home med) during an admission. Automatic IV to PO conversion by pharmacist per approved criteria. |
| daclizumab (Zinbryta) | Non-Formulary | Initiation of therapy should be deferred until after discharge, inpatients should use own supply. |
| Integra Vitamins |
Non-Formulary Therapeutic Interchanges Approved |
Orders for Integra or Integra F will be interchanged to Ferocon. Integra Plus will be converted to Prenatal Plus. |
| fluoxetine delayed-release (Prozac Weekly) |
Non-Formulary Therapeutic Interchanges Approved |
Prozac Weekly 90 mg will be interchanged to fluoxetine 20 mg daily beginning 7 days after the last dose. |
| factor IX complex (Profilnine SD) Update | Formulary, Restricted – Expanded Use | Expanded to include CV Surgery and Trauma. |
| defibrotide (Defitelio) | Pending Review of High Value Subcommittee | Cost for a 21-day course in a 70 kg patient could exceed $200,000. |
| eculizumab (Soliris) | Pending Review of High Value Subcommittee | Cost per dose (q 2 wks) is $15,000 to $20,000 depending on indication. |
| Adult ICU Continuous Paralytic Orders | Order Set Updated | Result of multidisciplinary teamwork, includes flowchart. |
| acetaminophen intravenous (Ofirmev) | Discussion |
The Committee reaffirmed the current use guidelines for IV acetaminophen (Ofirmev). Additionally, it was decided that if a physician makes a viable case for the use of Ofirmev (e.g. patient is intolerant of narcotics), a member of pharmacy leadership may approve a peri-operative dose of IV acetaminophen for that specific patient. Over the next two months, the P and T will finalize usage criteria for Ofirmev. |
| Risk Assessment Project – Sterile Product Assessment in OR | Drugs mixed together with physical or chemical incompatibility (injectable) was found to be medium risk. An action plan was developed and approved. | Action plan includes review of preference cards for compatibility, education for OR staff, specific drugs moved to pharmacy prep |