Study of the “hospital formularies” of different level hospitals based on the “World Health Organization - Essential Medicines List”

Abstract

Background: Health-care costs are continuously increasing and as consequence access to quality pharmaceutical care for everyone is becoming less evident. This is partly due to the increased aging population, new technologies, and patient expectations. Therefore, the rationalization of pharmacotherapy is needed. Effective, safe, and economic drugs have to be selected, used, and monitored to ensure high-quality therapy at an acceptable price for as many people as possible. Aims and Objectives: The aim of the study was to study the hospital formularies of different level hospitals based on the “World Health Organization (WHO) Essential Medicines List (EML).” Materials and Methods: A cross-sectional observational study was planned to be conducted in the hospitals from primary, secondary, and tertiary health-care setups. In each health-care level, one hospital from government, charitable (except primary), and private sectors was selected. From each of the eight hospitals, the hospital formulary was collected, after the permission of the hospital authority. Formularies were compared with the “WHO EML.” Results: Primary Health Care: Total number of drugs in the formulary of government sector was 108, and the same of the private sector was 171. Out of these, 74 (68.52%) drugs are from the WHO EML in government sector, while 81 (47.37%) drugs in the private sector. Secondary Health Care: Total number of drugs in the formulary of government sector was 147, and the same of charitable and private sectors were 314 and 1160, respectively. Out of these, 103 (70.07%) drugs are from the WHO-EML in government sector, 113 (35.99%) drugs in charitable sector, while 387 (33.36%) drugs in the private sector. Tertiary Health Care: Total number of drugs in the formulary of government sector was 209, and the same of charitable and private sectors were 944 and 730, respectively. Out of these, 115 (55.02%) drugs are from the WHO EML in government sector, 287 (30.40%) drugs in charitable sector, while 157 (21.51%) drugs in the private sector. Conclusion: Effective management of Hospital Formularies’ by the means of structuring “Drugs and Therapeutic Committees,” selection of drugs to be included in the formulary on the basis of the WHO EML and adherence of clinicians’ to the formularies are the mainstays for the rational, effective, safe, and affordable health services to the patients.