Irecently came across some minutes of the Pharmacy and Therapeutics Committee at our hospital in which the topic of formulary systems was being hotly debated. One member was quoted as saying that “a hospital formulary is too confining and would limit doctors on their choice of drugs”; another stated that “it has value as an educational aid and reference”, and yet another suggested that “it would eliminate some useless drugs and probably decrease drug costs”. The date on those minutes was January 16, 1959, and this documentation marked the birth of the formulary system at Vancouver General Hospital. Amazingly, over 40 years later, the controversy about hospital formulary systems continues. A few decades later, and after more than 10 years of personal experience working on drug management at this institution, I believe that a well-controlled drug formulary system is still and will continue to be a critical element of responsible acute care hospital pharmacy practice. As the godfather of pharmaceutical care has said, “I personally would much rather practice, and receive care, in a hospital with a well-managed formulary system than in one without”. 1 However, like