US Formulary Rates Benefits Over Cost

Omnicare, the largest independent provider of pharmacy services in the USA, has produced a formulary for geriatric care which provides recommendations for the use of more than 200 drug products, based on their safety and efficacy.

The company's Geriatric Pharmaceutical Care Guidelines classify the products as preferred, acceptable or unacceptable, based on evidence of positive effects or outcomes in comparisons with other products in the therapeutic class. They also consider whether the product provides advantages in a nursing home setting, for example if it needs to be administered only once a day instead of twice it may prove to be more cost-effective, even if it is a more expensive product.

The formulary was developed with assistance from the Philadelphia College of Pharmacy and Science. The executive director of the College's geriatric pharmacy institute, Gary Irwin, said he was impressed by the fact that "there was no way that pricing played any role in (drawing up the ratings) until the clinical content reviews were completed." Company president Joel Gemunder said that as far as he was aware, all other formularies of this kind are cost-based, in which "the cheapest drug is the one they push, giving no cognizance to the drug's benefits."