Non-Formulary Medication Order Consults at the VA: An Intervention

Presenter: Emily Hillel

Research Category: Health Sciences
Student Type: null
Additional Authors: Emily Hillel, Sabrina Song
PI: Neil Banoey, Jane Hughes

Medication is often the corner stone of treatment in patient disease state management. Formulary management contingent upon formulary and non-formulary criteria to deliver safe and cost effective patient care. The Veteran’s Affair Health Care formulary currently has approximately 1200 medications listed and it is continuously updated and maintained on the Pharmacy Benefits Management (PBM). A non-formulary request process exists at every facility to ensure access to necessary to these drugs when an alternative to formulary medication is needed. This study captured data at the Veterans Affair Boston Health Care System over a 3-month period to help evaluate and improve non- formulary medication management. After data was collected, at total of 1018 consult notes were reviewed to determine 1) the top 20 medications that requested a non-formulary consult and 2) The top 20 medications that took the longest to complete. These medications were reviewed against the VA’s national and local non-formulary criteria to identify which medications did not have policies in place. These medications were targeted to produce resources to aid in streamlining the non-formulary process. The objective of this project is to develop a hospital policy for ordering non-formulary drugs, update the non-formulary consults policy to ensure that they are completed within 96 hours (as per national criteria), and to create a Continuing Education (CE) program to provide more resources and identify common issues that could be resolved in the future.