Maximizing drug cost control opportunities is a mandate for every health-system pharmacist. As health systems expand, many have chosen to manage the formulary on a system-wide basis to take advantage of economies of scale. Centralization of formulary policy management can accelerate the benefits of cost-saving initiatives, such as therapeutic interchanges, restrictions, and enhanced contracting opportunities.1
University Hospitals (UH) is a 15-hospital health system (ranging in size from 25 to 1032 beds) that includes 28 outpatient health centers and primary care physician offices in 15 counties in and around Cleveland, Ohio. Six disparate electronic medical records (EMRs) are utilized throughout the health system: one covers eight hospitals, and the remaining five EMRs will be integrated in the future. UH manages its formulary process through two system-level pharmacy and therapeutics (P&T) committees, one for adults and one for pediatrics. After creating the system-wide formulary structure in 2013, it became apparent that additional optimization was necessary to maintain effectiveness and facilitate additional cost management.
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