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Journal of the Academy of Hospital Administration

WHO Model Formulary

Author(s): Reviewed by: Rajiv Kumar Jain*

Vol. 14, No. 2 (2002-07 - 2002-12)

Editors: Cooper, Mary R and Mehta, Dinesh K ISBN 924 1545593
Publisher: World Health Organisation, 1211, Geneva 27, Switzerland

Pharmaceuticals can constitute up to 40 per cent of the health care budget in a developing country, yet large proportions of the population often lack access to even the most essential medicines. Because of its considerable impact on the quality of care and the cost of treatment, the selection of essential medicines is one of the most cost-effective approaches to improving access to health care in both developed and developing countries.

To support countries in this selection process WHO regularly issues its Model List of Essential Drugs. This list contains some 300 medicines carefully chosen to contribute to more rational prescribing, lower costs, and improved medicines supply. It has proven a valued resource over many years, and has been widely adopted and adapted in over 150 countries.

A new era in drug prescribing has dawned with this First Edition of the WHO Model Formulary. It has international applicability. The history of preparation of the Formulary goes back to 1995 when the WHO Expert Committee on the Use of Essential Drugs recommended development of a WHO Model Formulary which would complement the WHO List of Essential Drugs and that would be updated every two years.

In November 1999, the Expert Committee on the Use of Essential Drugs recommended that WHO accept an offer by the Royal Pharmaceutical Society of Great Britain (which, together with the British Medical Association, publishes the British National Formulary) to take responsibility for final data validation, editing and layout. Agreement to this effect was reached in early 2000.

During the validation process, all statements in the drafts text were compared with the original references and checked for consistency with other WHO documents and recommendations and reputable drug information sources. This work took almost two years and was completed by the end of 2001.

Now, we have an extremely useful updated and relevant reference text of international standards. The Formulary is a must have for all Hospital and Health Administrators at all levels of health care facilities.

The Formulary is in a user friendly format. It has 27 sections pertaining to all possible groups of drugs, viz. drugs used in Anesthesia, Analgesics, Antiallergics, Antidotes, Anticonvulsants, Anti-infective, Antineoplastic, Antiparkinson drugs, blood products, Cardiovascular, Dermatological drugs, Immunologicals, Muscle relaxants, Ophthalmological, Obstetrics and Psychotherapeutic drugs, Peritoneal dialysis solution, Drugs acting on the respiratory tract, Solutions correcting water, electrolyte and acid-base disturbances and vitamins and minerals, etc. Each section starts with a brief comparative overview of various therapeutic alternatives. Each drug has been described concisely but accurately in terms of uses, contraindications, precautions, interactions, dosage, adverse effects. All the information is quite comprehensive and in user-friendly language.

In addition to above vast information, the Formulary also has general advice to Prescribers relating to rational approach to therapeutics, variation in dose response, adherence with drug treatment, adverse effects and interactions, prescription writing and sample prescription. Not only this, the Formulary also has five Appendices, viz. Interactions, Pregnancy, Breast Feeding, Renal impairment and Hepatic impairment. The Index consisting of 12 pages is a supplement to enable fast search of likely topics.

The Formulary is also available in Electronic Version in the WHO Medicine Web site. The Model Formulary will be linked to the Model List.

One of the major drawbacks of this Formulary is its lack of full concurrence with the numbering system of the WHO Model list of essential drugs. But this could be addressed in future editions of the Formulary. In any case, this Formulary would be a complement to the WHO Model list of essential drugs.

The WHO Model Formulary is an invaluable and unbiased resource for countries wishing to develop their own national formularies. It will also be useful to those developing hospital formularies, and to individual prescribers and students interested in medicines that are globally recognised as essential.

*Deputy Chief Medical Director, Indian Railways Medical Services, New Delhi, India.
For correspondence:
480, Sector 37, Faridabad 121 003, Haryana, India.
E-mail: [email protected] and [email protected].

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