Development of one paediatric and one neonatal formulary list in hospital settings

SUMMARY

Aim

To describe the stepwise process towards creating two formulary lists – one for paediatric and one for neonatal patients covering common diseases in hospital settings.

Methods

This study presents the concept for developing a formulary list. How to: 1) organize the editorial board, 2) procure drug consumption data and database management, including information on labelling status, dosing options, excipients and problematic adverse events, current guidelines, evidence and price, 3) develop the first edition for the formulary list and formulary manual, 4) to establish a paediatric sub-committee within the Regional Drug and Therapeutic Committee to maintain and continually develop the two formularies.

Results

The total number of drugs was 411 ATC level 5, which covers 1097 unique item numbers prior to the paediatric formulary list, 263 item numbers were included in the final list. In neonates, 201 drugs ATC level 5 were evaluated covering 348 unique item numbers of which 104 item numbers were included in the final neonatal formulary list. Eighty-eight percent of the included drugs in the paediatric formulary were licensed to children (not specified by age group), 2% were unlicensed in Denmark and 7% were extemporaneous preparations. For neonates, the percentage was 48%, 4% and 16%, correspondingly.

Conclusion

The process is time consuming as studies are lacking and age appropriate dosage forms and concentrations differ amongst countries. Nevertheless, the process should be somewhat similar between countries albeit, different drugs may be selected for the final formulary lists.

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