The American Society of Health-System Pharmacy (ASHP) provided a statement in 2008 on the Pharmacy and Therapeutics Committee (PTC) in the formulary system. In this position statement, the organization defines a formulary as a “continually updated list of medications and related information, representing the clinical judgment pharmacist, physicians, and other experts in the diagnosis and treatment of disease and promotion of health.”
Medication-use policies and procedures are most often reviewed, discussed, approved, and disseminated among the interdisciplinary group known as the PTC. Members of the committee are often appointed from multiple disciplines within an institution or in the field of medicine. Overall, the committee is responsible for the development, communication and education of policies and procedures related the formulary system and related decisions. However, there are different types of formularies healthcare professionals may encounter in clinical practice, such as health insurance formularies. For patients and healthcare professionals, health insurance formularies have become more complex and sometimes seem to be constantly changing medications among the tiered-system due to newly approved medications, new evidence, or overall cost of the medication.
Over the course of a year, a group of diabetes educators worked together to create a position statement related to the role of the diabetes educator and formularies with diabetes medications and other devices. The AADE Board of Directors approved this position statement, titled The Role of the Diabetes Educator in Diabetes Formulary and Medical Device Decisions, in July 2017. It details the types and development of formularies, as well as implications of tiered formularies.
A diabetes educator would have the impact to influence the formulary based on knowledge and clinical experience with specific medications and/or devices, ranging from glucometers, to insulin pens and insulin pumps.
While the pharmacist is a main contributor and leader for the PTC, the diabetes educator can be an expert consultant to the committee of institutions or health insurance companies to provide information on medications and other devices related to diabetes management. A diabetes educator would have the impact to influence the formulary based on knowledge and clinical experience with specific medications and/or devices, ranging from glucometers, to insulin pens and insulin pumps.
While there is a lack of evidence supporting or defining the role of a diabetes educator on a PTC, AADE does support diabetes educators as content expert representatives for committees that discuss diabetes medications and other related devices. In addition, the organization advocates for diabetes educators to be involved with the formulary decisions and/or changes. Another supporting statement from AADE would be that diabetes educators can help disseminate information but also train healthcare professionals on diabetes medications and devices. Lastly, the organization supports diabetes educators being involved through active research participation with investigational or currently approved formulary medications.
As one of the authors of this position statement, I want to thank AADE for the opportunity to work with other diabetes educators in developing this document. I want to thank the Board of Directors for approving this position statement, but also providing insightful feedback to elaborate on the details within the document.
However, I want to encourage all AADE members and diabetes educators to read and share this position statement at your institution or practice, as we can impact formulary decisions for our patients.
About the Author
Jennifer Clements received her Doctorate of Pharmacy from Campbell University in 2006 and completed a primary care residency at a Veterans Affairs Medical Center in 2007. She is also a certified diabetes educator and board certified in pharmacotherapy. Currently, she is an Associate Professor of Pharmacy Practice at Presbyterian College School of Pharmacy.