The Journal of Managed Care & Specialty Pharmacy this week published the proceedings from the Academy of Managed Care Pharmacy Partnership Forum, “Principles for Sound Pharmacy and Therapeutics (P&T) Practices: What’s Next?” which focused on the current state of P&T committees, challenges faced by these committees and trends in health care that will impact P&T committees in the future.
P&T committees play an important role by recommending which medications an insurer or health system will cover. Although P&T committee processes have continued to evolve, it has been nearly 20 years since the principles for making sound formulary decisions were developed. Since then, medications have become more personalized, the types of evidence available to guide decisions have advanced, and the way health plans pay for and reimburse health care has changed. The principles for determining what medications to cover and for whom, however, have not been substantially updated in that time.
To address the changing health care environment, participants at this AMCP cross-functional forum in March 2019 developed a series of recommendations for best practices in the conduct and deliberations of the P&T committees. The recommendations, summarized in the JMCP article, outlined best practices and challenges focused on six key areas:
- Team and meeting logistics for P&T Committees
- Evidence for P&T Committees to include and consider
- Training and education for P&T Committees
- Disclosing and managing potential conflicts of interest
- Providing transparency of rationale for formulary decisions
- Ensuring inclusion and representation from relevant stakeholders, including patients.
Research conducted by the National Pharmaceutical Council (NPC) and the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center provided the framework for the partnership forum discussion. This research found significant variation in the consistency, volume and types of evidence reviewed and cited in coverage documents. Additional research from NPC and Tufts Medical Center highlighted how and when stakeholder input — including patient input — is considered by P&T committees and other decision-makers.
The research is also part of NPC’s longstanding work to ensure that high-quality evidence is a critical component of decision-making.
NPC was among the sponsors of the forum. Learn more about NPC’s ongoing efforts in the evidence arena.