Making the P & T Committee and Process Work for You- It’s Worth the Effort

1. Making the P & T Committee and Process Work for You- It’s Worth the Effort Matthew J Nutaitis CAPT MC USN NNMC BETHESDA

2. It’s Worth the Effort • Increasing Complexity of Medical Care • Increasing Variety of Treatment Options for Patients and Providers • Advancements in Pharmacologic Treatment Options • Escalating Pharmaceutical Costs • Escalating MTF Costs

3. The Goal: A Functional P & T Committee and Process • Internal Pressures • Membership, Attendance, Decision Making • Education of Members • External Pressures • CO/XO, ECMS, Providers, Pharmacy, Patients • “Taking Care of Business” • Assist in the delivery of “State of the Art” medical care by supporting the Hospital, the Pharmacy, the Patient and the Provider

4. Keys to Success • Cooperation • Communication • Education • Resources

5. Cooperation • For Success, required within: • P&T Committee-Members and guests • MTF-Departments and Commands • Services and DoD

6. Cooperation • Key PTC and MTF Issues • Uniform Formulary Impact- Col Young • Practice and Prescribing Habits- John Daly, PhD • Cost Containment- Capt Nichols • Formulary Management-Cdr Richardson

7. Uniform Formulary Impact- Col Young • Some UF Key Points • A Formulary Management Tool to Unify Care in the Military Health System • Provider/Beneficiary Education Coordinated by TMA’s Communication and Customer Services • UF Emphasizes: Cost Effective POS, Provider/ Beneficiary Choice, Access to NF Clinically Necessary Drugs, Prior Authorizations

8. Practice and Prescribing Habits- John Daly, PhD • “Communication is Central to Effective Change” • “Who’s Your Audience” • “What’s in it for Me” • “Adapt”, “Create”

9. Cost Containment- Capt Nichols • Prescribing Behavior and Costs • Impact is Significant • Many Complex Influences are Present • Education is Key to Making Progress with the Prescriber/Beneficiary Population • An “Educated Team Player” is most likely to be Cost Effective

10. Formulary Management- Cdr Richardson • Flexibility will be Most Important as the Transition to the UF and BCF/ECF/NF Occurs

11. Communication • Key PTC Issues • Regular meeting times known to the MTF • Dedicated members with low absentee rate • Meaningful Minutes circulated to and read by MTF staff • Use of Ad Hoc members • High Volume/High Cost Users Participate

12. Communication • Key PTC and MTF Issues • Successfully Brief ECMS/XO/CO • Successfully incorporate DoD/DoD P&T/PEC Policy and Guidance into MTF Business Plan

13. Education • Transfer of information within the PTC • Process of educating the providers and patients • Input of information from DoD P&T and HA • Keeping up with industry

14. Education • Transfer of information within the PTC • Agenda reviewed before meeting-Email • Use PTC Member Expertise • Use Ad Hoc experts • Constantly look to make current Members and Future PTC leaders smarter-DoD PEC Conference • Process of educating the providers and patients • Input of information from DoD P&T and HA • Keeping up with industry

15. Education • Transfer of information within the PTC • Process of educating the providers and patients • PTC minutes/Email/News letters/ Command web sites • Pharmacist participation in clinics • Feedback incorporated in the Medication Prescribing Process • Command Priority is understood by MTF Staff • Input of information from DoD P&T and HA • Keeping up with industry

16. Education • Transfer of information within the PTC • Process of educating the providers and patients • Input of information from DoD P&T and HA • PTC reviews, distills and circulates information • Appropriate information reaches Providers and Patients • Confirm the incorporation of Key information into MTF Business • Keeping up with industry

17. Education • Transfer of information within the PTC • Process of educating the providers and patients • Input of information from DoD P&T and HA • Keeping up with industry • New drugs • Generics • Drug Importation • Provider exposure to Industry

18. Resources • DoD Pharmacoeconomics & Pharmacy Benefits Conference and • The Pharmacoeconomics Center • http://www.pec.ha.osd.mil • The Pharmacy and Therapeutics Society • http://www.ptsociety.org/index.htm • P&T Community • http://www.ptcommunity.com • Academy of Managed Care Pharmacy • http://www.amcp.org

19. Resources • Conference Workshops • Analyzing Data and Results-Bretzke • Searching Literature and Acquiring Key Information-Allerman • Designing Outcome Driven Research- Tiller/Trice • Pharmacoeconomics-Bennett/Moore/Dacus

20. Resources • PEC’s Supporting Role to MTF’s • Data • Provision • Analysis • Education • Already completed work • Drug class reviews • New drug monographs

21. Resources • Additional PEC Help • PEC Update • RxNET • The “Staff” • Feedback from the field is greatly appreciated and makes the process successful

22. The Successful P&T Committee • Patients, Providers and MTF Staff are satisfied with the care they receive/deliver • The MTF can pay for that level of care • The P&T Process is specific to the MTF, and is guided by a variety of information that P&T Committee actively seeks and distills for education of the MTF

23. A Final Thought……. • Always err in favor of safe quality care for the patient • Be prepared to remind the finance officers that quality medical care has a price and efforts are made to deliver this care wisely, then have the data to prove it!

24. Questions?