Implementing community-based standards of care.
OBJECTIVE
To briefly review steps that should be followed in the progression from considering therapeutic options on the basis of evidence-based medicine (EBM) to implementing formulary decisions and clinical guidelines.


CONCLUSIONS
Results from EBM should guide selection of therapy for routine clinical practice. Pharmacists must spend considerable time carefully reviewing the designs and results of clinical trials and postmarketing information to develop accurate safety and efficacy profiles. The Pharmacy & Therapeutics (P&T) committee also requires pharmacoeconomic data for its deliberations, and that should include information about the economic, clinical, and humanistic value of new therapies. The P&T committee ultimately determines the business value of the new therapy based on the efficacy and safety profile derived from EBM, comparison with treatment alternatives, cost, provider needs, and system orientation.


CONCLUSIONS
Proper accomplishment of all of these steps should result in adoption of efficacious, safe, and cost-effective therapies.
Urick
Paul N
PN
Independence Blue Cross, Philadelphia, Pennsylvania 19103, USA. paul.urick@ibx.com
D002986:Clinical Trials as Topic; D017850:Economics, Pharmaceutical; D019317:Evidence-Based Medicine; D005260:Female; D005569:Formularies as Topic; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010606:Pharmacy and Therapeutics Committee; D017410:Practice Guidelines as Topic / Q000592:standards*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors