The academy of managed care pharmacy's guidance on the use of clinical and economic evaluation data to support drug formulary decisions

The Format approved by the AMCP Board has two primary goals: (1) to improve the timeliness, scope, quality and relevance of information provided to P & T Committees; and (2) to streamline the process of acquiring data and reviewing products for health plans. In the United States' market-based health services insurance and delivery system, it is unlikely that there will be a centrally mandated set of guidelines for drug formulary considerations, as exist in some other nations - the most likely development will be de facto evolving standards based on a balance of rigor, utility in decision-making and economy of resources. To encourage such standards for information used in formulary decisions, the Academy of Managed Care Pharmacy (AMCP) supported the development of recommendations and a technical report for a Format for Formulary Submissions. This Format focuses on appropriate drug therapy rather than cost reduction and builds strongly on the experience of Regence BlueShield. The resulting "AMCP Guidance for Submission of Clinical and Economic Evaluation Data to Support Formulary Listing in United States Health Plans and Pharmacy Benefit Management Organizations" was completed and approved by the AMCP Board in Fall 2000. FMCP's subsequent training schedule is encouraging the rapid diffusion of the Format to support health plan, PBM and State Medicaid program Pharmacy and Therapeutics Committees in evidence-based decisions. This article provides a context for the development of the Format, the contents of AMCP's Guidance, and an update on dissemination and adoption of the Format.