Ethics of Nonformulary Review in Psychiatry
Abstract
Nonformulary drug regulation in psychiatry can lead to increased cost-effectiveness and rational prescribing practice. Choice and implementation of methods are ethically tinged because of the impact on the psychiatrist's autonomy and on the doctor-patient relationship. A common-sense approach in which enforcement of the formulary system is combined with tact, neutrality, transmission of up-to-date information, and flexibility is advocated.
The basic premise of nonformulary drug use is that the psychiatrist must be willing to justify the drug use to a reviewer. Such an exchange ideally has a consciousness-raising impact on drug prescribing practice that leads to improved clinical utility.
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