How to Increase Compliance with DoD PEC Formulary

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How to Increase Compliance with DoD PEC Formulary

• Major Robin J. Johnson
• Diagnostics Therapeutics Flt/CC
• PT Chairperson
• Ellsworth AFB, South Dakota

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Introduction

• Strategy
• Provider Buy-In
• Non-Formulary Request Process
• Physician Champion
• Stand firm

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Strategy

• Educate MTF Providers
• New PCM Pharmacy Orientation letter
• IAW AFI 44-102, section 10.6.2, PCMsuse
  formulary drugs wherever possibleDoD formulary
  1st line agents at all MTFs
• Costs/comments on CHCS
• choose Aciphex or Prilosec 1st line, costs less

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Strategy

• Educate MTF Providers (Cont)
• Invite PCMs to PT meetings as guests
• Explain all aspects of meeting why we do what we
  do at these meetings
• New Item Requests welcome
• Educate on cost of meds (also in CHCS)
• Explain ramifications of adding med to formulary
• Impact of Civilian Rxs

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Strategy

• Educate Civilian Providers Patients
• MTF Website available (update issues)
• Paper formularies hand carried by patients
• Paper formularies faxed by request
• Absolutely do NOT allow a medication to stay on
  or go onto the MTF formulary that is not
  consistent with DoD BCF

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Strategy

• Good relationship with Providers
• Invite them to PT as guests explain process
• Encourage them to use New Drug Request for
  consideration of MTF formulary addition
• Communicate, communicate, communicate
• Explain decisions made give options and
  alternatives

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Strategy

• Good relationship with Providers (cont)
• Make every effort to be available for the PCMs
  and try to work with their needs
• Its not just a business, its caring about the
  patient

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Provider Buy-In

• Understanding the PT Processes/Budget
• More willing to follow the formulary
• Encourage patients to try formulary items, not
  newest, most advertised med (Womans Day,
  Readers Digest, TV, etc.)
• Communication againmake yourself available for
  patients and providers
• Teamwork is keywere all one team
• If they think youre on their sidetheyll play
  ball

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Non-Formulary Requests

• Process in place
• MDG form 28, Patient Specific Special Purchase
  Request MUST be submitted
• IAW MDG Policy meds may be ordered for patients
• Enrolled to the MTF - CHCS Patient Enrollment
  History (PENR) status
• Must show medical necessity
• NO OTC meds

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Non-Formulary Requests

• Review Process by Pharmacist
• Ensure criteria are met
• 1-week turn around time
• Signed lastly by SGH after patient has received
  the medication
• Denials to requests are explained to the PCM with
  suggested options of formulary items
• If PCM disagrees with denial, SGH is final say

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Physician Champion

• SGH is the Physician Champion
• Make sure hes on-board with Pharmacy
• Co-chairs PT with Pharmacist and fully
  understands our processes and budget concerns
• Pharmacist is NOT just the recorder
• He has my back on decisions
• I respect his authority if he overrides a denial
  decision
• Good working relationship

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Stand Firm

• Its your budget you have to answer to spending
  too much
• DoD PEC mandated changes
• Voting is NOT an option at PT
• Remove the drug tell them at PT
• Add the drug tell them at PT
• Vote ONLY on items that you may carry

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Summary

• Strategy
• Provider buy-in
• Nonformulary Request Process
• Physician champion
• Stand firm

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Maj. Robin J. Johnson DT Flight/CC Ellsworth
AFB, South Dakota Robin.johnson_at_ellsworth.af.mil D
SN 675-3252 Comm 605-385-3252