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DEVELOPING NATIONAL
FORMULARIES BASED ON
THE WHO MODEL FORMULARY
Tisocki K, Laing RL, Hogerzeil H, Mehta DK, Ryan RSM
WHO Model Formulary (WMF)
Purpose
To promote safe and cost-effective use of medicines
included in the WHO Essential Medicines List
To serve as model for national, local or institutional
formularies
Brief history
1995 recommendation to develop Model Formulary by
WHO Expert Committee
2000 Start of validation and final editing of draft
2002 first edition out in print, CD-Rom and online on the
WHO website
2004 the second revised edition is now available in print
and online http://mednet3.who.int/eml/modelFormulary.asp
the CD-Rom will have files in multiple languages
and manual on how to produce a National
Formulary
WHO Model Formulary (WMF)
 Reflects evidence-based recommendations of WHO
and other reputable clinical guidelines
 Validated using current, reputable drug information
resources & WHO documents
 Design and organization is modeled on the
successful and widely used British National
Formulary (BNF)
 Produced in collaboration between
 BNF editorial team, Royal Pharmaceutical Society of
Great Britain and
 The Essential Medicine Department of WHO
Anatomy of WMF
Front matter
 General Advice to prescribers
 e.g. prescription writing, adherence
 Essential Medicines List
 List of deletion, additions, changes to
Essential Medicines List
Main body
 27 Sections organized into therapeutic categories
 Within each section general discussion of therapeutic options
and safety issues, followed by individual monographs
Rear Matter
 Appendices:
 Interactions, Pregnancy, Breastfeeding, Renal impairment,
Hepatic impairment
 Index: includes disease and drug terms
How the WMF can be used?
As…
a resource and model for developing national
and institutional formularies
a high quality, independent drug information
resource during the review of existing
formularies
an essential medicines/ clinical guideline
resource for individual prescribers
Developing/maintaining national
formularies based on WMF
Planning
Formulary &
Advisory
Committee
Editorial team
Agree on plan
& budget
Development
of draft
Start by using
WMF text
Add local info
Review and
approve
final text
Production/
Distribution
Final editing &
layout
Print
Distribute
Implement
Evaluation & Review using updated WMF
Important local information in
national formulary
Front matter
 Policies and procedures of National Formulary Committee
 Instruction on how to use formulary
 National policies & regulations on prescribing/ dispensing
Main body
 Local guideline recommendations
 Local, product-specific information
 New monographs, if local medicine is not in WMF
Note: Use local advisory committee for writing / reviewing draft
Rear matter
 Additional safety, pharmaceutical and administrative info e.g.
incompatibilities, poisoning information, dose calculators,
ADR reporting form, contact details
Production issues
 WMF text will be available as Word® files for
developing local formulary text
 Need skilled editor when modifying, deleting WMF
text in order to maintain integrity of information
 Careful copy-editing and proofreading
 Design a user friendly format
 Slim, light, durable
 Select good quality, affordable printing methods
Once the printed copy is out…
It is essential to have:
 Good distribution mechanism
 Implementation: launch, promotional, training
activities
 Evaluation to measure impact of formulary on local
prescribing
 Mechanism for collecting feed-back from users
 Carefully document errors during time between
revisions
 Plans for next review and update
Review & Update
 Planning for revisions – WMF will be updated every
two years
 Formulary revision may be linked to national guidelines
review
 Updates of WMF should be checked for changes,
especially in general therapeutic information section
 Consider information from evaluation and feed-back from
users
 Extensive involvement of local experts in review and
approval of updated text is important
Summary
 WMF provides current evidence-based
therapeutic and medicine information
 Using existing WMF files in development of
local formulary can greatly reduce workload
and ensure inclusion of valid information
but
 careful planning,
 skilled editorial team
 involvement of local experts
 adequate resources and time
will be still essential for successful production
and implementation of local formulary