COMDTINST 6570.4
08 JAN 1991
b.
In addition to those responsibilities outlined in reference (a), Pharmacy and Therapeutics
Committees shall ensure that:
(1) Drug formularies are based on the pharmaceutical needs of patients receiving care in
the clinic.
(2) Items are not stocked solely to meet civilian practitioner's demands.
(3) High cost, low use drugs that are obtained for an individual patient's use are not added
to the formulary.
(4) Formulary items, whenever possible, are obtained from the Defense Personnel
Support Center.
c.
Pharmacies shall:
(1) Adhere to all applicable state laws regarding dispensing generic equivalents for
civilian prescriptions. Civilian prescribers may provide the clinic, in writing, a
statement giving approval to dispense generics for their prescriptions. Obtain
permission from the prescriber prior to all non-generically equivalent therapeutic
substitutions.
(2) Dispense a three-month quantity, with appropriate refills, as the standard dispensing
unit for patients maintained on chronic medications (antihypertensives, oral
contraceptives, anti-epileptics, hormones, etc.). Dispensing more than a three-month
supply of medication when required due to patient travel or operational requirements
is authorized. Each initial prescription and each subsequent refill count separately as
"one" prescription.
(3) Dispense formulary items to beneficiaries with civilian prescriptions. These
prescriptions shall adhere to policy regarding quantities, refills, and the use of less
costly alternatives first.
(4) Establish, where feasible, borrowing policies with local government or civilian
pharmacies to cover temporary supply shortfalls. The individual responsible for the
pharmacy shall maintain a log of items loaned or borrowed, and review and initial
the log weekly to ensure timely replacement of all items.
(5) Rotate drugs (i.e., using items with the earliest expiration date first) to reduce waste
from having to discard outdated items. Pharmacies shall maintain a log of all
destroyed or discarded medication including: medication name, cost, expiration date,
and the date and reason destroyed or discarded. The MLC(k) designated pharmacy
officer responsible for the unit shall monitor these records and make
recommendations to reduce waste.
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