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New Hampshire Board of Nursing
Joint Health Council Minutes

Draft
JOINT HEALTH COUNCIL
March 16, 2006

Present: Dr. Jack Brown, Chair (JB), Dorothy Mullaney, ARNP (DM ), Mary Bidgood Wilson (MW), Jack Neary, ARNP (JN), Ira Schwartz (IS) , Dr. Peter Dicks (PD) , Dr. David LaCoste (DL)
Absent: Dr. Charles Felton, (CF), Dr. Paul Santos (PS)
Recorder: Margaret J. Walker, NH BON Executive Director

TOPIC
DISCUSSION
ACTION
  • Call to Order,

Approval of minutes

  
  • Meeting called to order at   6:08 pm. by JB.
  • Motion  IS/JN approve minutes of November 28, 2005 as written. Unanimous.
2. Public Forum No discussion requested.  

3. JB proposed review of goals for the JHC formulary after thoughts related to the letter from NH Board of Nursing presented at the last meeting.

JB discussed that the meeting is “essentially a retreat” to assure communication of goals and asked the audience to participate in the discussion Audience conveyed the old definition of consultation did not require written documentation and thus the old definition is similar to the present definition of collaboration.

JB distributed Attachment A and requested committee discussion. DM stated the need for specific question when applying determination of ARNP formulary decisions. JB stated all decisions must be based on scientific data available in peer-reviewed journals and other reliable sources. DL suggests the use of the Formulary Monograph Service that is a clearing house for research, peer-reviewed data.

Committee agreed to the following 4 question categories when determining formulary decisions:

  1. Indication/efficacy
  2. Safety
  3. Drug interactions
  4. Practice setting

JB will develop a template for committee decision-making.

Committee task force assignments:

New drug review-IS, JB, DM

Restricting formulary agents- JN, PD, DL

Unrestricting formulary agents-CF, PS, MW

Liz Hamlin expressed concern with review process will further restrict ARNP practice and stated drug danger justifies changes but if there is no new data, there is no need for changes.

JB and DM states they will review all formulary agents and believe there will be very few formulary changes. They assured the audience that all potential changes will be posted on the website and allow public discussion and rationale for all changes.

Committee will assure all information is posted on the NH BON website for public information.

See appendix A

 

 

 

 

 

 

 

 

 

 

Motion JB/DM Committee will initiate a review of products when the product use changes significantly (oral usage to IV usage).
Yea JB, DL, IS, PD
Nay DM, MW, JN - motion passed

8. Schedule Next Meeting.

 

Reviewed and discussed

Next meeting: Monday June 5, 2006
6pm

9. Adjournment

  

Adjourned at 7:57 pm
Margaret J. Walker MBA, BS, RN
   

Margaret J. Walker
Recorder

Appendix A

Goal: To create a fair, transparent and seamless process for the evaluation of new drug entities and existing agents on the JHC formulary.

  • Establish a process for reviewing new drugs
    • Identification of new drugs for review
      • How identified
        • Who identifies them (responsibility)
    • Data collection
      • What data should be collected on each agent
        • Who collects this data (responsibility)
      • Does an evaluation form need to be designed?
        • Who is should design this form (responsibility)
    • Evaluation of data
      • Should all data types be weighted equally?
        • For example: should efficacy and drug interactions be weighted the same?
      • How long before each meeting will members have access to this information?
        • Who will disseminate this information? (responsibility)
      • Should the evaluation be based on subjective and objective assessment of the agent?
        • How to quantify this
    • Determination of formulary status
      • A denial of a request to include a drug in the formulary shall be issued in writing and shall include relevant scientific information from recognized professional publications.
        • Since this is an inclusionary formulary the interpretation of this is that every time we designate a drug as not unrestricted we need to provide literature to support this.
          • Therefore every drug we review will have relevant scientific information presented
        • Who will do this (responsibility)
        • The council shall render decisions within 3 months of initial consideration unless there is a request for additional scientific information
      • Have we included all the different types of formulary status?
        • Restricted
        • Use with consultation
        • Use with collaboration
        • Unrestricted
  • Establish a process for further restricting formulary agents
    • Identification of existing formulary agents that should be reviewed
      • How identified
        • Appeals of decisions shall be submitted to the council in writing for further deliberation by the council.
        • Who identifies them (responsibility)
    • Data collection
      • What data should be collected on each agent
        • Is new information available?
        • Who collects this data (responsibility)
      • Does an evaluation form need to be designed?
        • Who is should design this form (responsibility)
    • Determination of formulary status
      • A denial of a request to include a drug in the formulary shall be issued in writing and shall include relevant scientific information from recognized professional publications.
        • Since this is an inclusionary formulary Is the interpretation of this that every time we designate a drug as not unrestricted we need to provide literature to support this?
        • Who will do this (responsibility)
        • The council shall render decisions within 3 months of initial consideration unless there is a request for additional scientific information
  • Establish a process for unrestricting formulary agents
      • How identified
        • Appeals of decisions shall be submitted to the council in writing for further deliberation by the council.
        • Who identifies them (responsibility)
    • Data collection
      • What data should be collected on each agent
        • Is new information available?
        • Who collects this data (responsibility)
      • Does an evaluation form need to be designed?
        • Who is should design this form (responsibility)
    • Determination of formulary status
      • A denial of a request to include a drug in the formulary shall be issued in writing and shall include relevant scientific information from recognized professional publications.
        • Since this is an inclusionary formulary Is the interpretation of this that every time we designate a drug as not unrestricted we need to provide literature to support this?
        • Who will do this (responsibility)
        • The council shall render decisions within 3 months of initial consideration unless there is a request for additional scientific information
 
 
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