Formulary is a continually updated list of medications and related information, representing the clinical judgment of physicians, pharmacists, and other experts in the diagnosis, prophylaxis, or treatment of diseases and promotion of health.
CCHI Formulary is an evidence-based disease focused open Formulary which provides an essential drug list, either prescription or over the counter (OTC), that is necessary to treat a certain disease. CCHI Formulary Governance Committee (FGC) with the Pharmacy and Therapeutic committee (PTC) govern, maintain and continually update the Formulary to make sure that all SFDA drugs are available based on the most recent clinical national and international guidelines and the provided drugs are safe and effective for the community of Saudi Arabia403F3F
The Objective of this Formulary is to provide impartial and objective information to insurance companies in the Kingdom of Saudi Arabia, as well as to service providers and patients to promote safe, effective and rational use of medicines, which is based on evidence and global best practices. Other Rationalize use of medicine Promote the use of generics
International Classification of Diseases (ICD) code, based on WHO definition, is “the international standard for defining and reporting diseases and health conditions. It allows the world to compare and share health information using a common language. The ICD defines the universe of diseases, disorders, injuries and other related health conditions. These entities are listed in a comprehensive way as a list of codes with their corresponding descriptions.”
Example:
“The Anatomical Therapeutic Chemical (ATC) Classification is an internationally accepted classification system for medicines that is maintained by the World Health Organization (WHO). The WHO assigns ATC codes to all active substances contained in medicines based on the therapeutic indication for the medicine.”
Some covered drugs may have additional requirements, rules or limits on coverage. These requirements and limits may include:
Examples:
Age edit: Desmopressin in Nocturnal Enuresis should not be prescribed for children < 5 years.
Concurrent Use Edit: Flavoxate in Nocturnal Enuresis should be used as add on to desmopressin after desmopressin failure and cannot be used alone.
Gender Edit: Exemestane in Endometriosis should be used only by Females.
Physician Specialty Edit: Fentanyl in Endometriosis should be prescribed by a gynecologist or pain management specialist.
Prior Authorization: Desmopressin in Nocturnal Enuresis: The prescriber must check the following before prescribing:
Quantity Limit: Idarubicin in Acute Leukemia: Cumulative dose should not exceed 150 mg/m2. Please note that this Quantity Limit is different than the one based on maximum daily dose as this is not necessary based on Maximum Daily Dose.
Step Therapy: Aripiprazole in Social Anxiety: should be used as third line after:
Emergency use only: Furosemide IV form in Hypertension is used only in emergency setting.
Protocol edit: Bendamustine Hydrochloride, Cyclophosphamide, Ifosfamide, Dacarbazine should be used in Lymphoma as per the following protocol
Also known as an originator drug, a brand-name is one marketed by a manufacturer under a brand name ( rather than its generic name). Brand-name drugs are often single-source drugs following their initial SFDA approval because of patent protection and SFDA-granted regulatory exclusivity. Later, generic versions of some brand-name drugs enter the market and compete with the brand-name drug on price.
This is a drug approved by the SFDA by referencing an originator brand-name drug s initial application. Generic drugs can enter the market after the reference product s regulatory exclusivity has expired and after its patents have either expired or been successfully challenged in court.
This is either the adult or pediatric maximum amount of a drug that can be administered per day based on a maximum daily dose.
“Notes” section provides details of the prescribing edits, extra important drug information and special warning and precautions.
The CCHI Formulary is provided on an excel sheet platform that users can filter by disease, ICD code, Drug classes, Active ingredient, ATC code, and whether the drug is a Brand or Generic.
The Formulary provides Appendices with various tables and protocols that users should refer to whenever mentioned in the notes. Hyperlinked Appendices are provided on a separate column for each disease or indication.
Insurance company and providers must comply with IDF requirements for the Essential benefit package (EBP) below is a general guide to follow:
With the following exceptions:
Disclaimer: Trade names listed are for guidance only complete list of registered trade names are available through Saudi Food and Drug Authority site.
