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November 1990

Less Expensive Is Not Always Less Effective

Author Affiliations

Chicago, Ill

Arch Intern Med. 1990;150(11):2420. doi:10.1001/archinte.1990.00390220146044

To the Editor. —We read with interest Brook's1 recent correspondence concerning the risks of substitution of therapeutically equivalent drugs on hospital formularies. We agree that caution is warranted and that the best interest of the patient should not be overshadowed by economic considerations. Several of Brook's statements are, however, quite disconcerting.

In his discussion Brook refers to "the committees of the institution" that are responsible for decisions regarding drug substitution on hospital formularies. This type of committee is most commonly known as the Pharmacy and Therapeutics (P & T) committee. Brook's statement that the major goal of the hospital [P & T] committee is to save money is both erroneous and insulting. The hospital P & T committee is generally composed of physicians, pharmacists, nurses, and hospital administrators who dedicate their own time to ensure the efficacious, safe, and economic use of drugs within the institution. In making decisions

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