At a recent pharmacy and therapeutics committee meeting, a highly respected specialist presented a novel hemostatic drug for addition to the formulary. The drug had been shown in a phase 2 trial to significantly reduce anti–factor-Xa activity in healthy volunteers, and a subsequent uncontrolled, open-label trial showed evidence of hemostasis.1,2 The cost of the drug was approximately $25 000 to $50 000 per treatment course. Additionally, due to a potential increase in thrombotic risk, a boxed warning was required by the US Food and Drug Administration (FDA). The specialist acknowledged the shortcomings of the trials and potential risks but advocated for the addition of the drug to the formulary based on the argument that few other options existed. Discussions about the merits of the drug ensued, and after 15 minutes, the committee was asked to vote.
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Austin JP, Halvorson SAC. Reducing the Expert Halo Effect on Pharmacy and Therapeutics Committees. JAMA. 2019;321(5):453–454. doi:10.1001/jama.2018.20789
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