Cancer Care Ontario’s Drug Formulary provides online Cancer Drug and Regimen information reflecting the choices of chemotherapy used across Ontario. The Formulary Maintenance Team is responsible for implementing and maintaining the Formulary database.

Updates to Existing Drug and Regimen Monographs

• Monographs are formally reviewed annually by the formulary team against:
  • The CPS or prescribing information for the individual drug
  • Developed Clinical Practice Guidelines for the regimen or drug
• Annual review does not involve the Disease Site Group unless a major change in indication or usage appears to be indicated. However, Disease Site Groups review all pertinent regimens in a 3-year cycle, after the initial review.
• Each disease site is reviewed annually, beginning one year after the regimen monographs have been posted. Drug monographs are reviewed annually, with 25% reviewed each quarter.
• Each monograph is reviewed by both the reference oncologist and pharmacist, with the sequence being dependent upon individual resources and availability. Thereafter, final changes will be made and the documents posted.

Addition of New Drugs and Regimen Monographs

New Drugs : Drug monographs will be added to the Formulary as they become available for use in Canada (i.e. approved by the TPP). The formulary team will create the document and ensure that it is added to the Formulary in a timely manner.

New Regimens : New regimens are suggested by investigators, disease site groups or formulary team members during the initial review period by the Disease Site Group, prior to finalization and posting. If the drugs and regimens will be widely applicable, these will be created, reviewed and finalized in parallel with the finalization of that Disease Site Groups Regimen monograph. Regimens designated as "Local" will be placed on the waiting list for creation.

Process for suggesting new regimens:

• Regimen Proposal Form
  Complete and submit the form, preferably electronically. Include the rationale for inclusion and references.

• Formulary team reviews proposal at the next scheduled meeting.
• Proposal sent to the Disease Site Group (where appropriate) for approval in concept at their next scheduled meeting.
• After approval, the final monograph will be created and published within three months.

Archiving Obsolete Regimens

Archived regimens are clearly defined in the Formulary, and are posted for their historical interest. However, if the archive grows too large, a separate section will be created for regimens archived for three years or more.

Updates to Existing Supportive Care and Symptom Control Regimens

• As new information becomes available
• Upon request from practitioners