After a long gap of more than three decades, the Union health ministry has issued the National Formulary of India (NFI) which is a guidance document for medical practitioners, medical students, nurses and pharmacists on rational usages of drugs and their right dosages. This is the fourth edition of the NFI and the third edition was published way back in 1979.
The 804-page long document, produced and published by the Indian Pharmacopoeia Commission (IPC), has been adopted from the WHO Model Formulary and thoroughly updated for its content, especially keeping in view the end user in India.
The NFI is not a regulatory document. Physicians are supposed to use their professional judgement. Inclusion or exclusion of monographs in NFI is a dynamic process. The drugs contained in NFI have been chosen for rational and economic prescribing. NFI would serve as a guidance document to medical practitioners, pharmacists, nurses, medical and pharmacy students, and other healthcare professionals and stakeholders in healthcare system.
Among other things, the document mentions about the rational approach to therapeutics. Drugs should only be prescribed when they are necessary, and in all cases the benefit of administering the medicine should be considered in relation to the risks involved. Bad prescribing habits lead to ineffective and unsafe treatment, exacerbation or prolongation of illness, distress and harm to the patient, and higher cost, the document in its preface says.
The publication of the NFI is significant as during the past three decades, there has been vast expansion in the range of new drugs and their formulations. During this period, there have been tremendous advancements in therapeutic strategies and newly available drugs. This edition incorporates the changes based on the current knowledge.
To address the need of publication of an updated version of NFI, the health ministry in May 2008 had assigned this mandatory responsibility to the IPC. For this purpose, an 11-member Apex Body under the chairmanship of secretary, ministry of health and family welfare, government of India and a 10-member Core Group were constituted.
Modelled after British National Formulary in 1949, the first, second and third editions of NFI were published in 1960, 1966 and 1979 respectively by the union health ministry. But no effort was made after 1979, whereas developed countries like UK publishes the document in every six months and make sure that it reaches the doctors and pharmacists across the country.
After issuing the comprehensive document, the IPC has invited feedback from the stakeholders.