P&T Committee: How Drug Decisions Are Made in Hospitals

When a hospital decides to add a new drug to its shelves, it’s not just the doctors or pharmacists making the call—it’s the P&T committee, a formal group of clinicians and pharmacists responsible for evaluating and approving medications for hospital use. Also known as the Pharmacy and Therapeutics committee, this team reviews every drug for safety, effectiveness, cost, and how it fits with existing treatments. Think of them as the gatekeepers of your hospital’s medicine cabinet.

The P&T committee doesn’t just pick drugs because they’re new or flashy. They look at real-world data: How does this drug compare to what’s already being used? Does it actually improve outcomes—or just cost more? They weigh studies, side effect profiles, and even how easy it is for nurses to administer it. For example, if a new painkiller works like ibuprofen but costs ten times more, it won’t make the cut unless it helps patients who can’t tolerate the older option. This is why you might see generic versions of drugs everywhere in hospitals—they’re not cheaper because they’re lesser, but because the P&T committee chose them to save money without sacrificing care.

The committee also handles drug recalls, updates formularies, and sets rules for when specialists can prescribe off-formulary meds. They work closely with pharmacy staff to track which drugs are overused, underused, or linked to errors. If a new anticoagulant like apixaban starts showing better results than warfarin in real hospital patients, the P&T committee will push to switch. Same goes for generics: when a drug like generic Coumadin or amoxicillin proves just as safe as the brand, they’ll update guidelines to encourage use. This is the quiet system behind every prescription you get in the hospital—balancing science, budget, and patient safety.

What you’ll find in the posts below are real examples of how these decisions play out. From why Avandia got pulled from most hospital lists to how Daliresp made it in for COPD patients, each article shows the P&T committee’s influence in action. You’ll see how alternatives like metformin, DOACs, or fluoroquinolones made the cut—or didn’t—based on real clinical and economic trade-offs. This isn’t theory. It’s the daily work of teams making sure you get the right drug, at the right price, with the least risk.