deny stocking the blood fraction in the pharmacy. If it does not provide any benefit to the patients, then it is similar to a placebo. Giving patients medications that serve no benefit violates the Classical Hippocratic ethics of doing whatever is necessary to benefit the patient.1 On the other hand, if there are benefits to using specialized blood fraction, for example, it has the ability to boost the patients’ immune system but the speed of healing time is unclear, I would allow it to be stocked for one year.
This allows us to gather more clinical data with its use. I would continue to monitor the patients’ recovery status and length of stay in the hospital. If the pharmacy budget permits and the results on healing time are positive and significant, I would allow the blood fraction to be stocked for subsequent years. If the results on healing time is insignificant, I would not continue stocking the blood fraction after one year. One may argue that it may have other benefits such as, the ability to boost the immune system. I would not stock this product for its ability to boost the patients’ immune system because there are better, more cost effective alternatives such as Immune Globulin.2 In contrast, if the budget is not enough for the pharmacy to stock the blood fraction but the healing time in patients have shown to be slightly positive, I would not add this medication to our formulary because this would require the pharmacy to destock other medications. Most of the formulary medications in hospitals have significant clinical data to support their use. Therefore, I would deny the surgeon’s request on the basis of low budget and insignificant clinical trials of specialized blood
fraction.