Development of institutional guidelines for use of high-cost biotechno
logy drugs, such as antithrombin III, is a valuable tool in formulary
management. This article describes the process by which the University
of California Davis Medical Center used an ad hoc committee to the P
& T Committee to develop guidelines for antithrombin III use. Performi
ng an objective analysis of available literature to address the approp
riate role of a biotechnology agent is necessary to develop consensus
guidelines. Approval of use guidelines by the P & T Committee provides
the necessary structure for optimal use of biotechnology agents, such
as antithrombin III.