The issue is that they are asking for clarification on the billing for a new product, Avonex Administration Pack. Should the product be billed as four (4) which is the dispensed quantity, or should it be billed as one (1)?
It was stated that in order to be compliant with NCPDP standards this should be a package of four (4), because pharmacists could split-up the package. Everybody was in agreement on this item.
The QUIC form was reviewed during two quarterly work group meetings, May 10, 1996 and November 7, 1996. The final resolution of QUIC #960004 was during the November 7, 1996 work group meeting.
Coreen Pickett stated that Aldara is a new topical ointment product, with a one (1) to two (2) year release date. The issue is what NCPDP feels would be a unit of measure for the product. The standard states that topical ointments should be in "grams". However, it comes in a packet of .25 gm. The issue is to eliminate rounding to one (1) for each unit. It would then be considered, in a box, to be 3 gm's total and would then be 12, because each packet would be rounded to one (1). There will be 12 single use packets in a box. The question Coreen Pickett asked, would "eaches" be a solution? The work group stated that "eaches" would require a new release of the standard. Ed Edelstein stated that during the Telecommunication meeting, held on May 9th, it was proposed in the new version that everything would be in metric decimal quantity. Therefore, it is possible that by the time this product is on the market, everything will be measured in metric decimal. There is another issue with HCFA, if something is less than one (1), they want it reported as one (1).
Barbara Reed recommended that before a final decision can be made, the pricing compendia should be contacted to see how many other products fall into this category, if this information is available prior to the August meeting, it should be distributed to the attendees for their review.
The members of the work group collected information from the pricing compendia (First Data Bank, Medi-Span and Medical Economics) and voted that a change be made to product identification standard. The change would be "Unit of use packages with a quantity less than one becomes a quantity of ONE EACH." The update of this addition to the product identification standard will become effective February 1, 1997. The unit of measurement for the product Aldara - One Each Packet.
Ed Edelstein stated that this is the new over-the-counter version of Nicorette. The product that contains 108 pieces also contains an audiotape. The Nicorette 48 does not contain an audiotape. The question is, is the one with the audiotape a "kit" and the one without the tape an "each." Ed Edelstein stated that the core 9 - NDC number is the same for both items. The work group recommended that the unit of measurement for these items stay as 48 each and 108 each, and to call the audiotape a package insert.
Ed Edelstein stated that the drug compendia's do not match the package quantity sizes on the HCFA database, which occurs when you have metric decimal. Ed Edelstein gave several examples of the discrepancies. Ed Edelstein volunteered to match all of the metric decimal quantities on First Data Bank's database against the HCFA reported quantities and to contact the manufacturers to see what they have on their label.
Ed Edelstein reported that Lisa Norton submitted a report with 193 NDC's with unit of measurement discrepancies between the HCFA file and her product/pricing database. Ed Edelstein contacted several manufacturers to discuss several discrepancies specific to their products. The manufacturers then contacted HCFA, which in turn stated that they would change to the appropriate unit of measure. Intron from Schering, is a powdered filled vial and should be "each." However, Schering contacted HCFA and after discussion, the decision was to leave it as is. Ed Edelstein stated that Goldline was willing to change amoxicillin and penicillins to "ml's" from "eaches". Rugby's discrepancies have been addressed and corrected. Ed Edelstein stated that those products that can be corrected by the manufacturer will be, however, there will be a period of adjustment. Both Ed Edelstein and Linda Schock agreed to continue working on this effort.