1. Matching to National Drug File Pharmacy Data Management (PDM) Urban Health Programs August 2010

2. Section Objectives Describe and Manage National Drug File (NDF) Matching Demonstrate proper set up Demonstrate proper maintenance

3. Overview National Drug File (NDF) matching controls: –Adverse Reaction checking –Interaction checking –Dosage form –“Possible doses” –Patient medication instructions (PMI) NDF Update Maintenance –Allows for matching new agents –Provides updates to the PMIs –Provides updates for Adverse Reactions and Interactions

4. Matching Process Local entry is compared to National Files –Can match by NDC/UPC or VA Generic name –Often specific to form and packaging –Must also choose a package size Match must be verified for correctness Match must be merged to the local file Matching or re-matching will RESET the doses

5. Matching through Drug Enter/Edit Opportunity to match when entering a new drug Opportunity to re-match when editing a drug Must hold PSNMGR key for this to work properly When matching through Drug Enter/Edit, will allow for Verification and Merging as well

6. Drug Enter/Edit After going through main drug file fields will see one of two questions: –Drug not currently matched (note default answer): Do you wish to match/rematch to NATIONAL DRUG file? Yes// –Drug currently matched (note default answer): points to AMOXICILLIN TRIHYDRATE 250MG CAP in the National Drug file. This drug has already been matched and classified with the National Drug file. In addition, if the dosage form changes as a result of rematching, you will have to match/rematch to Orderable Item. Do you wish to match/rematch to NATIONAL DRUG file? No//

7. Drug Enter/Edit Match Valid NDC exists in file: Do you wish to match/rematch to NATIONAL DRUG file? Yes// (Yes) Deleting Possible Dosages... Match local drug AMOXICILLIN 250MG CAPS ORDER UNIT: BT DISPENSE UNITS/ORDER UNITS: 100 DISPENSE UNIT: CAP I will try to match NDC: 00364-2040-01 to NDF. Local drug AMOXICILLIN 250MG CAPS matches AMOXICILLIN 250MG CAP PACKAGE SIZE: 100 PACKAGE TYPE: BOTTLE Is this a match ? Enter Yes or No: YES//

8. Match local drug METFORMIN 500MG *PLAIN* TAB U/D ORDER UNIT: BX DISPENSE UNITS/ORDER UNITS: 100 DISPENSE UNIT: TAB I will try to match NDC: 51079-0972-20 to NDF. No match on that NDC.... I will attempt to match the NDCs from your SYNONYMS. No match by Synonym NDC... now first word Match made with METFORMIN 500MG *PLAIN* TAB U/D Now select VA Product Name 1 METFORMIN HCL (FORTAMET) 1000MG TAB,SA TAB,SA HS502 M0814 2 METFORMIN HCL (FORTAMET) 500MG TAB,SA TAB,SA HS502 M0813 3 METFORMIN HCL (GLUMETZA) 1000MG TAB,SA TAB,SA HS502 M0848 4 METFORMIN HCL (GLUMETZA) 500MG TAB,SA TAB,SA HS502 M0815 5 METFORMIN HCL 1000MG TAB TAB,ORAL HS502 M0449 6 METFORMIN HCL 1000MG TAB,SA TAB,SA HS502 M0695 **INACTIVE** 7 METFORMIN HCL 1000MG TAB,UD TAB,ORAL HS502 M0587 8 METFORMIN HCL 500MG TAB TAB,ORAL HS502 M0261 9 METFORMIN HCL 500MG TAB,SA TAB,SA HS502 M0521 10 METFORMIN HCL 500MG TAB,UD TAB,ORAL HS502 M0585 Enter your choice or press return to continue: 10 Is this a match : Y CHOOSE FROM: 1 100 BOTTLE 2 100 UNIT DOSE 3 OTHER OTHER Enter Package Size & Type Combination: 2 Local drug METFORMIN 500MG *PLAIN* TAB U/D matches METFORMIN HCL 500MG TAB,UD PACKAGE SIZE: 100 PACKAGE TYPE: UNIT DOSE Is this a match ? No valid NDC exists in file:

9. No match found! Match local drug AMOXIPINE 25MG TAB ORDER UNIT: BT DISPENSE UNITS/ORDER UNITS: 60 DISPENSE UNIT: TAB No NDC to match... I will attempt to match the NDCs from your SYNONYMS. No match by Synonym NDC... now first word Match on first word failed... No match... attempting to match by Trade Name There are no Trade Names...unable to match Do you want to attempt to match by NDC or UPN: Select one of the following: N NDC U UPN Enter your choice(s) separated by commas : NDC// Please enter NDC Code : Unable to match by Name, Trade Name or NDC Code/UPN Select VA GENERIC NAME: AMOXIPINE ??

10. Oops! Watch for misspellings: Select VA GENERIC NAME: AMOX 1 AMOXAPINE  not “amoxipine”… 2 AMOXICILLIN 3 AMOXICILLIN/CLARITHROMYCIN/LANSOPRAZOLE 4 AMOXICILLIN/CLAVULANATE CHOOSE 1-4: 1 AMOXAPINE Match made with AMOXIPINE 25MG TAB Now select VA Product Name 1 AMOXAPINE 100MG TAB TAB CN601 A0252 2 AMOXAPINE 150MG TAB TAB CN601 A0253 3 AMOXAPINE 25MG TAB TAB CN601 A0254 4 AMOXAPINE 50MG TAB TAB CN601 A0255 5 AMOXAPINE 50MG TAB,UD TAB CN601 A0975 **INACTIVE**

11. Verify the match LOCAL DRUG NAME: AMOXICILLIN 250MG CAP ORDER UNIT: BT DISPENSE UNITS/ORDER UNITS: 500 DISPENSE UNIT: CAP VA PRODUCT NAME: AMOXICILLIN TRIHYDRATE 250MG CAP VA PRINT NAME: AMOXICILLIN 250MG CAP CMOP ID: A0259 VA DISPENSE UNIT: CAP MARKABLE FOR CMOP: YES PACKAGE SIZE: 500 PACKAGE TYPE: BOTTLE VA CLASS: AM111 PENICILLINS,AMINO DERIVATIVES CS FEDERAL SCHEDULE: INGREDIENTS: AMOXICILLIN TRIHYDRATE 250 MG NATIONAL FORMULARY INDICATOR: YES NATIONAL FORMULARY RESTRICTION: Is this a match ? Y You have just VERIFIED this match and MERGED the entry.

12. National Drug File menus REMARematch / Match Single Drugs VERVerify Matches SVERVerify Single Match MERGMerge National Drug File Data Into Local File AUTOAutomatic Match of Unmatched Drugs CLASAllow Unmatched Drugs To Be Classed RPRTNational Drug File Reports Menu... INQInquiry Options... PMISPrint a PMI Sheet FDADisplay FDA Medication Guide

13. Rematch / Match Single Drugs Looks much like in Drug Enter/Edit Does not offer verify option Does not offer merge option More dependant on the NDCs

14. Rematch / Match Single Drugs, cont. Match local drug AMOXICILLIN 250MG CAPS ORDER UNIT: BT DISPENSE UNITS/ORDER UNITS: 100 DISPENSE UNIT: CAP I will try to match NDC: 00364-2040-01 to NDF. Local drug AMOXICILLIN 250MG CAPS matches AMOXICILLIN 250MG CAP PACKAGE SIZE: 100 PACKAGE TYPE: BOTTLE Is this a match ? Select DRUG GENERIC NAME: Remember, these matches must be verified using the options "Verify Matches" or "Verify Single Match" and then be merged using the option "Merge National Drug File Data Into Local File".

15. Verify Matches Verify Matches will loop through all unverified matches –Can use “^” to stop at any time Verify Single Match will allow you to choose a drug to verify –If already verified, will see two question marks: Select DRUG GENERIC NAME: IBU200 ??

16. Verify Matches, cont. LOCAL DRUG NAME: AMOXIPINE 25MG TAB ORDER UNIT: BT DISPENSE UNITS/ORDER UNITS: 60 DISPENSE UNIT: TAB VA PRODUCT NAME: AMOXAPINE 25MG TAB VA PRINT NAME: AMOXAPINE 25MG TAB CMOP ID: A0254 VA DISPENSE UNIT: TAB MARKABLE FOR CMOP: YES PACKAGE SIZE: 60 PACKAGE TYPE: BOTTLE VA CLASS: CN601 TRICYCLIC ANTIDEPRESSANTS CS FEDERAL SCHEDULE: INGREDIENTS: AMOXAPINE 25 MG NATIONAL FORMULARY INDICATOR: NO NATIONAL FORMULARY RESTRICTION: Is this a match ? Y Select DRUG GENERIC NAME: Remember, these matches, after verified, must then be merged using the option "Merge National Drug File Data Into Local File".

17. Automatic Match of Unmatched Drugs Will go through all active drugs with either no or manually entered VA Class Only attempts to match by NDC code Still need to verify and merge This option will attempt to automatically match by NDC code, drugs which have not been matched to the National Drug File. These matches must be verified and merged. AUTOMATIC MATCH by NDC Code process will begin. It will attempt to match all items that are not presently MATCHED to the National Drug File. Are you sure you want to continue ? N// Y............................................................ OK, I'm through. Please verify these matches.

18. Merge National Drug File Data Into Local File Must have a printer to print the error report –Usually no errors Select National Drug File Menu Option: MER Merge National Drug File Data Into Local File This option will merge NDF fields into your local drug file. This will also produce an Error Report for entries in the translation file which are not in the local file if they should exist. These exceptions will not be merged. You may queue this report if you wish. Select Printer:

19. National Drug File Updates Released quarterly or more Installed like any other patch Generate MailMan bulletins –Will get bulletin if hold the PSNMGR key –Some are info only –Others require action

20. Sample messages Subj: Products with changed classes [#13062] 02/25/10@14:18 44 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- Product: BARRIER,ASSURA COLOPLAST #14233 Old Class: XA600 New Class:XA602 Product: CATHETER,SELF-CATH COUDE 14FR COLOPLAST #50202 Old Class: XA599 New Class:XA510 Product: CATHETER,SELF-CATH COUDE 14FR COLOPLAST #50203 Old Class: XA599 New Class:XA510 Product: CATHETER,SELF-CATH COUDE 16FR COLOPLAST #50204 Old Class: XA599 New Class:XA510 Product: DRESSING,BIOPATCH 4MM JJ#4150 Old Class: XA100 New Class:XA105

21. Subj: DRUGS UNMATCHED FROM NATIONAL DRUG FILE [#13060] 02/25/10@14:18 69 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following active entries in your DRUG file (#50) have been unmatched from the National Drug File (NDF). The VA Product name and CMOP ID corresponding to the unmatched local drug file name are listed on the indented line beneath each entry. An Inactivation Date may be listed for entries when this reason applies. Until you rematch these entries to NDF, they will not transmit to CMOP and drug-drug interaction checks will not check for these products. It is critical that you rematch these products immediately. You may also need to match a new orderable item. Any possible dosages and local possible dosages for these unmatched products have been deleted. Therefore, the dosages for each unmatched product should be reviewed after the rematch or recreated if the product can not be rematched to a VA Product through the NDF matching process. DRUG IEN INACTIVATION DATE ------------------------------------------------------------------------------- NONE

22. Subj: UPDATED INTERACTIONS [#13059] 02/25/10@14:18 263 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following interactions in National Drug File (NDF) have been added, edited or inactivated. These changes are the result of review and recommendations from the NDF support group. ADDED INTERACTIONS ALFENTANIL/ISOCARBOXAZID Critical ALFENTANIL/LINEZOLID Critical ALFENTANIL/PHENELZINE Critical ALFENTANIL/RASAGILINE Critical ALFENTANIL/SELEGILINE Critical ALFENTANIL/TRANYLCYPROMINE Critical AMPRENAVIR/DELAVIRDINE MESYLATE Critical AMPRENAVIR/RIFABUTIN Significant AMPRENAVIR/ROSUVASTATIN Significant AMPRENAVIR/TADALAFIL Significant ATAZANAVIR/ATORVASTATIN CALCIUM Significant ATAZANAVIR/DEXLANSOPRAZOLE Critical ATAZANAVIR/ESOMEPRAZOLE Critical

23. Subj: DATA UPDATE FOR NDF [#13058] 02/25/10@14:18 540 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following VA Products have been added to the National Drug File. You may wish to review, then match or unmatch local drug file entries based on this updated information. ATTENDS BRIEF PULL-ON XX-LARGE (CMOP - XT311) (DISPENSE UNIT - EA) 999004-6395-39 BANDAGE,DERMACEA 2IN X 4YD NONSTERILE KEN#441124 (CMOP - XT340) (DISPENSE UNIT - EA) 008884-4411-24 BANDAGE,DERMACEA 2IN X 4YD STERILE KEN#441108 (CMOP - XT336) (DISPENSE UNIT - EA) 008884-4411-08 BANDAGE,DERMACEA 3IN X 4YD NONSTERILE KEN#441123 (CMOP - XT341) (DISPENSE UNIT - EA) 008884-4411-23 BANDAGE,DERMACEA 3IN X 4YD STERILE KEN#441107 (CMOP - XT337) (DISPENSE UNIT - EA)

24. Subj: INTERACTIONS and ALLERGIES UPDATED [#13047] 02/25/10@13:02 29 lines From: NDF MANAGER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- The following interactions have been edited because they involved ingredients that are not primary ingredients. none found The following interactions have been deleted because Primary Ingredient/Other Ingredient combination already exists in the DRUG INGREDIENTS file involved ingredients that are not primary ingredients. GATIFLOXACIN/PIOGLITAZONE HCL GEMFIBROZIL/PIOGLITAZONE HCL ============================================================ Allergy information for the following patients has been changed. Patient: Pxxx,Bxxx Lxxx Non-primary ingredient PIOGLITAZONE HCL was replaced with primary ingredient PIOGLITAZONE HCL