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MEDICARE HOME I.V. PRICING DATABASE CONTRACT AWARDED TO FIRST DATABANK

Executive Summary

MEDICARE HOME I.V. PRICING DATABASE CONTRACT AWARDED TO FIRST DATABANK, the electronic services publishing division of Hearst Corp. First DataBank announced Aug. 18 that it has been chosen by the Health Care Financing Administration to "develop and maintain a prescription drug pricing database" for home intravenous and immunosuppressive drugs covered under the first phase of the new Medicare drug benefit. The contract does not include claims processing; that function will be handled by existing Medicare carriers. First DataBank's responsibilities "will involve calculating prices, adding new products, indicating which drugs are available from only one source or from several sources, and assigning Orange Book codes to drugs with two or more therapeutically equivalent products available," the firm said. Medicare coverage for home I.V. and immunosuppressive drugs begins Jan. 1, 1990. The contract with First DataBank is a one-year contract for calendar year 1990. Because it covers data management for only two categories of treatments, the contract is a relatively small one in the overall context of the Medicare outpatient drug benefit. The contract is worth only $ 22,680. However, First DataBank plans to enter a bid for the claims processing contracts that will be awarded for the full outpatient drug benefit, which is scheduled to go into effect beginning in January 1991. Headquartered in San Bruno, Calif., First DataBank currently operates a broad prescription drug computerized database that includes economic and clinical information. The data file "contains over 140,000 NDC numbers which represent every drug approved by the Food and Drug Administration," First DataBank noted. The firm said that, in addition to Medicaid programs, the data file is used by "more than 40" private third party administrators including PCS, PAID, Rx, Michigan Blue Cross and Metropolitan as well as by "more than 2,500" hospitals including Hospital Corporation of America, Kaiser Foundation and Humana, and 25,000 pharmacies. First DataBank also publishes The Blue Book, a reference of drug average wholesale prices that has been used by HCFA in the Medicaid program. The contract will be under the direction of First DataBank General Manager Joseph Hirschmann. The pharmacy aspects of the project will be handled by Marty Lockwood, the company's professional services manager. Lockwood will be responsible for preparing the initial home I.V. and immunosuppressive drug selection criteria in conjunction with HCFA. She will also handle: "direction of data collection from the published national compendium; analysis and review of mediam AWP algorithms and program output; design, implementation and testing of the database; ]and[ design, implementation and testing of file update algorithms."
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