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QUIC FORM 200507 ZMAX Resolution

Requested clarification for the billing unit quantity for ZMAX. Discussion at August 2005 Meeting: This is a noninjectable powder for reconstitution. 60 mls of water is added but the final volume is not stated, but it is a single dose product. Final volume is 75 ml. One participant noted that this is strictly defined in the standard. This can be dispensed as a powder as well - there are specific instructions to the patient as to how to mix it. This can go out as a powder or a liquid. This is in a bottle rather than a packet. Pfizer prefers that it be an each. It was asked if this were dispensed by ml, what happens if you had the package before it is reconstituted? Reconstituted antibiotics are dispensed this way today - one would still bill it as 75 mls. The problem is that it does not show 75 on the package insert. Until this is indicated on the package, what do we use? It was noted again that this is clearly defined in the standard as dispensing by ml. Pfizer could in the interim send out a "Dear Pharmacist" letter and the compendia would have mls so that the pharmacist sees the dispensing by ml is correct. Right now, as of August 1st, all the compendia have as one each - changed before this discussion. It was asked if there would be value in supplying a unit of ml on the fact sheet. One attendee thought it would be better to have the final volume be on the bottle and/or box - additionally it should be on the package insert. There was a motion moved and seconded to make this ml - 75 - to follow the standard. If we do that, will there be information going out to the pharmacists that says this should be 75? Can we use a Dear Pharmacist letter - a letter to the pharmacists from Pfizer? When was the launch date of this product? Not sure of the lunch date but it was on payers' files from June 15-Aug 1st as ml. It was changed to each after August 1 and now we are recommending another change. Explicit dates and advanced warning is needed if we go to 75. Pfizer will need to contact the compendia and communicate to the pharmacies that there is a change and the date of change. The motion carried with two in opposition. The change to 75 ml needs to be coordinated with the notification to the pharmacies. Can we wait to get feedback from Pfizer before we make that decision? We will wait for word from Ross and the Co-chairs will make a decision of the change - it should be on the quarterly compendia updates based on rebates. The compendia will leave as is until we get word from Ross. All compendia would change on the same quarterly update. Ross has no idea at this time as to how long this will take. There was a motion moved and seconded to coordinate the change according to Pfizer's guidance - either the end of Sept/early October or end of December. The dropdead date is December and the compendia will make the change if they have not gotten what they need from Pfizer. NCPDP Now or News Flash article to tell when the date of change will occur. The motion carried with no opposition.

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