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Index to Appendices

Appendix A. Prescription Dispensing Process

Appendix B. Multi-Version Drug Problem

Appendix C. Distributor Relabeling Problem

Appendix D. Exterior-Interior Packaging Problem

Appendix E. Bar Code and NDC Completely Different

Appendix F. Different 11-Digit NDCs Produce Same 10-Digit NDC

Appendix G. Bar Code Translation to NDC Problem

Appendix H. Pack Size Indicates Property of Product

Appendix I. Multiple Bar Codes Reference Same Drug

Appendix J. Various Types of Bar Codes on Drugs and Medical Supplies

Appendix K. Two Different Drugs Appear as only Different Package Sizes

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V.  Far Reaching Problems

We can testify that the problems described above are far reaching.

1.  We develop and maintain systems used in pharmacy dispensing, and we do everything possible to make these systems function efficiently and error-free.  This is a very challenging task, given the range of problems and exceptions described above.  

2.  We develop and maintain drug databases used by these systems.  The databases must cope with whatever drug products the pharmaceutical industry turns out and then make sense of how they are labeled.  For example, much time is spent dealing with the ongoing problem of multi-version drugs, where drugs change in appearance without new NDC numbers assigned.  Also, numerous cross-reference tables must be maintained in order to deal with all of the identification numbers and barcodes found on drug products.

3.  We train pharmacists and pharmacy technicians to use these systems.  We see the frustration and confusion that these problems cause.  Often, the best we can do for the people on the front line is to interrupt robotic processing and let them know that there is an exception that they need to resolve manually.

4.  We provide continuous help desk and on-site support and training for the users of these systems.  We know firsthand that errors do occur because of these problems.

We believe that the most important steps government can take to help the pharmacy industry cope with the burgeoning workload and avoid dispensing errors is to clean up the identification system for drug products and implement barcode standards.
 
   
   
 
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