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  1. eCQM Issue Tracker
  2. CQM-1356

Generic versus Brand

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    • Icon: Value Sets Value Sets
    • Resolution: Answered
    • Icon: Minor Minor
    • ValueSet
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    • Bonnie Norris
    • Mayo Clinic
    • Advise
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      Presently, RxNorm value sets only include generic medications and not their branded counterparts. The addition of branded drugs to RxNorm value sets has been considered and the determination was made that the inclusion of brand drugs would add complexity to measure development, updates and reporting and as such branded drugs will not be included in the eCQM value sets. However, it is expected that vendors and implementers will map brand drugs to generic drugs in their reports. ONC and CMS are considering whether the provision of mappings between brand and generic codes would be valuable to users and welcome feedback from the public on this topic.

      Please also refer to the 2014 eCQM Measure Logic Guidance & Release Notes v1.9 Update July 2014|http://cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/eCQM_LogicGuidance_v19_July2014.pdf Section 5, subsection 5.2 (Drug Representations Used in Value Sets), for additional information on the approach and expectations for vendors and providers using generic drug codes included in RxNorm value sets.
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      Presently, RxNorm value sets only include generic medications and not their branded counterparts. The addition of branded drugs to RxNorm value sets has been considered and the determination was made that the inclusion of brand drugs would add complexity to measure development, updates and reporting and as such branded drugs will not be included in the eCQM value sets. However, it is expected that vendors and implementers will map brand drugs to generic drugs in their reports. ONC and CMS are considering whether the provision of mappings between brand and generic codes would be valuable to users and welcome feedback from the public on this topic. Please also refer to the 2014 eCQM Measure Logic Guidance & Release Notes v1.9 Update July 2014| http://cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/eCQM_LogicGuidance_v19_July2014.pdf Section 5, subsection 5.2 (Drug Representations Used in Value Sets), for additional information on the approach and expectations for vendors and providers using generic drug codes included in RxNorm value sets.
    • Minimal

      In Meaningful Use EH CQM data validation, we noticed that Xarelto (brand for rivaroxaban) & Eliquis (brand for apixaban) were not being captured in our Antithrombotic medications. We have Eliquis mapped to RXNorm code 136441 internally (as we dispense the brand formulation). LIkewise we have Xarelto mapped to the brand RX norm code as that is what we dispense. The brand RX Norm codes for these medications are not in the Antithrombotic Therapy value sets. Going forward, how should we handle this? Should we be mapping to the generic medication RXNorm Code rather than the brand when brand is actually dispensed? Thank you for your guidance.

            JLeflore Mathematica EH eCQM Team
            BonnieNorris Bonnie Norris (Inactive)
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