National Council for Prescription Drug Programs

National Council for Prescription Drug Programs (NCPDP) is a not-for-profit, multi-stakeholder forum for developing and promoting industry standards and business solutions that improve patient safety and health outcomes, while also decreasing costs in the pharmacy sector. The organization plays a crucial role in the United States healthcare system by facilitating the exchange of healthcare information through standards development and implementation. These standards are vital for the electronic exchange of healthcare information related to pharmacy services, including electronic prescribing (e-Prescribing), claims processing, medication history reporting, and other pharmacy service transactions.

History

The NCPDP was established in the early 1970s in response to the growing need for a standardized system for processing prescription drug claims electronically. The organization has since evolved to address a wide range of issues related to the pharmacy services sector, including the standardization of information exchange for the management of pharmacy benefits, the facilitation of electronic prescribing, and the implementation of electronic prior authorization (ePA).

Standards Development

NCPDP develops and maintains standards that facilitate the electronic exchange of pharmacy and patient information among healthcare providers, pharmacy benefit managers (PBMs), pharmacies, and other stakeholders. These standards are designed to improve the efficiency and accuracy of pharmacy services, enhance patient safety, and ensure the privacy and security of patient information. Key standards developed by NCPDP include:

• SCRIPT: A standard for electronic prescribing that enables the secure transmission of prescription information between prescribers, pharmacies, and PBMs.
• Telecommunication Standard: Facilitates the electronic submission of pharmacy claim transactions.
• Medication History Standard: Allows for the electronic exchange of a patient's medication history among authorized healthcare providers.

Membership and Governance

NCPDP's membership includes a wide range of stakeholders in the pharmacy services and healthcare industries, including pharmacies, healthcare providers, PBMs, pharmaceutical manufacturers, and technology vendors. The organization is governed by a Board of Trustees, which is elected by the membership. The Board oversees the strategic direction of NCPDP and ensures that the organization's activities align with its mission and goals.

Impact and Initiatives

NCPDP's work has had a significant impact on the healthcare industry, particularly in the areas of electronic prescribing and pharmacy claims processing. The organization's standards have contributed to increased efficiency, accuracy, and safety in the delivery of pharmacy services. NCPDP also undertakes various initiatives to address emerging healthcare challenges, such as the opioid crisis and the need for improved patient access to prescription medications.

Challenges and Future Directions

As the healthcare industry continues to evolve, NCPDP faces ongoing challenges in developing and implementing standards that can accommodate new technologies and regulatory requirements. The organization must also work to ensure widespread adoption of its standards across the healthcare industry. Looking forward, NCPDP is focused on leveraging its expertise in standards development to facilitate innovation in pharmacy services and improve patient care.