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First Databank, Inc. (FDB) is a provider of drug and medical device databases that help healthcare professionals make precise decisions. FDB partners with information system developers to deliver useful medication- and medical device-related information to clinicians, business associates and patients. The firm creates and maintains widely used drug databases, software for drug database integration, drug reference products, and other pharmaceutically informatic relevant services. The firm has partnered with pharmaceutical informatic parties and agencies to make drug data useful and relevant for a wide range of drug delivery system applications. The firm's drug databases support pharmacy dispensing, formulary management, drug pricing analysis, medical insurance claims to process computerized physician order entry (CPOE) et al., electronic health records (EHR), electronic medical records (EMR), electronic prescribing (e-Prescribing), and electronic medication administration records (EMAR). FDB is part of the Hearst Health network.
FDB MedKnowledge (formerly National Drug Data File Plus)
First Databank's MedKnowledge provides prices, descriptions, and collateral clinical information on drugs approved by the US Food and Drug Administration (FDA), plus commonly used over-the-counter drugs, herbal remedies, nutraceuticals and dietary supplements.
FDB OrderKnowledge (formerly OrderView Med Knowledge Base)
First Databank has developed a drug ordering knowledge base that enables physicians to quickly look up and order drugs, sometimes as easily as using just two mouse clicks. Drug orders are generated based on patient parameters such as age, weight, renal and hepatic impairment, thereby reducing lists of candidate drugs to a minimum. The system is expected to affect the number of adverse drug reactions and side effects at facilities that have adopted the electronic drug order entry system, such as Beth Israel Deaconess Medical Center, an affiliate of Harvard Medical School.
A web-based software tool that enables, institution-specific modification of medication alerts using FDB MedKnowledge clinical modules based on clinician input, localized clinical experience, and other available evidence. The tool allows users to edit or turn off individual alerts, track all alert customizations and create an audit record, and view FDB updates in comparison with the user's own modifications. Users can load the results of their modifications directly into their medication decision support system for immediate use in the workflow. The approach follows the normal update process.
The FDB Prizm medical device database provides structured, categorized and normalized information about medical device products that are implanted into patients; hospital and durable medical equipment; and medical supplies. The medical device content comes from a variety of sources such as the FDA, medical device manufacturers and industry data pools. Also, it encompasses additional information from clinical, operational, and financial attributes and codes. Use of this database within supply chain and other information systems is designed to help decision makers to build and maintain device libraries, identify and document medical devices in case of recalls and adverse events, and group and analyze medical device utilization.
A consumer coalition filed separate suits in a Boston, Massachusetts federal court against drug wholesaler McKesson Corporation and First Databank, accusing the companies of artificially inflating drug prices. The lawsuits say that McKesson and FDB conspired from 2002 through 2005 to set the list prices artificially high. The suit against First DataBank accused it of limiting its survey of wholesalers to a single company, McKesson.
The plaintiffs contend that the practices have driven up the wholesale cost of drugs for institutional buyers, including health insurers and government programs such as Medicaid, which in turn has cost taxpayers and insurance buyers billions of dollars. Neither company may reap financial rewards directly from widening the spread between the two benchmarks, but the plaintiffs claim the defendants have another motive, performing favors for their drug industry customers. McKesson claims it does not benefit from a higher average wholesale price. A McKesson spokesman said, "An increase or decrease in branded AWPs has no impact on McKesson's wholesale business or its financials."
In a settlement agreement tentatively approved by the federal court, First Databank will not pay any damages to the plaintiffs, but has agreed to reduce average wholesale prices (AWPs) by five percent for about 2,033 drugs. However, McKesson has chosen to fight the suits. Both firms deny any wrongdoing. McKesson claims it was unaware that it was the only company in First DataBank's survey, and that FDB testified under oath that it never informed McKesson it had restricted its survey to one company.
Health care purchasers say the alleged price fixing adds substantial costs. One plaintiff, the New England Regional Council of Carpenters, estimated the settlement could save it about $400,000 a year, or four to five percent off the $10 million that the union's health fund pays to cover medications for about 18,000 people.
"This case is going to lead payers to demand more transparency in drug pricing," said Alex Sugerman-Brozan, director of the Prescription Access Litigation Project in Boston, which filed the suits. "It's this entire shadowy world that leads to massive overcharging."
Proposed settlement terms
On June 7, 2007 the United States District Court, District of Massachusetts granted 'preliminary approval' to the terms of the proposed price fixing litigation settlement. According to the pending settlement, First DataBank will:
- Adjust reporting of Blue Book Average Wholesale Prices for certain prescription drugs contained in National Drug Data File Plus (NDDF Plus) by reducing the mark-up to 1.2 (20%) for all NDCs that have a mark-up factor to actual cost (i.e., 'direct price') in excess of 1.2
- Discontinue publishing the Blue Book AWP data field for all drugs within two years after the effective date of the final court order
- Establish a centralized data repository to facilitate reasonable access to discoverable material from First DataBank concerning its drug price reporting practices
- Work with major participants in the healthcare industry in court approved discussions to facilitate the establishment of a sustainable benchmark for drug reimbursements
- fdbhealth.com - Website
- SFGate.com - 'Unhealthy practices? Lawsuits say companies artificially boosted drug prices', Victoria Colliver, San Francisco Chronicle (December 12, 2006)
-  - The Academy of Managed Care Pharmacy has produced a document explaining various drug payment methods. (October, 2007)