Condition

SAS Name
DISEASE

This variable is the FDA-approved indication for which the drug (represented by the FRMLRY_RX_ID) is considered on-formulary.

Comments

Starting in 2020, Medicare Part D plan sponsors may limit formulary inclusion of a Part D drug to only certain FDA-approved indications. The corresponding standardized medical subject headings (MeSH) for this value appears in the variable called “MESH_CUI.” Both variables are included in the CMS created indication-based reference file in HPMS for plan sponsors to use for indication-based drug coverage https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-…

The US National Library of Medicine maintains the standardized MeSH. MeSH is a hierarchically-organized terminology for indexing and cataloging of biomedical information. It is used for the indexing of PubMed and other NLM databases. Additional information is available on the NLM.NIH.gov website - https://www.nlm.nih.gov/research/umls/sourcereleasedocs/current/MSH/sou…

Values: Text description (e.g., CROHN DISEASE and ARTHRITIS, PSORIATIC)

Source: CMS (HPMS files)