New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 167A - PROVISION OF PHARMACEUTICAL SERVICES UNDER THE PHARMACEUTICAL ASSISTANCE TO THE AGED AND DISABLED PROGRAM (PAAD)
Subchapter 1 - REQUIREMENTS FOR PROVISION OF PHARMACEUTICAL SERVICES
Section 10:167A-1.22 - Drug Efficacy Study Implementation (DESI)
Universal Citation: NJ Admin Code 10:167A-1.22
Current through Register Vol. 56, No. 18, September 16, 2024
(a) "Less than effective drugs" are subject to a Notice of Opportunity for Hearing (NOOH) by the Food and Drug Administration (FDA).
1. Reimbursement is not available for the purchase or administration of any
drug product that meets all of the following conditions:
i. The drug
product was approved by the Food and Drug Administration (FDA) before October 10, 1962;
ii. The drug product is available only through prescription;
iii. The drug product is the subject of a NOOH issued under Section 505(e)
of the Federal Food, Drug, and Cosmetic Act and published in the Federal Register on a proposed order of the
FDA to withdraw its approval for the drug product because it has determined that the product is less than
effective for all its labeled indications; and
iv. The drug
product is presently the subject of an efficacy review study performed by FDA (see
21
CFR 310.6 including all subsequent amendments and supplements). The FDA
efficacy review potentially can determine justification for a drug product's medical need. If a drug product
fails this review, the product is classified as a DESI drug.
2. Reimbursement is not available for the purchase or administration of any
drug product that is identical, related or similar, as defined in
21
CFR 310.6 (including all subsequent amendments and supplements), to a drug
product that meets the conditions of (a) above.
3. The initial
list of drugs and related drug products classified as "less than effective" by the FDA pending outcome of the
NOOH appears at
21
CFR 310.6. Subsequent revisions to this list that are adopted, shall appear
in the Federal Register.
(b) To obtain a list of DESI drugs, see N.J.A.C. 10:51, Appendix A.
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