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International SNOMED CT releases contain concepts of the first type - i.e. those whose representation is both understandable internationally and whose use has international applicability (e.g. in support of medication information in international patient summaries, or for international pharmacovigilance). But clinical care within member nations requires both the first and the second type of representation for medicinal products, to enable each country to express their medicinal products with their names, their definitions, and if required, additional defining attributes that fits with their regulation and their healthcare culture and practice. This national drug extension model is provided to support the authoring of drug concepts of this second type, and to enable the sharing of tools (e.g. drug authoring tools), rules (e.g. international decision support rules), and drug extension content (e.g. to support the interoperability of a patient's medication information, for cross-border dispensing with contra-indication checking).

Use Cases for the National Drug Extension Model

National drug extensions have to support a variety of use cases; these can include any or all of:

• Prescribing medicines - such that medicinal products are described in sufficient detail that the next action in the process (either dispensing or administration) can identify the correct product to dispense/administer
• Dispensing
  • Reimbursement information
  • Supply chain management (including ordering of medicines for dispensing)
  • "Track and trace" including fraudulent medicines avoidance
• Administration
  • Closed loop medication systems
• Medication history/patient medication lists
• Linking to decision support
• Pharmacovigilance
• Secondary uses (clinical research, pharmacoepidiemiology)
• Supporting electronic data exchange for any or all of the above use cases (for both human users and for system users)

Purpose

This document specifies a drug extension concept model that can be used represent the real or actual medicinal products (sometimes referred to as "branded products") available for use in a particular country/territory. This model is compatible with the international core model for Medicinal Products. This compatibility means that, when classified using the appropriate tooling, the extension concepts will be correctly placed alongside other concepts in the international Medicinal Product hierarchy. This document should therefore be read together with the Medicinal Product Model Specification, which describes the classes of concepts present in the SNOMED CT international edition.

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