S-3.1. Submission Spreadsheet
Specialty Drug Submission Spreadsheet
Contact Tab
HHSC requests the following information on the Contact tab of the submission spreadsheet:
- Date of submission
- Name of person submitting the request
- Name of organization
- Email address and contact phone number
- The calendar year and a month of the SDL recommendation
Criteria Tab
HHSC includes the specialty drug criteria as a reference.
Layout Tab
The layout tab includes the fields required for submission on the Submit tab. HHSC requires the following information to consider your submission.
| Column | Field | Description |
|---|---|---|
| A | NDC | 11-digit national drug code number |
| B | Drug name | Name of product |
| K | Criteria #1 Justification | Stakeholder provides a detailed explanation of how NDC does or does not meet all of criteria #1 |
| M | Criteria #3 Justification | Stakeholder provides a detailed explanation of how NDC does or does not meet all of criteria #3 |
| N | Criteria #4 Justification | Stakeholder provides a detailed explanation of how NDC does or does not meet all of criteria #4 |
| O | Final Recommendation Status | Stakeholder identifies one of the following selections:
|
Submit Tab
HHSC requests the following information on the Submit tab of the submission spreadsheet:
- 11-digit national drug code number (column A)
- Name of product (column B)
- A detailed explanation of how the drug does or does not meet criteria #1 (column K), criteria #3 (column M), and criteria #4 (column N).
- Your justification should explain the drug’s complex education or treatment maintenance and list the name (and NPI, if known) of the pharmacies limited to dispensing the drug. Simply identifying a drug that meets or does not meet the criteria is insufficient, and HHSC will return submittals without adequate information.
- The stakeholder should identify the final recommendation status (column O) as either one of the two selections:
- Add: meets the three criteria
- Remove: does not meet at least one criteria
- Stakeholders should add new rows to the document as needed.
Stakeholders can manually enter drug information into this tab or copy a specific row from a published SDL.
Submission
Stakeholders should save a copy of the spreadsheet locally and ensure you complete all fields before sending the file to HHSC at vdp-formulary@hhsc.state.tx.us.