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This document serves as a notification form for drug manufacturers to include their generic drug products in the Illinois Notification List, allowing substitution by pharmacists under certain conditions.
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How to fill out notification form for inclusion
How to fill out Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List
01
Obtain the Notification Form from the appropriate Illinois Department of Public Health website or office.
02
Fill in the drug product's name as listed on the label.
03
Provide the manufacturer's name and address.
04
Include the National Drug Code (NDC) of the drug product.
05
Specify the dosage form, strength, and packaging of the drug product.
06
Indicate whether the product is a brand name or generic.
07
Sign and date the form, confirming that the information is accurate.
08
Submit the completed form to the designated state agency by mail or electronically.
Who needs Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List?
01
Pharmaceutical manufacturers who wish to have their drug products included in the Illinois Drug Product Selection Notification List.
02
Healthcare providers and pharmacists who require information regarding drug products for medication selection.
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What is Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List?
The Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List is a formal document that manufacturers must submit to request that their drug products be added to the state's approved drug product selection list. This list facilitates the selection of interchangeable drug products for pharmacists when filling prescriptions.
Who is required to file Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List?
Manufacturers of pharmaceuticals or their authorized representatives are required to file the Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List.
How to fill out Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List?
To fill out the Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List, manufacturers should provide accurate details of the drug product including its name, dosage form, strength, labeling information, and any relevant supporting documentation as specified by the Illinois Department of Public Health.
What is the purpose of Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List?
The purpose of the Notification Form is to ensure that only safe, effective, and FDA-approved drug products are available for selection in the state, allowing pharmacists to substitute drugs as needed while maintaining standards of patient care.
What information must be reported on Notification Form for Inclusion of Drug Product in the Illinois Drug Product Selection Notification List?
The information that must be reported includes the drug product name, chemical or therapeutic class, manufacturer information, dosage form, strength, NDC number (National Drug Code), and any specific labeling or instructions required for the drug product.
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