JA_Q0277-RFQ attachment.pdf

VHAPG Part 813.106 Simplified Acquisition Procedures: Soliciting from a Single Source

Attachment 1: Brand Name Justification for SAP under the SAT

DEPARTMENT OF VETERANS AFFAIRS

Justification for Brand Name IAW FAR 13.106-1

For

Over Micro-Purchase Threshold but Not Exceeding the SAT ($2SOK)

Acquisition Plan Action ID: 36C770-23-AP-0589

1. Contracting Activity: Department of Veterans Affairs, Network Contracting Office 15, CMOP

Divsion, Leavenworth CMOP, Leavenworth, KS

2. Brief Description of Supplies/ Services required and the intended use/Estimated Amount:

ITEM

MASTER

Item FILE Unit of Packaging

Number NUMBER Description Quantity NOC Measure Multiple OEM Name Address

RESERVOIR,OMNIPOD

11023 10CT,XR244 800 99999-0425-10 BX 10

lnsulet

Corporation VA CMOP Leavenworth - 760

This is an individual brand name justification to support the procurement of the one (1) Brand Name

Specific Med/Surg item, in the above table. The proposed procurement action will be a firm-fixed priced contract.

3. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used:

Product has been prescribed for patients by VA Physicians. Pharmacy employees do not have the training and/or authority to countermand physician orders. "Brand Specific" products are the same thing as "dispense as written" on a physician's prescription. No National Drug Code (NDC) substitutions are permitted. In the VA, Pharmacy Benefits Management (PBM) has determined that

CMOP IDs in the National Drug File (NDF) will most always identify "brand specific" products in the

VA PRINT NAME. This is not always inclusive where a particular NDC has been determined to be

"formulation specific" by clinical evaluation performed by the PBM or in the case where only one product in the marketplace has been identified to contain the specific ingredients to match the product code.