S02-JA_Q0194-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-0427

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

Divsion. 2237 # 760-23-2-050-0730, Leavenworth CMOP, Leavenworth, KS

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

Item ITEM Description Quantity Unit of Packaging National Drug OEM Name Address2

Number MASTER Measure Multiple Code (NOC)

FILE

NUMBER

6201 THYROID 432 BT 100 00456-0461-01 Forest VACMOP

120MGTAB Laboratories, Leavenworth l00CT (T0048) Inc. - 760

6206 THYROID 30- 864 BT 100 00456-0458-01 Forest VACMOP

32.5MG (1/2 Laboratories, Leavenworth

GRAIN)TAB Inc. - 760

100CT(T0751

This is an individual brand name justification to support the procurement of the two (2) Brand Name

Pharmaceutical items, in the above table.

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.