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Indian Health Service: A Profile for Manufacturers

The Indian Health Service (IHS) is a Federal Agency within the Department of Health and Human Services (DHHS). It is the principle Federal health care provider and health care advocate for approximately 2.6 million American Indians and Alaska Natives (AI/AN) people. IHS maintains a network of hospitals, clinics, and health centers staffed with practitioners from the Public Health Service Commissioned Corps, Federal civil service, and local tribes. IHS is considered mostly a rural, primary care health system and maintains a patient-focused, community driven environment. The most common disease states in the IHS patient population are diabetes, heart disease, and cancer.


The IHS maintains a unique National Core Formulary (NCF). Regulated through quarterly meetings of the IHS National Pharmacy and Therapeutics Committee (NPTC), the NCF establishes a minimum (or “floor”) of basic drugs that must be carried at all Federal facilities. Local facilities can then add other drugs to the local formulary as a need is identified.


The IHS National Supply Service Center (NSSC), which is located in Oklahoma City, Oklahoma, coordinates purchases and maintains stock of pharmaceuticals, medical items, and other health care related supply items for both health care facilities and warehouses. All direct IHS facilities can access the BIG4 pricing on the Department of Veteran Affairs (VA) Federal Supply Schedule (FSS) contracts. Through an interagency agreement with the VA, IHS receives distribution of FSS pharmaceuticals through the VA Pharmaceutical Prime Vendor (PPV) program. IHS can choose to participate (and generally does participate) in the VA-issued National Contracts to receive additional discounted pricing. IHS staff can also negotiate incentive agreements with individual manufacturers with distribution still occurring through the VA PPV. Ordering options that do not involve the PPV include FSS orders placed directly with manufacturers and open market solicitations.


IHS receives an annual, congressionally-mandated fixed budget, Manufacturers must acknowledge this key constraint on decisionmakers in this segment. Clinical outcomes and total cost of treatment are critical factors to product adoption and should be at the forefront of any engagement.

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