Introduction

Purpose

The SNOMED CT Medicinal Product hierarchy provides concepts to describe medicinal products at various levels of abstraction with international applicability and support for interoperability in patient care and health data analysis.  It provides a foundation from which member nations can extend with additional concepts suitable for their own healthcare culture and practice, or to which existing terminology can be mapped if required. 

This document describes the model for the concepts in the medicinal product hierarchy in the international edition of SNOMED CT; when populated, this model will provide:

• Concepts in the international edition to meet the core use cases
• A foundation for national medicinal product terminologies
  • For member nations with an existing terminology, the model underpinning the concepts will facilitate both direct use or mapping
  • For member nations without an existing terminology, the concepts provide a consistent starting set of concepts and a model to develop from

The document is primarily a specification; ongoing development will be through the documentation and actual implementation of the machine readable concept model for the medicinal product hierarchy and population of this model will be directed by the detailed Editorial and Terming Guidance for the hierarchy (see: SNOMED CT Editorial Guide - Medicinal Product).

This document also provides a description of how aspects of the SNOMED medicinal product hierarchy correspond with the suite of standards in ISO, collectively known as the "Identification of Medicinal Products standards" (IDMP).¹ These IDMP standards provide a conceptual model for the unique identification of a medicinal product globally, and standard terminology concepts to support this (for example, to describe substances and dose forms). The domain of use for the IDMP standards is primarily the regulatory domain, but since regulatory information is the source and underpinning for the description of medication and medicinal product concepts in a clinical/patient care medicinal product terminology, both internationally and nationally, it is important that the SNOMED CT medicinal product model and supporting concepts are in harmony with those standards.  Compatibility with the IDMP model for identification of medicinal products will facilitate information flow between the two domains of use, for example to support pharmacovigilance.  However, there is no sense that this harmony entails “full and exact compliance”; there would be little value in exact duplication.  The SNOMED CT medicinal product hierarchy therefore provides classes of concepts that are additional to those present in the IDMP model, to support the specific SNOMED CT and patient care/health data analysis use cases.  

Scope

The scope of specification for the concept model for representation of medicinal products in the international edition of SNOMED CT is limited to pharmaceutical and biological products only; products that represent blood products, foods/nutritional supplements, additives, and complementary medicines (including homoeopathic products) are currently out of scope.  The representation of autologous medicinal products (those created from tissue from and administered back to an individual) is also out of scope.  Concepts for vaccines also follow the pattern this model, although only to two of the three "levels" (MP and MPF).  Further detail on scope can be found in the SNOMED CT Editorial Guide.

The international medicinal product model and concepts in the international edition will be described in their more abstract form; real or actual products (including branded products and those marketed without a brand name) as authorised by medicines regulatory agencies within jurisdictions are not within scope.  Describing the packages in which medicinal products are placed into the supply chain are also not within scope;  both of these areas are covered in the national model specification.

Audience

This document is written for everyone with an interest in the development, maintenance and use of medicinal product concepts within SNOMED CT, including those in member nations who are or who wish to use medicinal product concepts from international edition, either directly (in an extension where appropriate) or by mapping, in any national/local medicinal product terminology.  It is relevant to those responsible for clinical or research systems using medicinal product concepts in both active medication processes (prescribing, dispensing and administration of medicines) or in recording of medication information, and also particularly to those responsible for systems providing decision support for medication safety.