{"text_format":"1","workbook":"xlsx","n_sheets":12,"sheets":["Title page","Version Control","Instructions","Irish Population Estimates","Patient Population","Drug Acquisition Costs","Drug Acquisition Costs (PAS)","Additional Costs","Results","Results (PAS)","References","Analysis of Uncertainty"],"not_rendered":{"charts":3,"images":2,"macros":1,"external_links":0,"defined_names":71,"comments":2,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Title page","index":0,"n_rows":63,"n_cols":7,"rows_kept":63,"cut":false,"hidden":false,"merged":[[38,3,38,8],[35,0,36,14],[46,0,46,2],[40,3,40,5],[40,6,40,14],[41,3,41,5],[42,3,42,5],[43,3,43,5],[44,3,44,5],[45,3,45,5],[46,3,46,5],[41,6,41,14],[42,6,42,14],[43,6,43,14],[44,6,44,14],[45,6,45,14],[46,6,46,14],[41,0,41,2],[42,0,42,2],[43,0,43,2],[44,0,44,2],[45,0,45,2],[18,0,20,14],[22,0,27,14],[29,0,29,2],[30,0,30,2],[31,0,31,2],[29,3,29,14],[30,3,30,14],[31,3,33,14],[47,3,47,5],[47,6,47,14],[48,3,48,5],[48,6,48,14],[49,3,49,5],[49,6,49,14],[50,3,50,5],[50,6,50,14],[51,3,51,5],[51,6,51,14],[52,3,52,5],[52,6,52,14]]}
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["Please reference this model as \"Lamrock F, O'Donnell H, Varley A, Trela-Larsen L, Tilson L. National Centre for Pharmacoeconomics Budget Impact Model Template Version 1.8. Dublin: NCPE May 2023\" in any adaptions or publications."]
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["General instructions: Please fill in all worksheets where there are grey or purple cells. See below to insert the INN, Brand name, indication under assessment, and comparators considered in this Title page.  The other worksheets in this model can be selected from along the bottom of the excel file, or using one of the buttons below or throughtout the template. The structure of the NCPE Budget Impact Model Template may not be adapted in any way, but extra worksheets/tabs may be added for any additional explanations or calculations on where parameter inputs are sourced from. For example, marketing estimates used to calculate market shares. If the information you have for your budget impact model do not fit within the requirements of the template please contact bim@ncpe.ie. "]
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["INN:"]
["Brand name:"]
["Indication under assessment:"]
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["Please select the number of comparators to be used in the model and insert a name and a short description (including INN and Brand name) for each comparator below.Up to 12 comparators can be used in this model. If more comparators exist, please contact bim@ncpe.ie Note: For HTA submissions comparators with the highest market share should align with the chosen comparators in the cost-effectiveness model."]
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[null,null,null,"How many comparators will be used in this model?"]
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[null,null,null,"Name",null,null,"Description"]
["Comparator 1:"]
["Comparator 2:"]
["Comparator 3:"]
["Comparator 4:"]
["Comparator 5:"]
["Comparator 6:"]
[null,"Comparator 7:"]
[null,"Comparator 8:"]
[null,"Comparator 9:"]
[null,"Comparator 10:"]
[null,"Comparator 11:"]
[null,"Comparator 12:"]
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["Next review date: October 2023"]

{"sheet":"Version Control","index":1,"n_rows":7,"n_cols":4,"rows_kept":7,"cut":false,"hidden":false,"merged":[]}
["Version","Date","Tab","Description of key changes"]
[1.8,"2023-05-08","Title page and Drug Acquisition Cost ","Number of comparators increased to 12"]
[null,null,"Irish Population Estimates","Updated to 2024-2028"]
[null,null,"Drug Acquisition Costs (PAS)","New tab included to allow separate calculation of commercial in confidence costs for the intervention, if the Applicant chooses to submit a PAS at this stage of the process. "]
[null,null,"Results (PAS)","New tab included to allow separate calculation of results when a commercial in confidence PAS has been offered. "]
[null,null,"References ","Framework Agreement rebate updated to -8.5%"]
[null,"Abbrevations: PAS Patient Access Scheme"]

{"sheet":"Instructions","index":2,"n_rows":96,"n_cols":5,"rows_kept":96,"cut":false,"hidden":false,"merged":[[21,4,24,13],[48,4,51,13],[65,4,67,13],[95,4,97,13],[89,4,91,13],[73,4,79,13],[40,4,43,13],[32,4,36,13],[57,4,59,13],[83,4,85,13]]}
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[null,null,null,null,"Cells highlighted in grey are input cells for the Applicant"]
[null,null,null,null,"Cells highlighted in purple are input cells for the Applicant in the form of a drop down menu"]
[null,null,null,null,"Input cells for the Applicant containing confidential information"]
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[null,null,null,null,"The other worksheets in this template can be selected from along the bottom of the excel file, or using one of the buttons above or throughout the template. This tab provides brief user instructions, guidance, and explanations for the use of the template. Each worksheet will have additional guidance."]
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[null,null,null,null,"This Budget Impact Model Template consists of the following worksheets:"]
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[null,null,null,null,"This worksheet provides the background demographic estimates of the Irish population, to aid in identifying the population subject to the indication under assessment. If using these estimates, it is important to show what cells and population was used. This worksheet should not be changed, but provides the most up to date estimates which are encouraged to be referenced on the Patient Population worksheet."]
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[null,null,null,null,"This worksheet calculates the eligible patient population for the intervention under assessment. Market share estimates are input here. For HTA submissions comparators with the highest market share should align with the chosen comparators in the cost-effectiveness model."]
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[null,null,null,null,"This worksheet calculates the price of the new intervention and any relevant comparators. The drug cost is inclusive of fees, rebates, and VAT if applicable. The price should correspond to the Price Application Form submitted to the Corporate Pharmaceutical Unit, HSE Primary Care Reimbursement Service. "]
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[null,null,null,null,"If a commercial in confidence (CIC) Patient Access Scheme (PAS) is planned, please include these details in the Drug Acquisition Costs (PAS) worksheet and provide this as a scenario analysis in the submission document. "]
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[null,null,null,null,"Other costs such as administration or concomitant medication costs may be presented in this worksheet."]
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[null,null,null,null,"This worksheet presents the results. The gross drug budget impact includes only the drug acquisition cost of the new intervention. The net drug budget impact is calculated to describe the potential drug costs and cost-offsets anticipated from the increased utilitsation and/or displacement of other drugs. The net drug budget impact includes only the drug acquisition costs. Finally, a broader health service net budget impact can also be calculated where additional costs and offsets are included.e should correspond to the Price Application Form submitted to the Corporate Pharmaceutical Unit, HSE Primary Care Reimbursement Service."]
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[null,null,null,null,"If a Commercial in Confidence (CIC) Patient Access Scheme (PAS) is planned, please present the results for the PAS scenario in the separate Results (PAS) worksheet and provide this as a scenario analysis in the submission document. "]
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[null,null,null,null,"This worksheet should be used to document any additional reference sources used to derive estimates for this budget impact model."]
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[null,null,null,null,"This worksheet explores the impact of parameter uncertainty on the budget impact analysis using deterministic one-way sensitivity analysis. Additional sensitivity analyses/scenario analyses can be manually inserted by the Applicant to include in the tornado diagram."]

{"sheet":"Irish Population Estimates","index":3,"n_rows":125,"n_cols":22,"rows_kept":125,"cut":false,"hidden":false,"merged":[[16,1,20,10]]}
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[null,"This worksheet provides the background demographic estimates of the Irish population, to aid in identifying the population subject to the indication under assessment. If using these estimates, it is important to show what cells and population was used. This worksheet should not be changed, but provides the most up to date estimates which are encouraged to be referenced on the Patient Population worksheet."]
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[null,"Males",null,null,null,null,null,null,null,"Females",null,null,null,null,null,null,null,"Total"]
["Age",2024,2025,2026,2027,2028,null,null,null,2024,2025,2026,2027,2028,null,null,null,2024,2025,2026,2027,2028]
[0,29791,29572,29432,29313,29327,null,null,null,28299,28091,27961,27849,27858,null,null,null,58090,57663,57393,57162,57185]
[1,29997,29716,29497,29358,29239,null,null,null,28542,28271,28063,27933,27822,null,null,null,58539,57987,57560,57291,57061]
[2,30411,30045,29764,29545,29407,null,null,null,29024,28680,28409,28201,28071,null,null,null,59435,58725,58173,57746,57478]
[3,30895,30432,30066,29785,29566,null,null,null,29563,29124,28780,28509,28301,null,null,null,60458,59556,58846,58294,57867]
[4,31406,30914,30451,30085,29804,null,null,null,30100,29626,29187,28843,28572,null,null,null,61506,60540,59638,58928,58376]
[5,32102,31720,31229,30766,30400,null,null,null,30726,30364,29890,29451,29107,null,null,null,62828,62084,61119,60217,59507]
[6,32749,32378,31997,31506,31043,null,null,null,31335,30974,30612,30138,29699,null,null,null,64084,63352,62609,61644,60742]
[7,33361,32966,32595,32214,31724,null,null,null,31906,31527,31166,30804,30330,null,null,null,65267,64493,63761,63018,62054]
[8,32851,33587,33192,32821,32440,null,null,null,31495,32096,31717,31356,30994,null,null,null,64346,65683,64909,64177,63434]
[9,34075,33040,33776,33381,33010,null,null,null,32500,31647,32248,31869,31508,null,null,null,66575,64687,66024,65250,64518]
[10,35406,34235,33200,33936,33541,null,null,null,33593,32626,31773,32374,31995,null,null,null,68999,66861,64973,66310,65536]
[11,36403,35571,34400,33365,34101,null,null,null,34664,33717,32750,31897,32498,null,null,null,71067,69288,67150,65262,66599]
[12,37926,36514,35682,34511,33476,null,null,null,36027,34757,33810,32843,31990,null,null,null,73953,71271,69492,67354,65466]
[13,38325,38056,36644,35812,34641,null,null,null,36809,36140,34870,33923,32956,null,null,null,75134,74196,71514,69735,67597]
[14,38423,38484,38215,36803,35971,null,null,null,36581,36952,36283,35013,34066,null,null,null,75004,75436,74498,71816,70037]
[15,38049,38504,38565,38296,36885,null,null,null,36293,36654,37025,36356,35086,null,null,null,74342,75158,75590,74652,71971]
[16,37503,38114,38569,38630,38361,null,null,null,35942,36366,36727,37098,36429,null,null,null,73445,74480,75296,75728,74790]
[17,35244,37569,38180,38635,38696,null,null,null,33453,36025,36449,36810,37181,null,null,null,68697,73594,74629,75445,75877]
[18,34155,35484,37808,38419,38874,null,null,null,32559,33725,36297,36721,37082,null,null,null,66714,69209,74105,75140,75956]
[19,34235,34497,35826,38150,38761,null,null,null,32190,32955,34122,36693,37117,null,null,null,66425,67452,69948,74843,75878]
[20,33942,34263,34525,35854,38177,null,null,null,32690,32343,33108,34275,36846,null,null,null,66632,66606,67633,70129,75023]
[21,33503,34208,34529,34792,36120,null,null,null,32692,33084,32738,33502,34669,null,null,null,66195,67292,67267,68294,70789]
[22,33558,34100,34805,35126,35389,null,null,null,32957,33487,33879,33533,34297,null,null,null,66515,67587,68684,68659,69686]
[23,33530,34218,34760,35465,35786,null,null,null,32827,33751,34281,34673,34327,null,null,null,66357,67969,69041,70138,70113]
[24,34241,34402,35090,35632,36337,null,null,null,33620,33807,34731,35261,35653,null,null,null,67861,68209,69821,70893,71990]
[25,35090,34957,35118,35806,36348,null,null,null,34274,34531,34718,35642,36172,null,null,null,69364,69488,69836,71448,72520]
[26,35485,35858,35725,35886,36574,null,null,null,34916,35112,35370,35557,36481,null,null,null,70401,70970,71095,71443,73055]
[27,33662,36053,36427,36294,36455,null,null,null,33499,35609,35805,36063,36250,null,null,null,67161,71662,72232,72357,72705]
[28,33435,34199,36590,36964,36832,null,null,null,33413,34105,36214,36410,36668,null,null,null,66848,68304,72804,73374,73500]
[29,32682,33768,34532,36920,37296,null,null,null,32907,33852,34544,36652,36848,null,null,null,65589,67620,69076,73572,74144]
[30,32501,33285,34371,35136,37523,null,null,null,32509,33368,34313,35005,37112,null,null,null,65010,66653,68684,70141,74635]
[31,32349,32924,33708,34794,35559,null,null,null,31958,32878,33737,34682,35375,null,null,null,64307,65802,67445,69476,70934]
[32,31617,32683,33258,34043,35129,null,null,null,32068,32192,33112,33971,34916,null,null,null,63685,64875,66370,68014,70045]
[33,32691,31864,32931,33506,34291,null,null,null,32207,32253,32377,33297,34156,null,null,null,64898,64117,65308,66803,68447]
[34,31164,33085,32259,33326,33901,null,null,null,31793,32545,32591,32715,33635,null,null,null,62957,65630,64850,66041,67536]
[35,33435,31508,33428,32603,33670,null,null,null,34219,32118,32870,32916,33040,null,null,null,67654,63626,66298,65519,66710]
[36,31436,33835,31910,33829,33005,null,null,null,33511,34580,32479,33232,33278,null,null,null,64947,68415,64389,67061,66283]
[37,33018,31785,34182,32261,34179,null,null,null,35138,33805,34875,32774,33528,null,null,null,68156,65590,69057,65035,67707]
[38,35300,33267,32035,34431,32512,null,null,null,37693,35395,34063,35132,33034,null,null,null,72993,68662,66098,69563,65546]
[39,35123,35457,33427,32196,34591,null,null,null,37493,37877,35580,34249,35318,null,null,null,72616,73334,69007,66445,69909]
[40,36458,35327,35661,33632,32404,null,null,null,39512,37724,38108,35813,34483,null,null,null,75970,73051,73769,69445,66887]
[41,38064,36617,35488,35822,33796,null,null,null,41636,39640,37853,38237,35945,null,null,null,79700,76257,73341,74059,69741]
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[43,41322,39212,38169,36724,35602,null,null,null,43115,42174,41805,39811,38027,null,null,null,84437,81386,79974,76535,73629]
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[45,38289,42045,41384,39283,38243,null,null,null,40580,43486,43237,42297,41931,null,null,null,78869,85531,84621,81580,80174]
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[47,36424,37397,38351,42101,41441,null,null,null,37448,38612,40687,43590,43343,null,null,null,73872,76009,79038,85691,84784]
[48,36805,36438,37411,38364,42109,null,null,null,37304,37476,38639,40712,43614,null,null,null,74109,73914,76050,79076,85723]
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[66,24411,25543,25394,26500,26482,null,null,null,25454,26137,26666,27640,27406,null,null,null,49865,51680,52060,54140,53888]
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[81,10895,11653,12300,13381,13960,null,null,null,12736,13286,14054,15219,15659,null,null,null,23631,24939,26354,28600,29619]
[82,9592,10348,11078,11703,12742,null,null,null,11100,12271,12808,13556,14687,null,null,null,20692,22619,23886,25259,27429]
[83,8460,9032,9752,10452,11052,null,null,null,10277,10633,11760,12283,13009,null,null,null,18737,19665,21512,22735,24061]
[84,7778,7877,8420,9102,9768,null,null,null,9685,9762,10109,11184,11692,null,null,null,17463,17639,18529,20286,21460]
[85,6834,7172,7276,7789,8431,null,null,null,8920,9127,9209,9545,10569,null,null,null,15754,16299,16485,17334,19000]
[86,5888,6228,6547,6656,7136,null,null,null,7908,8329,8533,8620,8946,null,null,null,13796,14557,15080,15276,16082]
[87,5146,5294,5614,5914,6025,null,null,null,7225,7304,7703,7902,7995,null,null,null,12371,12598,13317,13816,14020]
[88,4362,4570,4713,5009,5289,null,null,null,6420,6598,6681,7056,7250,null,null,null,10782,11168,11394,12065,12539]
[89,3571,3803,3997,4136,4408,null,null,null,5590,5778,5950,6037,6388,null,null,null,9161,9581,9947,10173,10796]
[90,2885,3069,3281,3456,3589,null,null,null,4763,4967,5147,5310,5399,null,null,null,7648,8036,8428,8766,8988]
[91,2246,2430,2593,2784,2944,null,null,null,3845,4160,4350,4517,4672,null,null,null,6091,6590,6943,7301,7616]
[92,1713,1856,2016,2160,2326,null,null,null,3207,3300,3581,3753,3907,null,null,null,4920,5156,5597,5913,6233]
[93,1334,1388,1508,1644,1767,null,null,null,2616,2697,2784,3026,3181,null,null,null,3950,4085,4292,4670,4948]
[94,926,1041,1087,1187,1299,null,null,null,2035,2135,2209,2286,2492,null,null,null,2961,3176,3296,3473,3791]
[95,621,705,794,830,911,null,null,null,1536,1621,1704,1769,1836,null,null,null,2157,2326,2498,2599,2747]
[96,420,465,528,596,624,null,null,null,1117,1194,1262,1330,1384,null,null,null,1537,1659,1790,1926,2008]
[97,281,296,329,374,423,null,null,null,818,831,889,943,995,null,null,null,1099,1127,1218,1317,1418]
[98,175,191,201,223,256,null,null,null,566,586,597,643,681,null,null,null,741,777,798,866,937]
["99+",237,253,274,294,319,null,null,null,925,971,1015,1050,1104,null,null,null,1162,1224,1289,1344,1423]
["All ages",2582931,2609491,2635542,2661114,2686314,null,null,null,2628085,2654860,2681205,2707104,2732684,null,null,null,5211016,5264351,5316747,5368218,5418998]

{"sheet":"Patient Population","index":4,"n_rows":138,"n_cols":14,"rows_kept":138,"cut":false,"hidden":false,"merged":[[134,1,134,3],[135,1,135,3],[136,1,136,3],[137,1,137,3],[115,1,115,3],[116,1,116,3],[117,1,117,3],[132,1,132,3],[133,1,133,3],[128,1,128,3],[129,1,129,3],[125,1,125,3],[126,1,126,3],[127,1,127,3],[79,1,79,3],[79,9,79,11],[112,1,112,3],[113,1,113,3],[114,1,114,3],[97,1,97,3],[97,9,97,11],[98,1,98,3],[98,9,98,11],[99,1,99,3],[99,9,99,11],[87,1,87,3],[87,9,87,11],[88,1,88,3],[88,9,88,11],[89,1,89,3],[89,9,89,11],[90,1,90,3],[90,9,90,11],[94,1,94,3],[94,9,94,11],[95,1,95,3],[95,9,95,11],[96,1,96,3],[74,1,74,3],[74,9,74,11],[75,1,75,3],[75,9,75,11],[76,1,76,3],[76,9,76,11],[77,1,77,3],[77,9,77,11],[78,1,78,3],[78,9,78,11],[71,9,71,11],[72,1,72,3],[73,1,73,3],[72,9,72,11],[73,9,73,11],[48,13,49,22],[52,1,52,3],[53,1,53,3],[52,9,52,11],[48,1,48,3],[48,9,48,11],[49,1,49,3],[49,9,49,11],[50,1,50,3],[50,9,50,11],[58,9,58,11],[59,1,59,3],[59,9,59,11],[54,1,54,3],[54,9,54,11],[55,1,55,3],[55,9,55,11],[56,1,56,3],[56,9,56,11],[111,1,111,3],[92,1,92,3],[93,1,93,3],[92,9,92,11],[93,9,93,11],[107,1,107,3],[108,1,108,3],[109,1,109,3],[106,1,106,3],[110,1,110,3],[96,9,96,11],[67,9,67,11],[68,1,68,3],[47,9,47,11],[53,9,53,11],[51,1,51,3],[51,9,51,11],[57,1,57,3],[57,9,57,11],[58,1,58,3],[69,1,69,3],[69,9,69,11],[70,1,70,3],[91,1,91,3],[91,9,91,11],[86,9,86,11],[70,9,70,11],[71,1,71,3],[26,9,26,11],[27,9,27,11],[28,9,28,11],[29,1,29,3],[29,9,29,11],[27,1,27,3],[28,1,28,3],[31,1,31,3],[31,9,31,11],[30,1,30,3],[35,1,35,3],[35,9,35,11],[33,1,33,3],[33,9,33,11],[45,1,45,6],[40,1,40,6],[25,13,27,22],[28,13,29,22],[130,1,130,3],[131,1,131,3],[16,1,20,10],[104,13,105,22],[67,13,68,22],[87,13,88,22],[24,1,24,6],[64,1,64,6],[84,1,84,6],[103,1,103,6],[122,1,122,6],[30,9,30,11],[66,9,66,11],[67,1,67,3],[34,13,34,22],[30,13,30,22],[32,13,32,22],[68,9,68,11],[32,1,32,3],[32,9,32,11],[34,1,34,3],[34,9,34,11]]}
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"In this worksheet, the patient population eligible to receive the new intervention is estimated by the Applicant. The market share estimates are used to calculate the expected number of patients to receive the new intervention over the next 5 years."]
[]
[]
[]
[]
[]
[]
[]
[null,"Eligible patient population"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"Insert the number of Irish prevalent and incident patients by using the \"Irish Population Estimates\" tab. If additional rows are needed for calculations, please add them to an additional worksheet but place the aggregated numbers here.  Please describe the reference source cells used and any calculations. The prevalent and incident cells can be manually inserted or linked to each other where the applicant deems appropriate for the calculations. Absolute numbers should be used."]
[null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5","Reference/Calculations"]
[null,"Prevalent patients"]
[null,"Incident patients",null,null,null,null,null,null,null,null,null,null,null,"Please note that prevalent and incidence calculations should not include mortality and sub-population calculation. Mortality will be calculated next, and the sub-population is an optional specific sub-population of patients narrower than that covered by the licence. "]
[null,"Number of patients with condition",null,null,{"$f":"(E28+E29)","v":0},0,0,0,0,"Calculation"]
[null,"Mortality rate in patients with condition",null,null,null,null,null,null,null,null,null,null,null,"Insert the mortality rate as a percent per annum of the patient cohort with the condition.  If the mortality rate is not known or is not significant, please set to 0. Please describe the reference source and any calculations."]
[null,"Net number of patients ",null,null,{"$f":"(E30*(1-(E31)))","v":0},{"$f":"(F30*(1-(F31)))","v":0},{"$f":"(G30*(1-(G31)))","v":0},{"$f":"(H30*(1-(H31)))","v":0},{"$f":"(I30*(1-(I31)))","v":0},"Calculation"]
[null,"Patients eligible for the new intervention under the license (%)",null,null,null,null,null,null,null,null,null,null,null,"Insert the percentage of patients eligible for the new intervention under the license. Please describe the reference source and any calculations."]
[null,"Number of patients potentially treatable under license",null,null,{"$f":"E32*E33","v":0},{"$f":"F32*F33","v":0},0,{"$f":"H32*H33","v":0},0,"Calculation"]
[null,"Sub-population of eligible patient population under consideration (%)",null,null,null,null,null,null,null,null,null,null,null,"Optional: If a sub-population is under consideration, please describe the reference source and any calculations, otherwise use 100%."]
[null,"Eligible patients treated with intervention",null,null,{"$f":"E35*E34","v":0},{"$f":"F35*F34","v":0},{"$f":"G35*G34","v":0},{"$f":"H35*H34","v":0},{"$f":"I35*I34","v":0},"Calculation"]
[]
[]
[]
[]
[null,"Market shares"]
[]
[]
[]
[]
[null,"Market share without intervention"]
[]
[null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5","Reference/Justification"]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "},null,null,null,null,null,null,null,null,null,null,null,"Estimated market shares should sum to 100% each year. Where appropriate, outline if the market share estimates represent mid-year or end-of-year projections and the justification for taking this approach. Additional information regarding how market shares were obtained, e.g. market research can be submitted as a separate document/tab/excel file. For HTA submissions comparators with the highest market share should align with the chosen comparators in the cost-effectiveness model."]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "}]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "}]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "}]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "}]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "}]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "}]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "}]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "}]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "}]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "}]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "}]
[]
[null,null,null,null,{"$f":"SUM(E49:E60)","v":0},{"$f":"SUM(F49:F60)","v":0},0,0,0,"Check market shares sum to 100%"]
[]
[]
[null,"Market share with intervention"]
[]
[null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5","Reference/Justification"]
[null,{"$f":"CONCATENATE(\"Intervention: \",InterventionINN)","v":"Intervention: "},null,null,null,null,null,null,null,null,null,null,null,"Estimated market shares should sum to 100% each year. Additional information regarding how market shares were obtained, e.g. market research can be submitted as a separate worksheet. For HTA submissions comparators with the highest market share should align with the chosen comparators in the cost-effectiveness model."]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "}]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "}]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "}]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "}]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "}]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "}]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "}]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "}]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "}]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "}]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "}]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "}]
[]
[null,null,null,null,{"$f":"SUM(E68:E80)","v":0},{"$f":"SUM(F68:F80)","v":0},0,0,0,"Check market shares sum to 100%"]
[]
[]
[null,"Discontinuation rates"]
[]
[null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5","Reference/Justification"]
[null,{"$f":"CONCATENATE(\"Intervention: \",InterventionINN)","v":"Intervention: "},null,null,null,null,null,null,null,null,null,null,null,"Optional: The proportion of patients discontinuing either the invertention or a comparator should be placed here. Discontinuation can also include adherence rates. For drugs calculated based on mean number of cycles, this will already take into account discontinuation rates."]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "}]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "}]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "}]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "}]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "}]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "}]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "}]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "}]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "}]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "}]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "}]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "}]
[]
[]
[]
[null,"Summary of population without new intervention"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"These are the population estimates of the intervention and comparator drugs for five years used in the budget impact calculations"]
[null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "},null,null,{"$f":"(E49*$E$36)*(1-E89)","v":0},{"$f":"(F49*$F$36)*(1-F89)","v":0},{"$f":"(G49*$G$36)*(1-G89)","v":0},{"$f":"(H49*$H$36)*(1-H89)","v":0},{"$f":"(I49*$I$36)*(1-I89)","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "},null,null,{"$f":"(E55*$E$36)*(1-E95)","v":0},{"$f":"(F55*$F$36)*(1-F95)","v":0},{"$f":"(G55*$G$36)*(1-G95)","v":0},{"$f":"(H55*$H$36)*(1-H95)","v":0},{"$f":"(I55*$I$36)*(1-I95)","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "},null,null,0,0,0,0,0]
[]
[]
[]
[]
[null,"Summary of population with new intervention"]
[]
[null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,{"$f":"CONCATENATE(\"Intervention: \",InterventionINN)","v":"Intervention: "},null,null,{"$f":"(E68*$E$36)*(1-E88)","v":0},{"$f":"(F68*$F$36)*(1-F88)","v":0},{"$f":"(G68*$G$36)*(1-G88)","v":0},{"$f":"(H68*$H$36)*(1-H88)","v":0},{"$f":"(I68*$I$36)*(1-I88)","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "},null,null,{"$f":"(E75*$E$36)*(1-E95)","v":0},{"$f":"(F75*$F$36)*(1-F95)","v":0},{"$f":"(G75*$G$36)*(1-G95)","v":0},{"$f":"(H75*$H$36)*(1-H95)","v":0},{"$f":"(I75*$I$36)*(1-I95)","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "},null,null,0,0,0,0,0]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "},null,null,0,0,0,0,0]

{"sheet":"Drug Acquisition 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[null,"• Following the instructions beside each table, use the drug cost calculators to calculate the cost per patient per year or per treatment course for the intervention and comparator(s). Purple cells represent drop down menus.\n• Insert the calculated cost per patient per year or cost per treatment course from Table F into the boxes in Table 1 for each intervention and comparator(s)\n• Please include additional calculations in the notes box if required. \n• The calculator applies the patient care fee and dispensing fees across time periods pro-rata. This may not always be appropriate depending on the data underlying how the average treatment duration was calculated where rounding may be more appropriate. Please add additional rows to  the calculator in Table F if it is more appropriate to adopt the rounding approach and highlight the change. \n• It is not possible to program the calculator for every form of dosing regimen. Please refer to the NCPE Drug Cost Guidelines for further detail on the calculation of drug costs. \n• If a Patient Access Scheme (PAS) is planned, please include the drug acquisitions costs as a separate worksheet (Drug Acquisition Costs (PAS))\n• Please note that the calculator assumes 1 month = 30.4375 days =365.25/12\n"]
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[null,null,null,null,null,null,null,null,null,null,"NCPE Drug Cost Guidelines"]
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[null,"Table 1"]
[null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,{"$f":"CONCATENATE(\"Intervention: \",InterventionINN)","v":"Intervention: "},null,null,null,null,null,null,null,null,"-Please link treatment costs to corresponding source cell (e.g. =H109)"]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "}]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "}]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "}]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "}]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "}]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "}]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "}]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "}]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "}]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "}]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "}]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "}]
[]
[]
[null,{"$f":"CONCATENATE(\"Intervention: \",InterventionINN)","v":"Intervention: "}]
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[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave the extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B49","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F49),\"\",F49)","v":""},{"$f":"IF(ISBLANK(G49),\"\",G49)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F49=\"\",\"\",F49)","v":""},{"$f":"IF(G49=\"\",\"\",G49)","v":""},{"$f":"IF(H49=\"\",\"\",H49)","v":""},{"$f":"IF(I49=\"\",\"\",I49)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F50=\"\",F51=\"\",F52=\"\"),\"\",IF(F50=\"Price to Wholesaler\",F51,IF(F50=\"Reimbursement Price\",(F73/(1+E72)*1),\"Error\")))","v":""},{"$f":"IF(OR(G50=\"\",G51=\"\",F52=\"\"),\"\",IF(G50=\"Price to Wholesaler\",G51,IF(G50=\"Reimbursement Price\",(G73/(1+E72)*1),\"Error\")))","v":""},{"$f":"IF(OR(H50=\"\",H51=\"\",F52=\"\"),\"\",IF(H50=\"Price to Wholesaler\",H51,IF(H50=\"Reimbursement Price\",(H73/(1+E72)*1),\"Error\")))","v":""},{"$f":"IF(OR(I50=\"\",I51=\"\",F52=\"\"),\"\",IF(I50=\"Price to Wholesaler\",I51,IF(I50=\"Reimbursement Price\",(I73/(1+E72)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F52=\"\"),\"\",IF(AND(F52=\"CDS\",F53=\"Yes\"),CYF,IF(AND(F52=\"CDS\",F53=\"No\"),CNF,IF(F52=\"HT\",CHT,IF(F52=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F52=\"\",F51=\"\",F50=\"\"),\"\",F71*E72)","v":""},{"$f":"IF(OR(F52=\"\",G51=\"\",G50=\"\"),\"\",G71*E72)","v":""},{"$f":"IF(OR(F52=\"\",H51=\"\",H50=\"\"),\"\",H71*E72)","v":""},{"$f":"IF(OR(F52=\"\",I51=\"\",I50=\"\"),\"\",I71*E72)","v":""}]
["C",{"$f":"IF(F52=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F50=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F50=\"Reimbursement Price\",F51,IF(ISBLANK(E72),\"\",IF(F50=\"Price to Wholesaler\",(F71+F72),IF(F50=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G50=\"Reimbursement Price\",G51,IF(ISBLANK(E72),\"\",IF(G50=\"Price to Wholesaler\",(G71+G72),IF(G50=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H50=\"Reimbursement Price\",H51,IF(ISBLANK(E72),\"\",IF(H50=\"Price to Wholesaler\",(H71+H72),IF(H50=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I50=\"Reimbursement Price\",I51,IF(ISBLANK(E72),\"\",IF(I50=\"Price to Wholesaler\",(I71+I72),IF(I50=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\")),\"\",IF(AND(F55=\"No\",F57=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F55=\"No\",F57=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F55=\"Yes\",F56=\"Biosimilar\"),\"None\",IF(AND(F55=\"Yes\",F56=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F55=\"Yes\",F56=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F55=\"Yes\",F56=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\"),F50=\"\",ISBLANK(F51)),\"\",IF(E74=\"None\",0,(E74*F71)))","v":""},{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\"),G50=\"\",ISBLANK(G51)),\"\",IF(E74=\"None\",0,(E74*G71)))","v":""},{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\"),H50=\"\",ISBLANK(H51)),\"\",IF(E74=\"None\",0,(E74*H71)))","v":""},{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\"),I50=\"\",ISBLANK(I51)),\"\",IF(E74=\"None\",0,(E74*I71)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F54=\"\",\"\",IF(F54=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B54=\"\",F51=\"\",ISBLANK(F51)),\"\",($E75*F73))","v":""},{"$f":"IF(OR($B54=\"\",G51=\"\",ISBLANK(G51)),\"\",($E75*G73))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(F73:F75))","v":""},{"$f":"IF(OR(G50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(G73:G75))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(F73:F74))","v":""},{"$f":"IF(OR(G50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(G73:G74))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F52=\"\",\"\",IF(F52=\"CDS\",\"per dispensing\",IF(F52=\"HT\",\"per month\",IF(F52=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F52=\"\",\"\",IF(F52=\"CDS\",DF,IF(F52=\"HT\",PC,IF(F52=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F52=\"\",F54=\"\"),\"\",IF(F52=\"Hosp\",\"No Fee\",IF(F52=\"HT\",\"No VAT\",IF(AND(F52=\"CDS\",F54=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F54=\"\",F52=\"Hosp\"),\"\",IF(OR(F54=\"Yes\",F52=\"HT\"),0,H84*G85))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F52=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F52=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,{"$f":" H85","v":""},null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H90),\"\",SUM(H90:H92))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H90),\"\",SUM(H90:H91))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B71","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F71:I71,F63:I63)","v":0},{"$f":"F102*G100","v":0},{"$f":"IF(H61=\"Days\",F102/F61*365.25,IF(H61=\"Months\",F102/F61*12,\"\"))","v":""},{"$f":"IF(AND(H61=\"Days\",I101=\"Days\"),F102/F61*I100,IF(AND(H61=\"Months\",I101=\"Months\"),F102/F61*I100,IF(AND(H61=\"Days\",I101=\"Months\"),F102/F61*30.4375*I100,IF(AND(H61=\"Months\",I101=\"Days\"),F102/F61/30.4375*I100,\"\"))))","v":""}]
["B",{"$f":"B72","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F72:I72,F63:I63)","v":0},{"$f":"F103*G100","v":0},{"$f":"IF(H61=\"Days\",F103/F61*365.25,IF(H61=\"Months\",F103/F61*12,\"\"))","v":""},{"$f":"IF(AND(H61=\"Days\",I101=\"Days\"),F103/F61*I100,IF(AND(H61=\"Months\",I101=\"Months\"),F103/F61*I100,IF(AND(H61=\"Days\",I101=\"Months\"),F103/F61*30.4375*I100,IF(AND(H61=\"Months\",I101=\"Days\"),F103/F61/30.4375*I100,\"\"))))","v":""}]
["C",{"$f":"B73","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F73:I73,F63:I63)","v":0},{"$f":"F104*G100","v":0},{"$f":"IF(H61=\"Days\",F104/F61*365.25,IF(H61=\"Months\",F104/F61*12,\"\"))","v":""},{"$f":"IF(AND(H61=\"Days\",I101=\"Days\"),F104/F61*I100,IF(AND(H61=\"Months\",I101=\"Months\"),F104/F61*I100,IF(AND(H61=\"Days\",I101=\"Months\"),F104/F61*30.4375*I100,IF(AND(H61=\"Months\",I101=\"Days\"),F104/F61/30.4375*I100,\"\"))))","v":""}]
["D",{"$f":"B74","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F74:I74,F63:I63)","v":0},{"$f":"F105*G100","v":0},{"$f":"IF(H61=\"Days\",F105/F61*365.25,IF(H61=\"Months\",F105/F61*12,\"\"))","v":""},{"$f":"IF(AND(H61=\"Days\",I101=\"Days\"),F105/F61*I100,IF(AND(H61=\"Months\",I101=\"Months\"),F105/F61*I100,IF(AND(H61=\"Days\",I101=\"Months\"),F105/F61*30.4375*I100,IF(AND(H61=\"Months\",I101=\"Days\"),F105/F61/30.4375*I100,\"\"))))","v":""}]
["E",{"$f":"B75","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F75:I75,F63:I63)","v":0},{"$f":"F106*G100","v":0},{"$f":"IF(H61=\"Days\",F106/F61*365.25,IF(H61=\"Months\",F106/F61*12,\"\"))","v":""},{"$f":"IF(AND(H61=\"Days\",I101=\"Days\"),F106/F61*I100,IF(AND(H61=\"Months\",I101=\"Months\"),F106/F61*I100,IF(AND(H61=\"Days\",I101=\"Months\"),F106/F61*30.4375*I100,IF(AND(H61=\"Months\",I101=\"Days\"),F106/F61/30.4375*I100,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H93=\"\",\"\",H93)","v":""},{"$f":"IF(F107=\"\",\"\",F107*G100)","v":""},{"$f":"IF(F107=\"\",\"\",IF(H61=\"Days\",F107/F61*365.25,IF(H61=\"Months\",F107/F61*12,\"\")))","v":""},{"$f":"IF(F107=\"\",\"\",IF(AND(H61=\"Days\",I101=\"Days\"),F107/F61*I100,IF(AND(H61=\"Months\",I101=\"Months\"),F107/F61*I100,IF(AND(H61=\"Days\",I101=\"Months\"),F107/F61*30.4375*I100,IF(AND(H61=\"Months\",I101=\"Days\"),F107/F61/30.4375*I100,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H94=\"\",\"\",H94)","v":""},{"$f":"IF(F108=\"\",\"\",F108*G100)","v":""},{"$f":"IF(F108=\"\",\"\",IF(H61=\"Days\",F108/F61*365.25,IF(H61=\"Months\",F108/F61*12,\"\")))","v":""},{"$f":"IF(F108=\"\",\"\",IF(AND(H61=\"Days\",I101=\"Days\"),F108/F61*I100,IF(AND(H61=\"Months\",I101=\"Months\"),F108/F61*I100,IF(AND(H61=\"Days\",I101=\"Months\"),F108/F61*30.4375*I100,IF(AND(H61=\"Months\",I101=\"Days\"),F108/F61/30.4375*I100,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F104:F107)","v":0},{"$f":"SUM(G104:G107)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F108=\"\",SUM(F104+F105),F104+F105+F108)","v":0},{"$f":"IF(G108=\"\",SUM(G104+G105),G104+G105+G108)","v":0},{"$f":"IF(H108=\"\",SUM(H104+H105),H104+H105+H108)","v":{"$error":"#VALUE!"}},{"$error":"#VALUE!"},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B134","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F134),\"\",F134)","v":""},{"$f":"IF(ISBLANK(G134),\"\",G134)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F134=\"\",\"\",F134)","v":""},{"$f":"IF(G134=\"\",\"\",G134)","v":""},{"$f":"IF(H134=\"\",\"\",H134)","v":""},{"$f":"IF(I134=\"\",\"\",I134)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F135=\"\",F136=\"\",F137=\"\"),\"\",IF(F135=\"Price to Wholesaler\",F136,IF(F135=\"Reimbursement Price\",(F158/(1+E157)*1),\"Error\")))","v":""},{"$f":"IF(OR(G135=\"\",G136=\"\",F137=\"\"),\"\",IF(G135=\"Price to Wholesaler\",G136,IF(G135=\"Reimbursement Price\",(G158/(1+E157)*1),\"Error\")))","v":""},{"$f":"IF(OR(H135=\"\",H136=\"\",F137=\"\"),\"\",IF(H135=\"Price to Wholesaler\",H136,IF(H135=\"Reimbursement Price\",(H158/(1+E157)*1),\"Error\")))","v":""},{"$f":"IF(OR(I135=\"\",I136=\"\",F137=\"\"),\"\",IF(I135=\"Price to Wholesaler\",I136,IF(I135=\"Reimbursement Price\",(I158/(1+E157)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F137=\"\"),\"\",IF(AND(F137=\"CDS\",F138=\"Yes\"),CYF,IF(AND(F137=\"CDS\",F138=\"No\"),CNF,IF(F137=\"HT\",CHT,IF(F137=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F137=\"\",F136=\"\",F135=\"\"),\"\",F156*E157)","v":""},{"$f":"IF(OR(F137=\"\",G136=\"\",G135=\"\"),\"\",G156*E157)","v":""},{"$f":"IF(OR(F137=\"\",H136=\"\",H135=\"\"),\"\",H156*E157)","v":""},{"$f":"IF(OR(F137=\"\",I136=\"\",I135=\"\"),\"\",I156*E157)","v":""}]
["C",{"$f":"IF(F137=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F135=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F135=\"Reimbursement Price\",F136,IF(ISBLANK(E157),\"\",IF(F135=\"Price to Wholesaler\",(F156+F157),IF(F135=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G135=\"Reimbursement Price\",G136,IF(ISBLANK(E157),\"\",IF(G135=\"Price to Wholesaler\",(G156+G157),IF(G135=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H135=\"Reimbursement Price\",H136,IF(ISBLANK(E157),\"\",IF(H135=\"Price to Wholesaler\",(H156+H157),IF(H135=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I135=\"Reimbursement Price\",I136,IF(ISBLANK(E157),\"\",IF(I135=\"Price to Wholesaler\",(I156+I157),IF(I135=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\")),\"\",IF(AND(F140=\"No\",F142=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F140=\"No\",F142=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F140=\"Yes\",F141=\"Biosimilar\"),\"None\",IF(AND(F140=\"Yes\",F141=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F140=\"Yes\",F141=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F140=\"Yes\",F141=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\"),F135=\"\",ISBLANK(F136)),\"\",IF(E159=\"None\",0,(E159*F156)))","v":""},{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\"),G135=\"\",ISBLANK(G136)),\"\",IF(E159=\"None\",0,(E159*G156)))","v":""},{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\"),H135=\"\",ISBLANK(H136)),\"\",IF(E159=\"None\",0,(E159*H156)))","v":""},{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\"),I135=\"\",ISBLANK(I136)),\"\",IF(E159=\"None\",0,(E159*I156)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F139=\"\",\"\",IF(F139=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B139=\"\",F136=\"\",ISBLANK(F136)),\"\",($E160*F158))","v":""},{"$f":"IF(OR($B139=\"\",G136=\"\",ISBLANK(G136)),\"\",($E160*G158))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(F158:F160))","v":""},{"$f":"IF(OR(G135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(G158:G160))","v":""},{"$f":"IF(OR(H135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(H158:H160))","v":""},{"$f":"IF(OR(I135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(I158:I160))","v":""}]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(F158:F159))","v":""},{"$f":"IF(OR(G135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(G158:G159))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F137=\"\",\"\",IF(F137=\"CDS\",\"per dispensing\",IF(F137=\"HT\",\"per month\",IF(F137=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F137=\"\",\"\",IF(F137=\"CDS\",DF,IF(F137=\"HT\",PC,IF(F137=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F137=\"\",F139=\"\"),\"\",IF(F137=\"Hosp\",\"No Fee\",IF(F137=\"HT\",\"No VAT\",IF(AND(F137=\"CDS\",F139=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F139=\"\",F137=\"Hosp\"),\"\",IF(OR(F139=\"Yes\",F137=\"HT\"),0,H169*G170))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F137=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F137=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H175),\"\",SUM(H175:H177))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H175),\"\",SUM(H175:H176))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B156","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F156:I156,F148:I148)","v":0},{"$f":"F187*G185","v":0},{"$f":"IF(H146=\"Days\",F187/F146*365.25,IF(H146=\"Months\",F187/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F187/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F187/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F187/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F187/F146/30.4375*I185,\"\"))))","v":""}]
["B",{"$f":"B157","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F157:I157,F148:I148)","v":0},{"$f":"F188*G185","v":0},{"$f":"IF(H146=\"Days\",F188/F146*365.25,IF(H146=\"Months\",F188/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F188/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F188/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F188/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F188/F146/30.4375*I185,\"\"))))","v":""}]
["C",{"$f":"B158","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F158:I158,F148:I148)","v":0},{"$f":"F189*G185","v":0},{"$f":"IF(H146=\"Days\",F189/F146*365.25,IF(H146=\"Months\",F189/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F189/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F189/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F189/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F189/F146/30.4375*I185,\"\"))))","v":""}]
["D",{"$f":"B159","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F159:I159,F148:I148)","v":0},{"$f":"F190*G185","v":0},{"$f":"IF(H146=\"Days\",F190/F146*365.25,IF(H146=\"Months\",F190/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F190/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F190/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F190/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F190/F146/30.4375*I185,\"\"))))","v":""}]
["E",{"$f":"B160","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F160:I160,F148:I148)","v":0},{"$f":"F191*G185","v":0},{"$f":"IF(H146=\"Days\",F191/F146*365.25,IF(H146=\"Months\",F191/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F191/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F191/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F191/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F191/F146/30.4375*I185,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H178=\"\",\"\",H178)","v":""},{"$f":"IF(F192=\"\",\"\",F192*G185)","v":""},{"$f":"IF(F192=\"\",\"\",IF(H146=\"Days\",F192/F146*365.25,IF(H146=\"Months\",F192/F146*12,\"\")))","v":""},{"$f":"IF(F192=\"\",\"\",IF(AND(H146=\"Days\",I186=\"Days\"),F192/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F192/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F192/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F192/F146/30.4375*I185,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H179=\"\",\"\",H179)","v":""},{"$f":"IF(F193=\"\",\"\",F193*G185)","v":""},{"$f":"IF(F193=\"\",\"\",IF(H146=\"Days\",F193/F146*365.25,IF(H146=\"Months\",F193/F146*12,\"\")))","v":""},{"$f":"IF(F193=\"\",\"\",IF(AND(H146=\"Days\",I186=\"Days\"),F193/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F193/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F193/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F193/F146/30.4375*I185,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F189:F192)","v":0},{"$f":"SUM(G189:G192)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F193=\"\",SUM(F189+F190),F189+F190+F193)","v":0},{"$f":"IF(G193=\"\",SUM(G189+G190),G189+G190+G193)","v":0},{"$f":"IF(H193=\"\",SUM(H189+H190),H189+H190+H193)","v":{"$error":"#VALUE!"}},{"$f":"IF(I193=\"\",SUM(I189+I190),I189+I190+I193)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B219","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F219),\"\",F219)","v":""},{"$f":"IF(ISBLANK(G219),\"\",G219)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F219=\"\",\"\",F219)","v":""},{"$f":"IF(G219=\"\",\"\",G219)","v":""},{"$f":"IF(H219=\"\",\"\",H219)","v":""},{"$f":"IF(I219=\"\",\"\",I219)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F220=\"\",F221=\"\",F222=\"\"),\"\",IF(F220=\"Price to Wholesaler\",F221,IF(F220=\"Reimbursement Price\",(F243/(1+E242)*1),\"Error\")))","v":""},{"$f":"IF(OR(G220=\"\",G221=\"\",F222=\"\"),\"\",IF(G220=\"Price to Wholesaler\",G221,IF(G220=\"Reimbursement Price\",(G243/(1+E242)*1),\"Error\")))","v":""},{"$f":"IF(OR(H220=\"\",H221=\"\",F222=\"\"),\"\",IF(H220=\"Price to Wholesaler\",H221,IF(H220=\"Reimbursement Price\",(H243/(1+E242)*1),\"Error\")))","v":""},{"$f":"IF(OR(I220=\"\",I221=\"\",F222=\"\"),\"\",IF(I220=\"Price to Wholesaler\",I221,IF(I220=\"Reimbursement Price\",(I243/(1+E242)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F222=\"\"),\"\",IF(AND(F222=\"CDS\",F223=\"Yes\"),CYF,IF(AND(F222=\"CDS\",F223=\"No\"),CNF,IF(F222=\"HT\",CHT,IF(F222=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F222=\"\",F221=\"\",F220=\"\"),\"\",F241*E242)","v":""},{"$f":"IF(OR(F222=\"\",G221=\"\",G220=\"\"),\"\",G241*E242)","v":""},{"$f":"IF(OR(F222=\"\",H221=\"\",H220=\"\"),\"\",H241*E242)","v":""},{"$f":"IF(OR(F222=\"\",I221=\"\",I220=\"\"),\"\",I241*E242)","v":""}]
["C",{"$f":"IF(F222=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F220=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F220=\"Reimbursement Price\",F221,IF(ISBLANK(E242),\"\",IF(F220=\"Price to Wholesaler\",(F241+F242),IF(F220=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G220=\"Reimbursement Price\",G221,IF(ISBLANK(E242),\"\",IF(G220=\"Price to Wholesaler\",(G241+G242),IF(G220=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H220=\"Reimbursement Price\",H221,IF(ISBLANK(E242),\"\",IF(H220=\"Price to Wholesaler\",(H241+H242),IF(H220=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I220=\"Reimbursement Price\",I221,IF(ISBLANK(E242),\"\",IF(I220=\"Price to Wholesaler\",(I241+I242),IF(I220=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\")),\"\",IF(AND(F225=\"No\",F227=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F225=\"No\",F227=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F225=\"Yes\",F226=\"Biosimilar\"),\"None\",IF(AND(F225=\"Yes\",F226=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F225=\"Yes\",F226=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F225=\"Yes\",F226=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\"),F220=\"\",ISBLANK(F221)),\"\",IF(E244=\"None\",0,(E244*F241)))","v":""},{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\"),G220=\"\",ISBLANK(G221)),\"\",IF(E244=\"None\",0,(E244*G241)))","v":""},{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\"),H220=\"\",ISBLANK(H221)),\"\",IF(E244=\"None\",0,(E244*H241)))","v":""},{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\"),I220=\"\",ISBLANK(I221)),\"\",IF(E244=\"None\",0,(E244*I241)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F224=\"\",\"\",IF(F224=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B224=\"\",F221=\"\",ISBLANK(F221)),\"\",($E245*F243))","v":""},{"$f":"IF(OR($B224=\"\",G221=\"\",ISBLANK(G221)),\"\",($E245*G243))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(F243:F245))","v":""},{"$f":"IF(OR(G220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(G243:G245))","v":""},{"$f":"IF(OR(H220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(H243:H245))","v":""},{"$f":"IF(OR(I220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(I243:I245))","v":""}]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(F243:F244))","v":""},{"$f":"IF(OR(G220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(G243:G244))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F222=\"\",\"\",IF(F222=\"CDS\",\"per dispensing\",IF(F222=\"HT\",\"per month\",IF(F222=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F222=\"\",\"\",IF(F222=\"CDS\",DF,IF(F222=\"HT\",PC,IF(F222=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F222=\"\",F224=\"\"),\"\",IF(F222=\"Hosp\",\"No Fee\",IF(F222=\"HT\",\"No VAT\",IF(AND(F222=\"CDS\",F224=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F224=\"\",F222=\"Hosp\"),\"\",IF(OR(F224=\"Yes\",F222=\"HT\"),0,H254*G255))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F222=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F222=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H260),\"\",SUM(H260:H262))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H260),\"\",SUM(H260:H261))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B241","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F241:I241,F233:I233)","v":0},{"$f":"F272*G270","v":0},{"$f":"IF(H231=\"Days\",F272/F231*365.25,IF(H231=\"Months\",F272/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F272/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F272/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F272/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F272/F231/30.4375*I270,\"\"))))","v":""}]
["B",{"$f":"B242","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F242:I242,F233:I233)","v":0},{"$f":"F273*G270","v":0},{"$f":"IF(H231=\"Days\",F273/F231*365.25,IF(H231=\"Months\",F273/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F273/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F273/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F273/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F273/F231/30.4375*I270,\"\"))))","v":""}]
["C",{"$f":"B243","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F243:I243,F233:I233)","v":0},{"$f":"F274*G270","v":0},{"$f":"IF(H231=\"Days\",F274/F231*365.25,IF(H231=\"Months\",F274/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F274/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F274/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F274/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F274/F231/30.4375*I270,\"\"))))","v":""}]
["D",{"$f":"B244","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F244:I244,F233:I233)","v":0},{"$f":"F275*G270","v":0},{"$f":"IF(H231=\"Days\",F275/F231*365.25,IF(H231=\"Months\",F275/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F275/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F275/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F275/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F275/F231/30.4375*I270,\"\"))))","v":""}]
["E",{"$f":"B245","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F245:I245,F233:I233)","v":0},{"$f":"F276*G270","v":0},{"$f":"IF(H231=\"Days\",F276/F231*365.25,IF(H231=\"Months\",F276/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F276/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F276/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F276/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F276/F231/30.4375*I270,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H263=\"\",\"\",H263)","v":""},{"$f":"IF(F277=\"\",\"\",F277*G270)","v":""},{"$f":"IF(F277=\"\",\"\",IF(H231=\"Days\",F277/F231*365.25,IF(H231=\"Months\",F277/F231*12,\"\")))","v":""},{"$f":"IF(F277=\"\",\"\",IF(AND(H231=\"Days\",I271=\"Days\"),F277/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F277/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F277/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F277/F231/30.4375*I270,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H264=\"\",\"\",H264)","v":""},{"$f":"IF(F278=\"\",\"\",F278*G270)","v":""},{"$f":"IF(F278=\"\",\"\",IF(H231=\"Days\",F278/F231*365.25,IF(H231=\"Months\",F278/F231*12,\"\")))","v":""},{"$f":"IF(F278=\"\",\"\",IF(AND(H231=\"Days\",I271=\"Days\"),F278/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F278/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F278/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F278/F231/30.4375*I270,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F274:F277)","v":0},{"$f":"SUM(G274:G277)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F278=\"\",SUM(F274+F275),F274+F275+F278)","v":0},{"$f":"IF(G278=\"\",SUM(G274+G275),G274+G275+G278)","v":0},{"$f":"IF(H278=\"\",SUM(H274+H275),H274+H275+H278)","v":{"$error":"#VALUE!"}},{"$f":"IF(I278=\"\",SUM(I274+I275),I274+I275+I278)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B305","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F305),\"\",F305)","v":""},{"$f":"IF(ISBLANK(G305),\"\",G305)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F305=\"\",\"\",F305)","v":""},{"$f":"IF(G305=\"\",\"\",G305)","v":""},{"$f":"IF(H305=\"\",\"\",H305)","v":""},{"$f":"IF(I305=\"\",\"\",I305)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F306=\"\",F307=\"\",F308=\"\"),\"\",IF(F306=\"Price to Wholesaler\",F307,IF(F306=\"Reimbursement Price\",(F329/(1+E328)*1),\"Error\")))","v":""},{"$f":"IF(OR(G306=\"\",G307=\"\",F308=\"\"),\"\",IF(G306=\"Price to Wholesaler\",G307,IF(G306=\"Reimbursement Price\",(G329/(1+E328)*1),\"Error\")))","v":""},{"$f":"IF(OR(H306=\"\",H307=\"\",F308=\"\"),\"\",IF(H306=\"Price to Wholesaler\",H307,IF(H306=\"Reimbursement Price\",(H329/(1+E328)*1),\"Error\")))","v":""},{"$f":"IF(OR(I306=\"\",I307=\"\",F308=\"\"),\"\",IF(I306=\"Price to Wholesaler\",I307,IF(I306=\"Reimbursement Price\",(I329/(1+E328)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F308=\"\"),\"\",IF(AND(F308=\"CDS\",F309=\"Yes\"),CYF,IF(AND(F308=\"CDS\",F309=\"No\"),CNF,IF(F308=\"HT\",CHT,IF(F308=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F308=\"\",F307=\"\",F306=\"\"),\"\",F327*E328)","v":""},{"$f":"IF(OR(F308=\"\",G307=\"\",G306=\"\"),\"\",G327*E328)","v":""},{"$f":"IF(OR(F308=\"\",H307=\"\",H306=\"\"),\"\",H327*E328)","v":""},{"$f":"IF(OR(F308=\"\",I307=\"\",I306=\"\"),\"\",I327*E328)","v":""}]
["C",{"$f":"IF(F308=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F306=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F306=\"Reimbursement Price\",F307,IF(ISBLANK(E328),\"\",IF(F306=\"Price to Wholesaler\",(F327+F328),IF(F306=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G306=\"Reimbursement Price\",G307,IF(ISBLANK(E328),\"\",IF(G306=\"Price to Wholesaler\",(G327+G328),IF(G306=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H306=\"Reimbursement Price\",H307,IF(ISBLANK(E328),\"\",IF(H306=\"Price to Wholesaler\",(H327+H328),IF(H306=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I306=\"Reimbursement Price\",I307,IF(ISBLANK(E328),\"\",IF(I306=\"Price to Wholesaler\",(I327+I328),IF(I306=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\")),\"\",IF(AND(F311=\"No\",F313=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F311=\"No\",F313=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F311=\"Yes\",F312=\"Biosimilar\"),\"None\",IF(AND(F311=\"Yes\",F312=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F311=\"Yes\",F312=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F311=\"Yes\",F312=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\"),F306=\"\",ISBLANK(F307)),\"\",IF(E330=\"None\",0,(E330*F327)))","v":""},{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\"),G306=\"\",ISBLANK(G307)),\"\",IF(E330=\"None\",0,(E330*G327)))","v":""},{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\"),H306=\"\",ISBLANK(H307)),\"\",IF(E330=\"None\",0,(E330*H327)))","v":""},{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\"),I306=\"\",ISBLANK(I307)),\"\",IF(E330=\"None\",0,(E330*I327)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F310=\"\",\"\",IF(F310=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B310=\"\",F307=\"\",ISBLANK(F307)),\"\",($E331*F329))","v":""},{"$f":"IF(OR($B310=\"\",G307=\"\",ISBLANK(G307)),\"\",($E331*G329))","v":""},{"$f":"IF(OR($B310=\"\",H307=\"\",ISBLANK(H307)),\"\",($E331*H329))","v":""},{"$f":"IF(OR($B310=\"\",I307=\"\",ISBLANK(I307)),\"\",($E331*I329))","v":""}]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(F329:F331))","v":""},{"$f":"IF(OR(G306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(G329:G331))","v":""},{"$f":"IF(OR(H306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(H329:H331))","v":""},{"$f":"IF(OR(I306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(I329:I331))","v":""}]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(F329:F330))","v":""},{"$f":"IF(OR(G306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(G329:G330))","v":""},{"$f":"IF(OR(H306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(H329:H330))","v":""},""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F308=\"\",\"\",IF(F308=\"CDS\",\"per dispensing\",IF(F308=\"HT\",\"per month\",IF(F308=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F308=\"\",\"\",IF(F308=\"CDS\",DF,IF(F308=\"HT\",PC,IF(F308=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F308=\"\",F310=\"\"),\"\",IF(F308=\"Hosp\",\"No Fee\",IF(F308=\"HT\",\"No VAT\",IF(AND(F308=\"CDS\",F310=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F310=\"\",F308=\"Hosp\"),\"\",IF(OR(F310=\"Yes\",F308=\"HT\"),0,H340*G341))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F308=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F308=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H346),\"\",SUM(H346:H348))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H346),\"\",SUM(H346:H347))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B327","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F327:I327,F319:I319)","v":0},{"$f":"F358*G356","v":0},{"$f":"IF(H317=\"Days\",F358/F317*365.25,IF(H317=\"Months\",F358/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F358/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F358/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F358/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F358/F317/30.4375*I356,\"\"))))","v":""}]
["B",{"$f":"B328","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F328:I328,F319:I319)","v":0},{"$f":"F359*G356","v":0},{"$f":"IF(H317=\"Days\",F359/F317*365.25,IF(H317=\"Months\",F359/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F359/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F359/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F359/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F359/F317/30.4375*I356,\"\"))))","v":""}]
["C",{"$f":"B329","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F329:I329,F319:I319)","v":0},{"$f":"F360*G356","v":0},{"$f":"IF(H317=\"Days\",F360/F317*365.25,IF(H317=\"Months\",F360/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F360/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F360/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F360/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F360/F317/30.4375*I356,\"\"))))","v":""}]
["D",{"$f":"B330","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F330:I330,F319:I319)","v":0},{"$f":"F361*G356","v":0},{"$f":"IF(H317=\"Days\",F361/F317*365.25,IF(H317=\"Months\",F361/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F361/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F361/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F361/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F361/F317/30.4375*I356,\"\"))))","v":""}]
["E",{"$f":"B331","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F331:I331,F319:I319)","v":0},{"$f":"F362*G356","v":0},{"$f":"IF(H317=\"Days\",F362/F317*365.25,IF(H317=\"Months\",F362/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F362/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F362/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F362/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F362/F317/30.4375*I356,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H349=\"\",\"\",H349)","v":""},{"$f":"IF(F363=\"\",\"\",F363*G356)","v":""},{"$f":"IF(F363=\"\",\"\",IF(H317=\"Days\",F363/F317*365.25,IF(H317=\"Months\",F363/F317*12,\"\")))","v":""},{"$f":"IF(F363=\"\",\"\",IF(AND(H317=\"Days\",I357=\"Days\"),F363/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F363/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F363/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F363/F317/30.4375*I356,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H350=\"\",\"\",H350)","v":""},{"$f":"IF(F364=\"\",\"\",F364*G356)","v":""},{"$f":"IF(F364=\"\",\"\",IF(H317=\"Days\",F364/F317*365.25,IF(H317=\"Months\",F364/F317*12,\"\")))","v":""},{"$f":"IF(F364=\"\",\"\",IF(AND(H317=\"Days\",I357=\"Days\"),F364/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F364/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F364/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F364/F317/30.4375*I356,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F360:F363)","v":0},{"$f":"SUM(G360:G363)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F364=\"\",SUM(F360+F361),F360+F361+F364)","v":0},{"$f":"IF(G364=\"\",SUM(G360+G361),G360+G361+G364)","v":0},{"$f":"IF(H364=\"\",SUM(H360+H361),H360+H361+H364)","v":{"$error":"#VALUE!"}},{"$f":"IF(I364=\"\",SUM(I360+I361),I360+I361+I364)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B390","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F390),\"\",F390)","v":""},{"$f":"IF(ISBLANK(G390),\"\",G390)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F390=\"\",\"\",F390)","v":""},{"$f":"IF(G390=\"\",\"\",G390)","v":""},{"$f":"IF(H390=\"\",\"\",H390)","v":""},{"$f":"IF(I390=\"\",\"\",I390)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F391=\"\",F392=\"\",F393=\"\"),\"\",IF(F391=\"Price to Wholesaler\",F392,IF(F391=\"Reimbursement Price\",(F414/(1+E413)*1),\"Error\")))","v":""},{"$f":"IF(OR(G391=\"\",G392=\"\",F393=\"\"),\"\",IF(G391=\"Price to Wholesaler\",G392,IF(G391=\"Reimbursement Price\",(G414/(1+E413)*1),\"Error\")))","v":""},{"$f":"IF(OR(H391=\"\",H392=\"\",F393=\"\"),\"\",IF(H391=\"Price to Wholesaler\",H392,IF(H391=\"Reimbursement Price\",(H414/(1+E413)*1),\"Error\")))","v":""},{"$f":"IF(OR(I391=\"\",I392=\"\",F393=\"\"),\"\",IF(I391=\"Price to Wholesaler\",I392,IF(I391=\"Reimbursement Price\",(I414/(1+E413)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F393=\"\"),\"\",IF(AND(F393=\"CDS\",F394=\"Yes\"),CYF,IF(AND(F393=\"CDS\",F394=\"No\"),CNF,IF(F393=\"HT\",CHT,IF(F393=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F393=\"\",F392=\"\",F391=\"\"),\"\",F412*E413)","v":""},{"$f":"IF(OR(F393=\"\",G392=\"\",G391=\"\"),\"\",G412*E413)","v":""},{"$f":"IF(OR(F393=\"\",H392=\"\",H391=\"\"),\"\",H412*E413)","v":""},{"$f":"IF(OR(F393=\"\",I392=\"\",I391=\"\"),\"\",I412*E413)","v":""}]
["C",{"$f":"IF(F393=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F391=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F391=\"Reimbursement Price\",F392,IF(ISBLANK(E413),\"\",IF(F391=\"Price to Wholesaler\",(F412+F413),IF(F391=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G391=\"Reimbursement Price\",G392,IF(ISBLANK(E413),\"\",IF(G391=\"Price to Wholesaler\",(G412+G413),IF(G391=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H391=\"Reimbursement Price\",H392,IF(ISBLANK(E413),\"\",IF(H391=\"Price to Wholesaler\",(H412+H413),IF(H391=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I391=\"Reimbursement Price\",I392,IF(ISBLANK(E413),\"\",IF(I391=\"Price to Wholesaler\",(I412+I413),IF(I391=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\")),\"\",IF(AND(F396=\"No\",F398=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F396=\"No\",F398=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F396=\"Yes\",F397=\"Biosimilar\"),\"None\",IF(AND(F396=\"Yes\",F397=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F396=\"Yes\",F397=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F396=\"Yes\",F397=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\"),F391=\"\",ISBLANK(F392)),\"\",IF(E415=\"None\",0,(E415*F412)))","v":""},{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\"),G391=\"\",ISBLANK(G392)),\"\",IF(E415=\"None\",0,(E415*G412)))","v":""},{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\"),H391=\"\",ISBLANK(H392)),\"\",IF(E415=\"None\",0,(E415*H412)))","v":""},{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\"),I391=\"\",ISBLANK(I392)),\"\",IF(E415=\"None\",0,(E415*I412)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F395=\"\",\"\",IF(F395=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B395=\"\",F392=\"\",ISBLANK(F392)),\"\",($E416*F414))","v":""},{"$f":"IF(OR($B395=\"\",G392=\"\",ISBLANK(G392)),\"\",($E416*G414))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(F414:F416))","v":""},{"$f":"IF(OR(G391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(G414:G416))","v":""},{"$f":"IF(OR(H391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(H414:H416))","v":""},{"$f":"IF(OR(I391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(I414:I416))","v":""}]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(F414:F415))","v":""},{"$f":"IF(OR(G391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(G414:G415))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F393=\"\",\"\",IF(F393=\"CDS\",\"per dispensing\",IF(F393=\"HT\",\"per month\",IF(F393=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F393=\"\",\"\",IF(F393=\"CDS\",DF,IF(F393=\"HT\",PC,IF(F393=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F393=\"\",F395=\"\"),\"\",IF(F393=\"Hosp\",\"No Fee\",IF(F393=\"HT\",\"No VAT\",IF(AND(F393=\"CDS\",F395=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F395=\"\",F393=\"Hosp\"),\"\",IF(OR(F395=\"Yes\",F393=\"HT\"),0,H425*G426))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F393=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F393=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H431),\"\",SUM(H431:H433))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H431),\"\",SUM(H431:H432))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B412","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F412:I412,F404:I404)","v":0},{"$f":"F443*G441","v":0},{"$f":"IF(H402=\"Days\",F443/F402*365.25,IF(H402=\"Months\",F443/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F443/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F443/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F443/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F443/F402/30.4375*I441,\"\"))))","v":""}]
["B",{"$f":"B413","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F413:I413,F404:I404)","v":0},{"$f":"F444*G441","v":0},{"$f":"IF(H402=\"Days\",F444/F402*365.25,IF(H402=\"Months\",F444/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F444/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F444/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F444/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F444/F402/30.4375*I441,\"\"))))","v":""}]
["C",{"$f":"B414","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F414:I414,F404:I404)","v":0},{"$f":"F445*G441","v":0},{"$f":"IF(H402=\"Days\",F445/F402*365.25,IF(H402=\"Months\",F445/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F445/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F445/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F445/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F445/F402/30.4375*I441,\"\"))))","v":""}]
["D",{"$f":"B415","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F415:I415,F404:I404)","v":0},{"$f":"F446*G441","v":0},{"$f":"IF(H402=\"Days\",F446/F402*365.25,IF(H402=\"Months\",F446/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F446/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F446/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F446/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F446/F402/30.4375*I441,\"\"))))","v":""}]
["E",{"$f":"B416","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F416:I416,F404:I404)","v":0},{"$f":"F447*G441","v":0},{"$f":"IF(H402=\"Days\",F447/F402*365.25,IF(H402=\"Months\",F447/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F447/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F447/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F447/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F447/F402/30.4375*I441,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H434=\"\",\"\",H434)","v":""},{"$f":"IF(F448=\"\",\"\",F448*G441)","v":""},{"$f":"IF(F448=\"\",\"\",IF(H402=\"Days\",F448/F402*365.25,IF(H402=\"Months\",F448/F402*12,\"\")))","v":""},{"$f":"IF(F448=\"\",\"\",IF(AND(H402=\"Days\",I442=\"Days\"),F448/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F448/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F448/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F448/F402/30.4375*I441,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H435=\"\",\"\",H435)","v":""},{"$f":"IF(F449=\"\",\"\",F449*G441)","v":""},{"$f":"IF(F449=\"\",\"\",IF(H402=\"Days\",F449/F402*365.25,IF(H402=\"Months\",F449/F402*12,\"\")))","v":""},{"$f":"IF(F449=\"\",\"\",IF(AND(H402=\"Days\",I442=\"Days\"),F449/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F449/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F449/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F449/F402/30.4375*I441,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F445:F448)","v":0},{"$f":"SUM(G445:G448)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F449=\"\",SUM(F445+F446),F445+F446+F449)","v":0},{"$f":"IF(G449=\"\",SUM(G445+G446),G445+G446+G449)","v":0},{"$f":"IF(H449=\"\",SUM(H445+H446),H445+H446+H449)","v":{"$error":"#VALUE!"}},{"$f":"IF(I449=\"\",SUM(I445+I446),I445+I446+I449)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B476","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F476),\"\",F476)","v":""},{"$f":"IF(ISBLANK(G476),\"\",G476)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F476=\"\",\"\",F476)","v":""},{"$f":"IF(G476=\"\",\"\",G476)","v":""},{"$f":"IF(H476=\"\",\"\",H476)","v":""},{"$f":"IF(I476=\"\",\"\",I476)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F477=\"\",F478=\"\",F479=\"\"),\"\",IF(F477=\"Price to Wholesaler\",F478,IF(F477=\"Reimbursement Price\",(F500/(1+E499)*1),\"Error\")))","v":""},{"$f":"IF(OR(G477=\"\",G478=\"\",F479=\"\"),\"\",IF(G477=\"Price to Wholesaler\",G478,IF(G477=\"Reimbursement Price\",(G500/(1+E499)*1),\"Error\")))","v":""},{"$f":"IF(OR(H477=\"\",H478=\"\",F479=\"\"),\"\",IF(H477=\"Price to Wholesaler\",H478,IF(H477=\"Reimbursement Price\",(H500/(1+E499)*1),\"Error\")))","v":""},{"$f":"IF(OR(I477=\"\",I478=\"\",F479=\"\"),\"\",IF(I477=\"Price to Wholesaler\",I478,IF(I477=\"Reimbursement Price\",(I500/(1+E499)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F479=\"\"),\"\",IF(AND(F479=\"CDS\",F480=\"Yes\"),CYF,IF(AND(F479=\"CDS\",F480=\"No\"),CNF,IF(F479=\"HT\",CHT,IF(F479=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F479=\"\",F478=\"\",F477=\"\"),\"\",F498*E499)","v":""},{"$f":"IF(OR(F479=\"\",G478=\"\",G477=\"\"),\"\",G498*E499)","v":""},{"$f":"IF(OR(F479=\"\",H478=\"\",H477=\"\"),\"\",H498*E499)","v":""},{"$f":"IF(OR(F479=\"\",I478=\"\",I477=\"\"),\"\",I498*E499)","v":""}]
["C",{"$f":"IF(F479=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F477=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F477=\"Reimbursement Price\",F478,IF(ISBLANK(E499),\"\",IF(F477=\"Price to Wholesaler\",(F498+F499),IF(F477=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G477=\"Reimbursement Price\",G478,IF(ISBLANK(E499),\"\",IF(G477=\"Price to Wholesaler\",(G498+G499),IF(G477=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H477=\"Reimbursement Price\",H478,IF(ISBLANK(E499),\"\",IF(H477=\"Price to Wholesaler\",(H498+H499),IF(H477=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I477=\"Reimbursement Price\",I478,IF(ISBLANK(E499),\"\",IF(I477=\"Price to Wholesaler\",(I498+I499),IF(I477=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\")),\"\",IF(AND(F482=\"No\",F484=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F482=\"No\",F484=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F482=\"Yes\",F483=\"Biosimilar\"),\"None\",IF(AND(F482=\"Yes\",F483=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F482=\"Yes\",F483=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F482=\"Yes\",F483=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\"),F477=\"\",ISBLANK(F478)),\"\",IF(E501=\"None\",0,(E501*F498)))","v":""},{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\"),G477=\"\",ISBLANK(G478)),\"\",IF(E501=\"None\",0,(E501*G498)))","v":""},{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\"),H477=\"\",ISBLANK(H478)),\"\",IF(E501=\"None\",0,(E501*H498)))","v":""},{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\"),I477=\"\",ISBLANK(I478)),\"\",IF(E501=\"None\",0,(E501*I498)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F481=\"\",\"\",IF(F481=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B481=\"\",F478=\"\",ISBLANK(F478)),\"\",($E502*F500))","v":""},{"$f":"IF(OR($B481=\"\",G478=\"\",ISBLANK(G478)),\"\",($E502*G500))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(F500:F502))","v":""},{"$f":"IF(OR(G477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(G500:G502))","v":""},{"$f":"IF(OR(H477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(H500:H502))","v":""},{"$f":"IF(OR(I477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(I500:I502))","v":""}]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(F500:F501))","v":""},{"$f":"IF(OR(G477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(G500:G501))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F479=\"\",\"\",IF(F479=\"CDS\",\"per dispensing\",IF(F479=\"HT\",\"per month\",IF(F479=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F479=\"\",\"\",IF(F479=\"CDS\",DF,IF(F479=\"HT\",PC,IF(F479=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F479=\"\",F481=\"\"),\"\",IF(F479=\"Hosp\",\"No Fee\",IF(F479=\"HT\",\"No VAT\",IF(AND(F479=\"CDS\",F481=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F481=\"\",F479=\"Hosp\"),\"\",IF(OR(F481=\"Yes\",F479=\"HT\"),0,H511*G512))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F479=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F479=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H517),\"\",SUM(H517:H519))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H517),\"\",SUM(H517:H518))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B498","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F498:I498,F490:I490)","v":0},{"$f":"F529*G527","v":0},{"$f":"IF(H488=\"Days\",F529/F488*365.25,IF(H488=\"Months\",F529/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F529/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F529/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F529/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F529/F488/30.4375*I527,\"\"))))","v":""}]
["B",{"$f":"B499","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F499:I499,F490:I490)","v":0},{"$f":"F530*G527","v":0},{"$f":"IF(H488=\"Days\",F530/F488*365.25,IF(H488=\"Months\",F530/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F530/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F530/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F530/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F530/F488/30.4375*I527,\"\"))))","v":""}]
["C",{"$f":"B500","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F500:I500,F490:I490)","v":0},{"$f":"F531*G527","v":0},{"$f":"IF(H488=\"Days\",F531/F488*365.25,IF(H488=\"Months\",F531/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F531/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F531/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F531/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F531/F488/30.4375*I527,\"\"))))","v":""}]
["D",{"$f":"B501","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F501:I501,F490:I490)","v":0},{"$f":"F532*G527","v":0},{"$f":"IF(H488=\"Days\",F532/F488*365.25,IF(H488=\"Months\",F532/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F532/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F532/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F532/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F532/F488/30.4375*I527,\"\"))))","v":""}]
["E",{"$f":"B502","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F502:I502,F490:I490)","v":0},{"$f":"F533*G527","v":0},{"$f":"IF(H488=\"Days\",F533/F488*365.25,IF(H488=\"Months\",F533/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F533/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F533/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F533/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F533/F488/30.4375*I527,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H520=\"\",\"\",H520)","v":""},{"$f":"IF(F534=\"\",\"\",F534*G527)","v":""},{"$f":"IF(F534=\"\",\"\",IF(H488=\"Days\",F534/F488*365.25,IF(H488=\"Months\",F534/F488*12,\"\")))","v":""},{"$f":"IF(F534=\"\",\"\",IF(AND(H488=\"Days\",I528=\"Days\"),F534/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F534/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F534/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F534/F488/30.4375*I527,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H521=\"\",\"\",H521)","v":""},{"$f":"IF(F535=\"\",\"\",F535*G527)","v":""},{"$f":"IF(F535=\"\",\"\",IF(H488=\"Days\",F535/F488*365.25,IF(H488=\"Months\",F535/F488*12,\"\")))","v":""},{"$f":"IF(F535=\"\",\"\",IF(AND(H488=\"Days\",I528=\"Days\"),F535/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F535/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F535/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F535/F488/30.4375*I527,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F531:F534)","v":0},{"$f":"SUM(G531:G534)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F535=\"\",SUM(F531+F532),F531+F532+F535)","v":0},{"$f":"IF(G535=\"\",SUM(G531+G532),G531+G532+G535)","v":0},{"$f":"IF(H535=\"\",SUM(H531+H532),H531+H532+H535)","v":{"$error":"#VALUE!"}},{"$f":"IF(I535=\"\",SUM(I531+I532),I531+I532+I535)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B561","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F561),\"\",F561)","v":""},{"$f":"IF(ISBLANK(G561),\"\",G561)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F561=\"\",\"\",F561)","v":""},{"$f":"IF(G561=\"\",\"\",G561)","v":""},{"$f":"IF(H561=\"\",\"\",H561)","v":""},{"$f":"IF(I561=\"\",\"\",I561)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F562=\"\",F563=\"\",F564=\"\"),\"\",IF(F562=\"Price to Wholesaler\",F563,IF(F562=\"Reimbursement Price\",(F585/(1+E584)*1),\"Error\")))","v":""},{"$f":"IF(OR(G562=\"\",G563=\"\",F564=\"\"),\"\",IF(G562=\"Price to Wholesaler\",G563,IF(G562=\"Reimbursement Price\",(G585/(1+E584)*1),\"Error\")))","v":""},{"$f":"IF(OR(H562=\"\",H563=\"\",F564=\"\"),\"\",IF(H562=\"Price to Wholesaler\",H563,IF(H562=\"Reimbursement Price\",(H585/(1+E584)*1),\"Error\")))","v":""},{"$f":"IF(OR(I562=\"\",I563=\"\",F564=\"\"),\"\",IF(I562=\"Price to Wholesaler\",I563,IF(I562=\"Reimbursement Price\",(I585/(1+E584)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F564=\"\"),\"\",IF(AND(F564=\"CDS\",F565=\"Yes\"),CYF,IF(AND(F564=\"CDS\",F565=\"No\"),CNF,IF(F564=\"HT\",CHT,IF(F564=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F564=\"\",F563=\"\",F562=\"\"),\"\",F583*E584)","v":""},{"$f":"IF(OR(F564=\"\",G563=\"\",G562=\"\"),\"\",G583*E584)","v":""},{"$f":"IF(OR(F564=\"\",H563=\"\",H562=\"\"),\"\",H583*E584)","v":""},{"$f":"IF(OR(F564=\"\",I563=\"\",I562=\"\"),\"\",I583*E584)","v":""}]
["C",{"$f":"IF(F564=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F562=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F562=\"Reimbursement Price\",F563,IF(ISBLANK(E584),\"\",IF(F562=\"Price to Wholesaler\",(F583+F584),IF(F562=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G562=\"Reimbursement Price\",G563,IF(ISBLANK(E584),\"\",IF(G562=\"Price to Wholesaler\",(G583+G584),IF(G562=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H562=\"Reimbursement Price\",H563,IF(ISBLANK(E584),\"\",IF(H562=\"Price to Wholesaler\",(H583+H584),IF(H562=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I562=\"Reimbursement Price\",I563,IF(ISBLANK(E584),\"\",IF(I562=\"Price to Wholesaler\",(I583+I584),IF(I562=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\")),\"\",IF(AND(F567=\"No\",F569=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F567=\"No\",F569=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F567=\"Yes\",F568=\"Biosimilar\"),\"None\",IF(AND(F567=\"Yes\",F568=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F567=\"Yes\",F568=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F567=\"Yes\",F568=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\"),F562=\"\",ISBLANK(F563)),\"\",IF(E586=\"None\",0,(E586*F583)))","v":""},{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\"),G562=\"\",ISBLANK(G563)),\"\",IF(E586=\"None\",0,(E586*G583)))","v":""},{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\"),H562=\"\",ISBLANK(H563)),\"\",IF(E586=\"None\",0,(E586*H583)))","v":""},{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\"),I562=\"\",ISBLANK(I563)),\"\",IF(E586=\"None\",0,(E586*I583)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F566=\"\",\"\",IF(F566=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B566=\"\",F563=\"\",ISBLANK(F563)),\"\",($E587*F585))","v":""},{"$f":"IF(OR($B566=\"\",G563=\"\",ISBLANK(G563)),\"\",($E587*G585))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(F585:F587))","v":""},{"$f":"IF(OR(G562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(G585:G587))","v":""},{"$f":"IF(OR(H562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(H585:H587))","v":""},{"$f":"IF(OR(I562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(I585:I587))","v":""}]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(F585:F586))","v":""},{"$f":"IF(OR(G562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(G585:G586))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F564=\"\",\"\",IF(F564=\"CDS\",\"per dispensing\",IF(F564=\"HT\",\"per month\",IF(F564=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F564=\"\",\"\",IF(F564=\"CDS\",DF,IF(F564=\"HT\",PC,IF(F564=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F564=\"\",F566=\"\"),\"\",IF(F564=\"Hosp\",\"No Fee\",IF(F564=\"HT\",\"No VAT\",IF(AND(F564=\"CDS\",F566=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F566=\"\",F564=\"Hosp\"),\"\",IF(OR(F566=\"Yes\",F564=\"HT\"),0,H596*G597))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F564=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F564=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H602),\"\",SUM(H602:H604))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H602),\"\",SUM(H602:H603))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B583","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F583:I583,F575:I575)","v":0},{"$f":"F614*G612","v":0},{"$f":"IF(H573=\"Days\",F614/F573*365.25,IF(H573=\"Months\",F614/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F614/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F614/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F614/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F614/F573/30.4375*I612,\"\"))))","v":""}]
["B",{"$f":"B584","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F584:I584,F575:I575)","v":0},{"$f":"F615*G612","v":0},{"$f":"IF(H573=\"Days\",F615/F573*365.25,IF(H573=\"Months\",F615/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F615/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F615/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F615/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F615/F573/30.4375*I612,\"\"))))","v":""}]
["C",{"$f":"B585","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F585:I585,F575:I575)","v":0},{"$f":"F616*G612","v":0},{"$f":"IF(H573=\"Days\",F616/F573*365.25,IF(H573=\"Months\",F616/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F616/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F616/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F616/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F616/F573/30.4375*I612,\"\"))))","v":""}]
["D",{"$f":"B586","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F586:I586,F575:I575)","v":0},{"$f":"F617*G612","v":0},{"$f":"IF(H573=\"Days\",F617/F573*365.25,IF(H573=\"Months\",F617/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F617/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F617/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F617/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F617/F573/30.4375*I612,\"\"))))","v":""}]
["E",{"$f":"B587","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F587:I587,F575:I575)","v":0},{"$f":"F618*G612","v":0},{"$f":"IF(H573=\"Days\",F618/F573*365.25,IF(H573=\"Months\",F618/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F618/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F618/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F618/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F618/F573/30.4375*I612,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H605=\"\",\"\",H605)","v":""},{"$f":"IF(F619=\"\",\"\",F619*G612)","v":""},{"$f":"IF(F619=\"\",\"\",IF(H573=\"Days\",F619/F573*365.25,IF(H573=\"Months\",F619/F573*12,\"\")))","v":""},{"$f":"IF(F619=\"\",\"\",IF(AND(H573=\"Days\",I613=\"Days\"),F619/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F619/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F619/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F619/F573/30.4375*I612,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H606=\"\",\"\",H606)","v":""},{"$f":"IF(F620=\"\",\"\",F620*G612)","v":""},{"$f":"IF(F620=\"\",\"\",IF(H573=\"Days\",F620/F573*365.25,IF(H573=\"Months\",F620/F573*12,\"\")))","v":""},{"$f":"IF(F620=\"\",\"\",IF(AND(H573=\"Days\",I613=\"Days\"),F620/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F620/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F620/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F620/F573/30.4375*I612,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F616:F619)","v":0},{"$f":"SUM(G616:G619)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F620=\"\",SUM(F616+F617),F616+F617+F620)","v":0},{"$f":"IF(G620=\"\",SUM(G616+G617),G616+G617+G620)","v":0},{"$f":"IF(H620=\"\",SUM(H616+H617),H616+H617+H620)","v":{"$error":"#VALUE!"}},{"$f":"IF(I620=\"\",SUM(I616+I617),I616+I617+I620)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B646","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F646),\"\",F646)","v":""},{"$f":"IF(ISBLANK(G646),\"\",G646)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F646=\"\",\"\",F646)","v":""},{"$f":"IF(G646=\"\",\"\",G646)","v":""},{"$f":"IF(H646=\"\",\"\",H646)","v":""},{"$f":"IF(I646=\"\",\"\",I646)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F647=\"\",F648=\"\",F649=\"\"),\"\",IF(F647=\"Price to Wholesaler\",F648,IF(F647=\"Reimbursement Price\",(F670/(1+E669)*1),\"Error\")))","v":""},{"$f":"IF(OR(G647=\"\",G648=\"\",F649=\"\"),\"\",IF(G647=\"Price to Wholesaler\",G648,IF(G647=\"Reimbursement Price\",(G670/(1+E669)*1),\"Error\")))","v":""},{"$f":"IF(OR(H647=\"\",H648=\"\",F649=\"\"),\"\",IF(H647=\"Price to Wholesaler\",H648,IF(H647=\"Reimbursement Price\",(H670/(1+E669)*1),\"Error\")))","v":""},{"$f":"IF(OR(I647=\"\",I648=\"\",F649=\"\"),\"\",IF(I647=\"Price to Wholesaler\",I648,IF(I647=\"Reimbursement Price\",(I670/(1+E669)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F649=\"\"),\"\",IF(AND(F649=\"CDS\",F650=\"Yes\"),CYF,IF(AND(F649=\"CDS\",F650=\"No\"),CNF,IF(F649=\"HT\",CHT,IF(F649=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F649=\"\",F648=\"\",F647=\"\"),\"\",F668*E669)","v":""},{"$f":"IF(OR(F649=\"\",G648=\"\",G647=\"\"),\"\",G668*E669)","v":""},{"$f":"IF(OR(F649=\"\",H648=\"\",H647=\"\"),\"\",H668*E669)","v":""},{"$f":"IF(OR(F649=\"\",I648=\"\",I647=\"\"),\"\",I668*E669)","v":""}]
["C",{"$f":"IF(F649=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F647=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F647=\"Reimbursement Price\",F648,IF(ISBLANK(E669),\"\",IF(F647=\"Price to Wholesaler\",(F668+F669),IF(F647=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G647=\"Reimbursement Price\",G648,IF(ISBLANK(E669),\"\",IF(G647=\"Price to Wholesaler\",(G668+G669),IF(G647=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H647=\"Reimbursement Price\",H648,IF(ISBLANK(E669),\"\",IF(H647=\"Price to Wholesaler\",(H668+H669),IF(H647=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I647=\"Reimbursement Price\",I648,IF(ISBLANK(E669),\"\",IF(I647=\"Price to Wholesaler\",(I668+I669),IF(I647=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\")),\"\",IF(AND(F652=\"No\",F654=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F652=\"No\",F654=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F652=\"Yes\",F653=\"Biosimilar\"),\"None\",IF(AND(F652=\"Yes\",F653=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F652=\"Yes\",F653=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F652=\"Yes\",F653=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\"),F647=\"\",ISBLANK(F648)),\"\",IF(E671=\"None\",0,(E671*F668)))","v":""},{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\"),G647=\"\",ISBLANK(G648)),\"\",IF(E671=\"None\",0,(E671*G668)))","v":""},{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\"),H647=\"\",ISBLANK(H648)),\"\",IF(E671=\"None\",0,(E671*H668)))","v":""},{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\"),I647=\"\",ISBLANK(I648)),\"\",IF(E671=\"None\",0,(E671*I668)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F651=\"\",\"\",IF(F651=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B651=\"\",F648=\"\",ISBLANK(F648)),\"\",($E672*F670))","v":""},{"$f":"IF(OR($B651=\"\",G648=\"\",ISBLANK(G648)),\"\",($E672*G670))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F647=\"\",$F649=\"\",$F651=\"\",$F652=\"\"),\"\",SUM(F670:F672))","v":""},{"$f":"IF(OR(G647=\"\",$F649=\"\",$F651=\"\",$F652=\"\"),\"\",SUM(G670:G672))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F647=\"\",$F649=\"\",$F651=\"\",$F652=\"\"),\"\",SUM(F670:F671))","v":""},{"$f":"IF(OR(G647=\"\",$F649=\"\",$F651=\"\",$F652=\"\"),\"\",SUM(G670:G671))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F649=\"\",\"\",IF(F649=\"CDS\",\"per dispensing\",IF(F649=\"HT\",\"per month\",IF(F649=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F649=\"\",\"\",IF(F649=\"CDS\",DF,IF(F649=\"HT\",PC,IF(F649=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F649=\"\",F651=\"\"),\"\",IF(F649=\"Hosp\",\"No Fee\",IF(F649=\"HT\",\"No VAT\",IF(AND(F649=\"CDS\",F651=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F651=\"\",F649=\"Hosp\"),\"\",IF(OR(F651=\"Yes\",F649=\"HT\"),0,H681*G682))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F649=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F649=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H687),\"\",SUM(H687:H689))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H687),\"\",SUM(H687:H688))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B668","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F668:I668,F660:I660)","v":0},{"$f":"F699*G697","v":0},{"$f":"IF(H658=\"Days\",F699/F658*365.25,IF(H658=\"Months\",F699/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F699/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F699/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F699/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F699/F658/30.4375*I697,\"\"))))","v":""}]
["B",{"$f":"B669","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F669:I669,F660:I660)","v":0},{"$f":"F700*G697","v":0},{"$f":"IF(H658=\"Days\",F700/F658*365.25,IF(H658=\"Months\",F700/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F700/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F700/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F700/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F700/F658/30.4375*I697,\"\"))))","v":""}]
["C",{"$f":"B670","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F670:I670,F660:I660)","v":0},{"$f":"F701*G697","v":0},{"$f":"IF(H658=\"Days\",F701/F658*365.25,IF(H658=\"Months\",F701/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F701/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F701/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F701/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F701/F658/30.4375*I697,\"\"))))","v":""}]
["D",{"$f":"B671","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F671:I671,F660:I660)","v":0},{"$f":"F702*G697","v":0},{"$f":"IF(H658=\"Days\",F702/F658*365.25,IF(H658=\"Months\",F702/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F702/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F702/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F702/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F702/F658/30.4375*I697,\"\"))))","v":""}]
["E",{"$f":"B672","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F672:I672,F660:I660)","v":0},{"$f":"F703*G697","v":0},{"$f":"IF(H658=\"Days\",F703/F658*365.25,IF(H658=\"Months\",F703/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F703/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F703/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F703/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F703/F658/30.4375*I697,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H690=\"\",\"\",H690)","v":""},{"$f":"IF(F704=\"\",\"\",F704*G697)","v":""},{"$f":"IF(F704=\"\",\"\",IF(H658=\"Days\",F704/F658*365.25,IF(H658=\"Months\",F704/F658*12,\"\")))","v":""},{"$f":"IF(F704=\"\",\"\",IF(AND(H658=\"Days\",I698=\"Days\"),F704/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F704/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F704/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F704/F658/30.4375*I697,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H691=\"\",\"\",H691)","v":""},{"$f":"IF(F705=\"\",\"\",F705*G697)","v":""},{"$f":"IF(F705=\"\",\"\",IF(H658=\"Days\",F705/F658*365.25,IF(H658=\"Months\",F705/F658*12,\"\")))","v":""},{"$f":"IF(F705=\"\",\"\",IF(AND(H658=\"Days\",I698=\"Days\"),F705/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F705/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F705/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F705/F658/30.4375*I697,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F701:F704)","v":0},{"$f":"SUM(G701:G704)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F705=\"\",SUM(F701+F702),F701+F702+F705)","v":0},{"$f":"IF(G705=\"\",SUM(G701+G702),G701+G702+G705)","v":0},{"$f":"IF(H705=\"\",SUM(H701+H702),H701+H702+H705)","v":{"$error":"#VALUE!"}},{"$f":"IF(I705=\"\",SUM(I701+I702),I701+I702+I705)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B731","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F731),\"\",F731)","v":""},{"$f":"IF(ISBLANK(G731),\"\",G731)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F731=\"\",\"\",F731)","v":""},{"$f":"IF(G731=\"\",\"\",G731)","v":""},{"$f":"IF(H731=\"\",\"\",H731)","v":""},{"$f":"IF(I731=\"\",\"\",I731)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F732=\"\",F733=\"\",F734=\"\"),\"\",IF(F732=\"Price to Wholesaler\",F733,IF(F732=\"Reimbursement Price\",(F755/(1+E754)*1),\"Error\")))","v":""},{"$f":"IF(OR(G732=\"\",G733=\"\",F734=\"\"),\"\",IF(G732=\"Price to Wholesaler\",G733,IF(G732=\"Reimbursement Price\",(G755/(1+E754)*1),\"Error\")))","v":""},{"$f":"IF(OR(H732=\"\",H733=\"\",F734=\"\"),\"\",IF(H732=\"Price to Wholesaler\",H733,IF(H732=\"Reimbursement Price\",(H755/(1+E754)*1),\"Error\")))","v":""},{"$f":"IF(OR(I732=\"\",I733=\"\",F734=\"\"),\"\",IF(I732=\"Price to Wholesaler\",I733,IF(I732=\"Reimbursement Price\",(I755/(1+E754)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F734=\"\"),\"\",IF(AND(F734=\"CDS\",F735=\"Yes\"),CYF,IF(AND(F734=\"CDS\",F735=\"No\"),CNF,IF(F734=\"HT\",CHT,IF(F734=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F734=\"\",F733=\"\",F732=\"\"),\"\",F753*E754)","v":""},{"$f":"IF(OR(F734=\"\",G733=\"\",G732=\"\"),\"\",G753*E754)","v":""},{"$f":"IF(OR(F734=\"\",H733=\"\",H732=\"\"),\"\",H753*E754)","v":""},{"$f":"IF(OR(F734=\"\",I733=\"\",I732=\"\"),\"\",I753*E754)","v":""}]
["C",{"$f":"IF(F734=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F732=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F732=\"Reimbursement Price\",F733,IF(ISBLANK(E754),\"\",IF(F732=\"Price to Wholesaler\",(F753+F754),IF(F732=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G732=\"Reimbursement Price\",G733,IF(ISBLANK(E754),\"\",IF(G732=\"Price to Wholesaler\",(G753+G754),IF(G732=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H732=\"Reimbursement Price\",H733,IF(ISBLANK(E754),\"\",IF(H732=\"Price to Wholesaler\",(H753+H754),IF(H732=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I732=\"Reimbursement Price\",I733,IF(ISBLANK(E754),\"\",IF(I732=\"Price to Wholesaler\",(I753+I754),IF(I732=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\")),\"\",IF(AND(F737=\"No\",F739=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F737=\"No\",F739=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F737=\"Yes\",F738=\"Biosimilar\"),\"None\",IF(AND(F737=\"Yes\",F738=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F737=\"Yes\",F738=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F737=\"Yes\",F738=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\"),F732=\"\",ISBLANK(F733)),\"\",IF(E756=\"None\",0,(E756*F753)))","v":""},{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\"),G732=\"\",ISBLANK(G733)),\"\",IF(E756=\"None\",0,(E756*G753)))","v":""},{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\"),H732=\"\",ISBLANK(H733)),\"\",IF(E756=\"None\",0,(E756*H753)))","v":""},{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\"),I732=\"\",ISBLANK(I733)),\"\",IF(E756=\"None\",0,(E756*I753)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F736=\"\",\"\",IF(F736=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B736=\"\",F733=\"\",ISBLANK(F733)),\"\",($E757*F755))","v":""},{"$f":"IF(OR($B736=\"\",G733=\"\",ISBLANK(G733)),\"\",($E757*G755))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F732=\"\",$F734=\"\",$F736=\"\",$F737=\"\"),\"\",SUM(F755:F757))","v":""},{"$f":"IF(OR(G732=\"\",$F734=\"\",$F736=\"\",$F737=\"\"),\"\",SUM(G755:G757))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F732=\"\",$F734=\"\",$F736=\"\",$F737=\"\"),\"\",SUM(F755:F756))","v":""},{"$f":"IF(OR(G732=\"\",$F734=\"\",$F736=\"\",$F737=\"\"),\"\",SUM(G755:G756))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F734=\"\",\"\",IF(F734=\"CDS\",\"per dispensing\",IF(F734=\"HT\",\"per month\",IF(F734=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F734=\"\",\"\",IF(F734=\"CDS\",DF,IF(F734=\"HT\",PC,IF(F734=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F734=\"\",F736=\"\"),\"\",IF(F734=\"Hosp\",\"No Fee\",IF(F734=\"HT\",\"No VAT\",IF(AND(F734=\"CDS\",F736=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F736=\"\",F734=\"Hosp\"),\"\",IF(OR(F736=\"Yes\",F734=\"HT\"),0,H766*G767))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F734=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F734=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H772),\"\",SUM(H772:H774))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H772),\"\",SUM(H772:H773))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B753","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F753:I753,F745:I745)","v":0},{"$f":"F784*G782","v":0},{"$f":"IF(H743=\"Days\",F784/F743*365.25,IF(H743=\"Months\",F784/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F784/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F784/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F784/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F784/F743/30.4375*I782,\"\"))))","v":""}]
["B",{"$f":"B754","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F754:I754,F745:I745)","v":0},{"$f":"F785*G782","v":0},{"$f":"IF(H743=\"Days\",F785/F743*365.25,IF(H743=\"Months\",F785/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F785/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F785/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F785/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F785/F743/30.4375*I782,\"\"))))","v":""}]
["C",{"$f":"B755","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F755:I755,F745:I745)","v":0},{"$f":"F786*G782","v":0},{"$f":"IF(H743=\"Days\",F786/F743*365.25,IF(H743=\"Months\",F786/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F786/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F786/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F786/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F786/F743/30.4375*I782,\"\"))))","v":""}]
["D",{"$f":"B756","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F756:I756,F745:I745)","v":0},{"$f":"F787*G782","v":0},{"$f":"IF(H743=\"Days\",F787/F743*365.25,IF(H743=\"Months\",F787/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F787/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F787/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F787/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F787/F743/30.4375*I782,\"\"))))","v":""}]
["E",{"$f":"B757","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F757:I757,F745:I745)","v":0},{"$f":"F788*G782","v":0},{"$f":"IF(H743=\"Days\",F788/F743*365.25,IF(H743=\"Months\",F788/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F788/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F788/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F788/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F788/F743/30.4375*I782,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H775=\"\",\"\",H775)","v":""},{"$f":"IF(F789=\"\",\"\",F789*G782)","v":""},{"$f":"IF(F789=\"\",\"\",IF(H743=\"Days\",F789/F743*365.25,IF(H743=\"Months\",F789/F743*12,\"\")))","v":""},{"$f":"IF(F789=\"\",\"\",IF(AND(H743=\"Days\",I783=\"Days\"),F789/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F789/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F789/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F789/F743/30.4375*I782,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H776=\"\",\"\",H776)","v":""},{"$f":"IF(F790=\"\",\"\",F790*G782)","v":""},{"$f":"IF(F790=\"\",\"\",IF(H743=\"Days\",F790/F743*365.25,IF(H743=\"Months\",F790/F743*12,\"\")))","v":""},{"$f":"IF(F790=\"\",\"\",IF(AND(H743=\"Days\",I783=\"Days\"),F790/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F790/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F790/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F790/F743/30.4375*I782,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F786:F789)","v":0},{"$f":"SUM(G786:G789)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F790=\"\",SUM(F786+F787),F786+F787+F790)","v":0},{"$f":"IF(G790=\"\",SUM(G786+G787),G786+G787+G790)","v":0},{"$f":"IF(H790=\"\",SUM(H786+H787),H786+H787+H790)","v":{"$error":"#VALUE!"}},{"$f":"IF(I790=\"\",SUM(I786+I787),I786+I787+I790)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B816","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F816),\"\",F816)","v":""},{"$f":"IF(ISBLANK(G816),\"\",G816)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F816=\"\",\"\",F816)","v":""},{"$f":"IF(G816=\"\",\"\",G816)","v":""},{"$f":"IF(H816=\"\",\"\",H816)","v":""},{"$f":"IF(I816=\"\",\"\",I816)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F817=\"\",F818=\"\",F819=\"\"),\"\",IF(F817=\"Price to Wholesaler\",F818,IF(F817=\"Reimbursement Price\",(F840/(1+E839)*1),\"Error\")))","v":""},{"$f":"IF(OR(G817=\"\",G818=\"\",F819=\"\"),\"\",IF(G817=\"Price to Wholesaler\",G818,IF(G817=\"Reimbursement Price\",(G840/(1+E839)*1),\"Error\")))","v":""},{"$f":"IF(OR(H817=\"\",H818=\"\",F819=\"\"),\"\",IF(H817=\"Price to Wholesaler\",H818,IF(H817=\"Reimbursement Price\",(H840/(1+E839)*1),\"Error\")))","v":""},{"$f":"IF(OR(I817=\"\",I818=\"\",F819=\"\"),\"\",IF(I817=\"Price to Wholesaler\",I818,IF(I817=\"Reimbursement Price\",(I840/(1+E839)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F819=\"\"),\"\",IF(AND(F819=\"CDS\",F820=\"Yes\"),CYF,IF(AND(F819=\"CDS\",F820=\"No\"),CNF,IF(F819=\"HT\",CHT,IF(F819=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F819=\"\",F818=\"\",F817=\"\"),\"\",F838*E839)","v":""},{"$f":"IF(OR(F819=\"\",G818=\"\",G817=\"\"),\"\",G838*E839)","v":""},{"$f":"IF(OR(F819=\"\",H818=\"\",H817=\"\"),\"\",H838*E839)","v":""},{"$f":"IF(OR(F819=\"\",I818=\"\",I817=\"\"),\"\",I838*E839)","v":""}]
["C",{"$f":"IF(F819=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F817=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F817=\"Reimbursement Price\",F818,IF(ISBLANK(E839),\"\",IF(F817=\"Price to Wholesaler\",(F838+F839),IF(F817=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G817=\"Reimbursement Price\",G818,IF(ISBLANK(E839),\"\",IF(G817=\"Price to Wholesaler\",(G838+G839),IF(G817=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H817=\"Reimbursement Price\",H818,IF(ISBLANK(E839),\"\",IF(H817=\"Price to Wholesaler\",(H838+H839),IF(H817=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I817=\"Reimbursement Price\",I818,IF(ISBLANK(E839),\"\",IF(I817=\"Price to Wholesaler\",(I838+I839),IF(I817=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\")),\"\",IF(AND(F822=\"No\",F824=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F822=\"No\",F824=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F822=\"Yes\",F823=\"Biosimilar\"),\"None\",IF(AND(F822=\"Yes\",F823=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F822=\"Yes\",F823=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F822=\"Yes\",F823=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\"),F817=\"\",ISBLANK(F818)),\"\",IF(E841=\"None\",0,(E841*F838)))","v":""},{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\"),G817=\"\",ISBLANK(G818)),\"\",IF(E841=\"None\",0,(E841*G838)))","v":""},{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\"),H817=\"\",ISBLANK(H818)),\"\",IF(E841=\"None\",0,(E841*H838)))","v":""},{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\"),I817=\"\",ISBLANK(I818)),\"\",IF(E841=\"None\",0,(E841*I838)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F821=\"\",\"\",IF(F821=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B821=\"\",F818=\"\",ISBLANK(F818)),\"\",($E842*F840))","v":""},{"$f":"IF(OR($B821=\"\",G818=\"\",ISBLANK(G818)),\"\",($E842*G840))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F817=\"\",$F819=\"\",$F821=\"\",$F822=\"\"),\"\",SUM(F840:F842))","v":""},{"$f":"IF(OR(G817=\"\",$F819=\"\",$F821=\"\",$F822=\"\"),\"\",SUM(G840:G842))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F817=\"\",$F819=\"\",$F821=\"\",$F822=\"\"),\"\",SUM(F840:F841))","v":""},{"$f":"IF(OR(G817=\"\",$F819=\"\",$F821=\"\",$F822=\"\"),\"\",SUM(G840:G841))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F819=\"\",\"\",IF(F819=\"CDS\",\"per dispensing\",IF(F819=\"HT\",\"per month\",IF(F819=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F819=\"\",\"\",IF(F819=\"CDS\",DF,IF(F819=\"HT\",PC,IF(F819=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F819=\"\",F821=\"\"),\"\",IF(F819=\"Hosp\",\"No Fee\",IF(F819=\"HT\",\"No VAT\",IF(AND(F819=\"CDS\",F821=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F821=\"\",F819=\"Hosp\"),\"\",IF(OR(F821=\"Yes\",F819=\"HT\"),0,H851*G852))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F819=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F819=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H857),\"\",SUM(H857:H859))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H857),\"\",SUM(H857:H858))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B838","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F838:I838,F830:I830)","v":0},{"$f":"F869*G867","v":0},{"$f":"IF(H828=\"Days\",F869/F828*365.25,IF(H828=\"Months\",F869/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F869/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F869/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F869/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F869/F828/30.4375*I867,\"\"))))","v":""}]
["B",{"$f":"B839","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F839:I839,F830:I830)","v":0},{"$f":"F870*G867","v":0},{"$f":"IF(H828=\"Days\",F870/F828*365.25,IF(H828=\"Months\",F870/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F870/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F870/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F870/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F870/F828/30.4375*I867,\"\"))))","v":""}]
["C",{"$f":"B840","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F840:I840,F830:I830)","v":0},{"$f":"F871*G867","v":0},{"$f":"IF(H828=\"Days\",F871/F828*365.25,IF(H828=\"Months\",F871/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F871/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F871/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F871/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F871/F828/30.4375*I867,\"\"))))","v":""}]
["D",{"$f":"B841","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F841:I841,F830:I830)","v":0},{"$f":"F872*G867","v":0},{"$f":"IF(H828=\"Days\",F872/F828*365.25,IF(H828=\"Months\",F872/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F872/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F872/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F872/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F872/F828/30.4375*I867,\"\"))))","v":""}]
["E",{"$f":"B842","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F842:I842,F830:I830)","v":0},{"$f":"F873*G867","v":0},{"$f":"IF(H828=\"Days\",F873/F828*365.25,IF(H828=\"Months\",F873/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F873/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F873/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F873/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F873/F828/30.4375*I867,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H860=\"\",\"\",H860)","v":""},{"$f":"IF(F874=\"\",\"\",F874*G867)","v":""},{"$f":"IF(F874=\"\",\"\",IF(H828=\"Days\",F874/F828*365.25,IF(H828=\"Months\",F874/F828*12,\"\")))","v":""},{"$f":"IF(F874=\"\",\"\",IF(AND(H828=\"Days\",I868=\"Days\"),F874/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F874/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F874/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F874/F828/30.4375*I867,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H861=\"\",\"\",H861)","v":""},{"$f":"IF(F875=\"\",\"\",F875*G867)","v":""},{"$f":"IF(F875=\"\",\"\",IF(H828=\"Days\",F875/F828*365.25,IF(H828=\"Months\",F875/F828*12,\"\")))","v":""},{"$f":"IF(F875=\"\",\"\",IF(AND(H828=\"Days\",I868=\"Days\"),F875/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F875/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F875/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F875/F828/30.4375*I867,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F871:F874)","v":0},{"$f":"SUM(G871:G874)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F875=\"\",SUM(F871+F872),F871+F872+F875)","v":0},{"$f":"IF(G875=\"\",SUM(G871+G872),G871+G872+G875)","v":0},{"$f":"IF(H875=\"\",SUM(H871+H872),H871+H872+H875)","v":{"$error":"#VALUE!"}},{"$f":"IF(I875=\"\",SUM(I871+I872),I871+I872+I875)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B901","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F901),\"\",F901)","v":""},{"$f":"IF(ISBLANK(G901),\"\",G901)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F901=\"\",\"\",F901)","v":""},{"$f":"IF(G901=\"\",\"\",G901)","v":""},{"$f":"IF(H901=\"\",\"\",H901)","v":""},{"$f":"IF(I901=\"\",\"\",I901)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F902=\"\",F903=\"\",F904=\"\"),\"\",IF(F902=\"Price to Wholesaler\",F903,IF(F902=\"Reimbursement Price\",(F925/(1+E924)*1),\"Error\")))","v":""},{"$f":"IF(OR(G902=\"\",G903=\"\",F904=\"\"),\"\",IF(G902=\"Price to Wholesaler\",G903,IF(G902=\"Reimbursement Price\",(G925/(1+E924)*1),\"Error\")))","v":""},{"$f":"IF(OR(H902=\"\",H903=\"\",F904=\"\"),\"\",IF(H902=\"Price to Wholesaler\",H903,IF(H902=\"Reimbursement Price\",(H925/(1+E924)*1),\"Error\")))","v":""},{"$f":"IF(OR(I902=\"\",I903=\"\",F904=\"\"),\"\",IF(I902=\"Price to Wholesaler\",I903,IF(I902=\"Reimbursement Price\",(I925/(1+E924)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F904=\"\"),\"\",IF(AND(F904=\"CDS\",F905=\"Yes\"),CYF,IF(AND(F904=\"CDS\",F905=\"No\"),CNF,IF(F904=\"HT\",CHT,IF(F904=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F904=\"\",F903=\"\",F902=\"\"),\"\",F923*E924)","v":""},{"$f":"IF(OR(F904=\"\",G903=\"\",G902=\"\"),\"\",G923*E924)","v":""},{"$f":"IF(OR(F904=\"\",H903=\"\",H902=\"\"),\"\",H923*E924)","v":""},{"$f":"IF(OR(F904=\"\",I903=\"\",I902=\"\"),\"\",I923*E924)","v":""}]
["C",{"$f":"IF(F904=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F902=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F902=\"Reimbursement Price\",F903,IF(ISBLANK(E924),\"\",IF(F902=\"Price to Wholesaler\",(F923+F924),IF(F902=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G902=\"Reimbursement Price\",G903,IF(ISBLANK(E924),\"\",IF(G902=\"Price to Wholesaler\",(G923+G924),IF(G902=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H902=\"Reimbursement Price\",H903,IF(ISBLANK(E924),\"\",IF(H902=\"Price to Wholesaler\",(H923+H924),IF(H902=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I902=\"Reimbursement Price\",I903,IF(ISBLANK(E924),\"\",IF(I902=\"Price to Wholesaler\",(I923+I924),IF(I902=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\")),\"\",IF(AND(F907=\"No\",F909=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F907=\"No\",F909=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F907=\"Yes\",F908=\"Biosimilar\"),\"None\",IF(AND(F907=\"Yes\",F908=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F907=\"Yes\",F908=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F907=\"Yes\",F908=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\"),F902=\"\",ISBLANK(F903)),\"\",IF(E926=\"None\",0,(E926*F923)))","v":""},{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\"),G902=\"\",ISBLANK(G903)),\"\",IF(E926=\"None\",0,(E926*G923)))","v":""},{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\"),H902=\"\",ISBLANK(H903)),\"\",IF(E926=\"None\",0,(E926*H923)))","v":""},{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\"),I902=\"\",ISBLANK(I903)),\"\",IF(E926=\"None\",0,(E926*I923)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F906=\"\",\"\",IF(F906=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B906=\"\",F903=\"\",ISBLANK(F903)),\"\",($E927*F925))","v":""},{"$f":"IF(OR($B906=\"\",G903=\"\",ISBLANK(G903)),\"\",($E927*G925))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F902=\"\",$F904=\"\",$F906=\"\",$F907=\"\"),\"\",SUM(F925:F927))","v":""},{"$f":"IF(OR(G902=\"\",$F904=\"\",$F906=\"\",$F907=\"\"),\"\",SUM(G925:G927))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F902=\"\",$F904=\"\",$F906=\"\",$F907=\"\"),\"\",SUM(F925:F926))","v":""},{"$f":"IF(OR(G902=\"\",$F904=\"\",$F906=\"\",$F907=\"\"),\"\",SUM(G925:G926))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F904=\"\",\"\",IF(F904=\"CDS\",\"per dispensing\",IF(F904=\"HT\",\"per month\",IF(F904=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F904=\"\",\"\",IF(F904=\"CDS\",DF,IF(F904=\"HT\",PC,IF(F904=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F904=\"\",F906=\"\"),\"\",IF(F904=\"Hosp\",\"No Fee\",IF(F904=\"HT\",\"No VAT\",IF(AND(F904=\"CDS\",F906=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F906=\"\",F904=\"Hosp\"),\"\",IF(OR(F906=\"Yes\",F904=\"HT\"),0,H936*G937))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F904=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F904=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H942),\"\",SUM(H942:H944))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H942),\"\",SUM(H942:H943))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B923","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F923:I923,F915:I915)","v":0},{"$f":"F954*G952","v":0},{"$f":"IF(H913=\"Days\",F954/F913*365.25,IF(H913=\"Months\",F954/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F954/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F954/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F954/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F954/F913/30.4375*I952,\"\"))))","v":""}]
["B",{"$f":"B924","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F924:I924,F915:I915)","v":0},{"$f":"F955*G952","v":0},{"$f":"IF(H913=\"Days\",F955/F913*365.25,IF(H913=\"Months\",F955/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F955/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F955/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F955/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F955/F913/30.4375*I952,\"\"))))","v":""}]
["C",{"$f":"B925","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F925:I925,F915:I915)","v":0},{"$f":"F956*G952","v":0},{"$f":"IF(H913=\"Days\",F956/F913*365.25,IF(H913=\"Months\",F956/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F956/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F956/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F956/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F956/F913/30.4375*I952,\"\"))))","v":""}]
["D",{"$f":"B926","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F926:I926,F915:I915)","v":0},{"$f":"F957*G952","v":0},{"$f":"IF(H913=\"Days\",F957/F913*365.25,IF(H913=\"Months\",F957/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F957/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F957/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F957/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F957/F913/30.4375*I952,\"\"))))","v":""}]
["E",{"$f":"B927","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F927:I927,F915:I915)","v":0},{"$f":"F958*G952","v":0},{"$f":"IF(H913=\"Days\",F958/F913*365.25,IF(H913=\"Months\",F958/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F958/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F958/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F958/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F958/F913/30.4375*I952,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H945=\"\",\"\",H945)","v":""},{"$f":"IF(F959=\"\",\"\",F959*G952)","v":""},{"$f":"IF(F959=\"\",\"\",IF(H913=\"Days\",F959/F913*365.25,IF(H913=\"Months\",F959/F913*12,\"\")))","v":""},{"$f":"IF(F959=\"\",\"\",IF(AND(H913=\"Days\",I953=\"Days\"),F959/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F959/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F959/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F959/F913/30.4375*I952,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H946=\"\",\"\",H946)","v":""},{"$f":"IF(F960=\"\",\"\",F960*G952)","v":""},{"$f":"IF(F960=\"\",\"\",IF(H913=\"Days\",F960/F913*365.25,IF(H913=\"Months\",F960/F913*12,\"\")))","v":""},{"$f":"IF(F960=\"\",\"\",IF(AND(H913=\"Days\",I953=\"Days\"),F960/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F960/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F960/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F960/F913/30.4375*I952,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F956:F959)","v":0},{"$f":"SUM(G956:G959)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F960=\"\",SUM(F956+F957),F956+F957+F960)","v":0},{"$f":"IF(G960=\"\",SUM(G956+G957),G956+G957+G960)","v":0},{"$f":"IF(H960=\"\",SUM(H956+H957),H956+H957+H960)","v":{"$error":"#VALUE!"}},{"$f":"IF(I960=\"\",SUM(I956+I957),I956+I957+I960)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B986","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F986),\"\",F986)","v":""},{"$f":"IF(ISBLANK(G986),\"\",G986)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F986=\"\",\"\",F986)","v":""},{"$f":"IF(G986=\"\",\"\",G986)","v":""},{"$f":"IF(H986=\"\",\"\",H986)","v":""},{"$f":"IF(I986=\"\",\"\",I986)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F987=\"\",F988=\"\",F989=\"\"),\"\",IF(F987=\"Price to Wholesaler\",F988,IF(F987=\"Reimbursement Price\",(F1010/(1+E1009)*1),\"Error\")))","v":""},{"$f":"IF(OR(G987=\"\",G988=\"\",F989=\"\"),\"\",IF(G987=\"Price to Wholesaler\",G988,IF(G987=\"Reimbursement Price\",(G1010/(1+E1009)*1),\"Error\")))","v":""},{"$f":"IF(OR(H987=\"\",H988=\"\",F989=\"\"),\"\",IF(H987=\"Price to Wholesaler\",H988,IF(H987=\"Reimbursement Price\",(H1010/(1+E1009)*1),\"Error\")))","v":""},{"$f":"IF(OR(I987=\"\",I988=\"\",F989=\"\"),\"\",IF(I987=\"Price to Wholesaler\",I988,IF(I987=\"Reimbursement Price\",(I1010/(1+E1009)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F989=\"\"),\"\",IF(AND(F989=\"CDS\",F990=\"Yes\"),CYF,IF(AND(F989=\"CDS\",F990=\"No\"),CNF,IF(F989=\"HT\",CHT,IF(F989=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F989=\"\",F988=\"\",F987=\"\"),\"\",F1008*E1009)","v":""},{"$f":"IF(OR(F989=\"\",G988=\"\",G987=\"\"),\"\",G1008*E1009)","v":""},{"$f":"IF(OR(F989=\"\",H988=\"\",H987=\"\"),\"\",H1008*E1009)","v":""},{"$f":"IF(OR(F989=\"\",I988=\"\",I987=\"\"),\"\",I1008*E1009)","v":""}]
["C",{"$f":"IF(F989=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F987=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F987=\"Reimbursement Price\",F988,IF(ISBLANK(E1009),\"\",IF(F987=\"Price to Wholesaler\",(F1008+F1009),IF(F987=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G987=\"Reimbursement Price\",G988,IF(ISBLANK(E1009),\"\",IF(G987=\"Price to Wholesaler\",(G1008+G1009),IF(G987=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H987=\"Reimbursement Price\",H988,IF(ISBLANK(E1009),\"\",IF(H987=\"Price to Wholesaler\",(H1008+H1009),IF(H987=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I987=\"Reimbursement Price\",I988,IF(ISBLANK(E1009),\"\",IF(I987=\"Price to Wholesaler\",(I1008+I1009),IF(I987=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\")),\"\",IF(AND(F992=\"No\",F994=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F992=\"No\",F994=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F992=\"Yes\",F993=\"Biosimilar\"),\"None\",IF(AND(F992=\"Yes\",F993=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F992=\"Yes\",F993=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F992=\"Yes\",F993=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\"),F987=\"\",ISBLANK(F988)),\"\",IF(E1011=\"None\",0,(E1011*F1008)))","v":""},{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\"),G987=\"\",ISBLANK(G988)),\"\",IF(E1011=\"None\",0,(E1011*G1008)))","v":""},{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\"),H987=\"\",ISBLANK(H988)),\"\",IF(E1011=\"None\",0,(E1011*H1008)))","v":""},{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\"),I987=\"\",ISBLANK(I988)),\"\",IF(E1011=\"None\",0,(E1011*I1008)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F991=\"\",\"\",IF(F991=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B991=\"\",F988=\"\",ISBLANK(F988)),\"\",($E1012*F1010))","v":""},{"$f":"IF(OR($B991=\"\",G988=\"\",ISBLANK(G988)),\"\",($E1012*G1010))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F987=\"\",$F989=\"\",$F991=\"\",$F992=\"\"),\"\",SUM(F1010:F1012))","v":""},{"$f":"IF(OR(G987=\"\",$F989=\"\",$F991=\"\",$F992=\"\"),\"\",SUM(G1010:G1012))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F987=\"\",$F989=\"\",$F991=\"\",$F992=\"\"),\"\",SUM(F1010:F1011))","v":""},{"$f":"IF(OR(G987=\"\",$F989=\"\",$F991=\"\",$F992=\"\"),\"\",SUM(G1010:G1011))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F989=\"\",\"\",IF(F989=\"CDS\",\"per dispensing\",IF(F989=\"HT\",\"per month\",IF(F989=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F989=\"\",\"\",IF(F989=\"CDS\",DF,IF(F989=\"HT\",PC,IF(F989=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F989=\"\",F991=\"\"),\"\",IF(F989=\"Hosp\",\"No Fee\",IF(F989=\"HT\",\"No VAT\",IF(AND(F989=\"CDS\",F991=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F991=\"\",F989=\"Hosp\"),\"\",IF(OR(F991=\"Yes\",F989=\"HT\"),0,H1021*G1022))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F989=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F989=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H1027),\"\",SUM(H1027:H1029))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H1027),\"\",SUM(H1027:H1028))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B1008","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F1008:I1008,F1000:I1000)","v":0},{"$f":"F1039*G1037","v":0},{"$f":"IF(H998=\"Days\",F1039/F998*365.25,IF(H998=\"Months\",F1039/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1039/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1039/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1039/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1039/F998/30.4375*I1037,\"\"))))","v":""}]
["B",{"$f":"B1009","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F1009:I1009,F1000:I1000)","v":0},{"$f":"F1040*G1037","v":0},{"$f":"IF(H998=\"Days\",F1040/F998*365.25,IF(H998=\"Months\",F1040/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1040/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1040/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1040/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1040/F998/30.4375*I1037,\"\"))))","v":""}]
["C",{"$f":"B1010","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F1010:I1010,F1000:I1000)","v":0},{"$f":"F1041*G1037","v":0},{"$f":"IF(H998=\"Days\",F1041/F998*365.25,IF(H998=\"Months\",F1041/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1041/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1041/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1041/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1041/F998/30.4375*I1037,\"\"))))","v":""}]
["D",{"$f":"B1011","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F1011:I1011,F1000:I1000)","v":0},{"$f":"F1042*G1037","v":0},{"$f":"IF(H998=\"Days\",F1042/F998*365.25,IF(H998=\"Months\",F1042/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1042/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1042/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1042/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1042/F998/30.4375*I1037,\"\"))))","v":""}]
["E",{"$f":"B1012","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F1012:I1012,F1000:I1000)","v":0},{"$f":"F1043*G1037","v":0},{"$f":"IF(H998=\"Days\",F1043/F998*365.25,IF(H998=\"Months\",F1043/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1043/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1043/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1043/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1043/F998/30.4375*I1037,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H1030=\"\",\"\",H1030)","v":""},{"$f":"IF(F1044=\"\",\"\",F1044*G1037)","v":""},{"$f":"IF(F1044=\"\",\"\",IF(H998=\"Days\",F1044/F998*365.25,IF(H998=\"Months\",F1044/F998*12,\"\")))","v":""},{"$f":"IF(F1044=\"\",\"\",IF(AND(H998=\"Days\",I1038=\"Days\"),F1044/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1044/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1044/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1044/F998/30.4375*I1037,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H1031=\"\",\"\",H1031)","v":""},{"$f":"IF(F1045=\"\",\"\",F1045*G1037)","v":""},{"$f":"IF(F1045=\"\",\"\",IF(H998=\"Days\",F1045/F998*365.25,IF(H998=\"Months\",F1045/F998*12,\"\")))","v":""},{"$f":"IF(F1045=\"\",\"\",IF(AND(H998=\"Days\",I1038=\"Days\"),F1045/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1045/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1045/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1045/F998/30.4375*I1037,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F1041:F1044)","v":0},{"$f":"SUM(G1041:G1044)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F1045=\"\",SUM(F1041+F1042),F1041+F1042+F1045)","v":0},{"$f":"IF(G1045=\"\",SUM(G1041+G1042),G1041+G1042+G1045)","v":0},{"$f":"IF(H1045=\"\",SUM(H1041+H1042),H1041+H1042+H1045)","v":{"$error":"#VALUE!"}},{"$f":"IF(I1045=\"\",SUM(I1041+I1042),I1041+I1042+I1045)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B1071","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F1071),\"\",F1071)","v":""},{"$f":"IF(ISBLANK(G1071),\"\",G1071)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F1071=\"\",\"\",F1071)","v":""},{"$f":"IF(G1071=\"\",\"\",G1071)","v":""},{"$f":"IF(H1071=\"\",\"\",H1071)","v":""},{"$f":"IF(I1071=\"\",\"\",I1071)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F1072=\"\",F1073=\"\",F1074=\"\"),\"\",IF(F1072=\"Price to Wholesaler\",F1073,IF(F1072=\"Reimbursement Price\",(F1095/(1+E1094)*1),\"Error\")))","v":""},{"$f":"IF(OR(G1072=\"\",G1073=\"\",F1074=\"\"),\"\",IF(G1072=\"Price to Wholesaler\",G1073,IF(G1072=\"Reimbursement Price\",(G1095/(1+E1094)*1),\"Error\")))","v":""},{"$f":"IF(OR(H1072=\"\",H1073=\"\",F1074=\"\"),\"\",IF(H1072=\"Price to Wholesaler\",H1073,IF(H1072=\"Reimbursement Price\",(H1095/(1+E1094)*1),\"Error\")))","v":""},{"$f":"IF(OR(I1072=\"\",I1073=\"\",F1074=\"\"),\"\",IF(I1072=\"Price to Wholesaler\",I1073,IF(I1072=\"Reimbursement Price\",(I1095/(1+E1094)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F1074=\"\"),\"\",IF(AND(F1074=\"CDS\",F1075=\"Yes\"),CYF,IF(AND(F1074=\"CDS\",F1075=\"No\"),CNF,IF(F1074=\"HT\",CHT,IF(F1074=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F1074=\"\",F1073=\"\",F1072=\"\"),\"\",F1093*E1094)","v":""},{"$f":"IF(OR(F1074=\"\",G1073=\"\",G1072=\"\"),\"\",G1093*E1094)","v":""},{"$f":"IF(OR(F1074=\"\",H1073=\"\",H1072=\"\"),\"\",H1093*E1094)","v":""},{"$f":"IF(OR(F1074=\"\",I1073=\"\",I1072=\"\"),\"\",I1093*E1094)","v":""}]
["C",{"$f":"IF(F1074=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F1072=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F1072=\"Reimbursement Price\",F1073,IF(ISBLANK(E1094),\"\",IF(F1072=\"Price to Wholesaler\",(F1093+F1094),IF(F1072=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G1072=\"Reimbursement Price\",G1073,IF(ISBLANK(E1094),\"\",IF(G1072=\"Price to Wholesaler\",(G1093+G1094),IF(G1072=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H1072=\"Reimbursement Price\",H1073,IF(ISBLANK(E1094),\"\",IF(H1072=\"Price to Wholesaler\",(H1093+H1094),IF(H1072=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I1072=\"Reimbursement Price\",I1073,IF(ISBLANK(E1094),\"\",IF(I1072=\"Price to Wholesaler\",(I1093+I1094),IF(I1072=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\")),\"\",IF(AND(F1077=\"No\",F1079=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F1077=\"No\",F1079=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F1077=\"Yes\",F1078=\"Biosimilar\"),\"None\",IF(AND(F1077=\"Yes\",F1078=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F1077=\"Yes\",F1078=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F1077=\"Yes\",F1078=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\"),F1072=\"\",ISBLANK(F1073)),\"\",IF(E1096=\"None\",0,(E1096*F1093)))","v":""},{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\"),G1072=\"\",ISBLANK(G1073)),\"\",IF(E1096=\"None\",0,(E1096*G1093)))","v":""},{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\"),H1072=\"\",ISBLANK(H1073)),\"\",IF(E1096=\"None\",0,(E1096*H1093)))","v":""},{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\"),I1072=\"\",ISBLANK(I1073)),\"\",IF(E1096=\"None\",0,(E1096*I1093)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F1076=\"\",\"\",IF(F1076=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B1076=\"\",F1073=\"\",ISBLANK(F1073)),\"\",($E1097*F1095))","v":""},{"$f":"IF(OR($B1076=\"\",G1073=\"\",ISBLANK(G1073)),\"\",($E1097*G1095))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F1072=\"\",$F1074=\"\",$F1076=\"\",$F1077=\"\"),\"\",SUM(F1095:F1097))","v":""},{"$f":"IF(OR(G1072=\"\",$F1074=\"\",$F1076=\"\",$F1077=\"\"),\"\",SUM(G1095:G1097))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F1072=\"\",$F1074=\"\",$F1076=\"\",$F1077=\"\"),\"\",SUM(F1095:F1096))","v":""},{"$f":"IF(OR(G1072=\"\",$F1074=\"\",$F1076=\"\",$F1077=\"\"),\"\",SUM(G1095:G1096))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F1074=\"\",\"\",IF(F1074=\"CDS\",\"per dispensing\",IF(F1074=\"HT\",\"per month\",IF(F1074=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F1074=\"\",\"\",IF(F1074=\"CDS\",DF,IF(F1074=\"HT\",PC,IF(F1074=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F1074=\"\",F1076=\"\"),\"\",IF(F1074=\"Hosp\",\"No Fee\",IF(F1074=\"HT\",\"No VAT\",IF(AND(F1074=\"CDS\",F1076=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F1076=\"\",F1074=\"Hosp\"),\"\",IF(OR(F1076=\"Yes\",F1074=\"HT\"),0,H1106*G1107))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F1074=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F1074=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H1112),\"\",SUM(H1112:H1114))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H1112),\"\",SUM(H1112:H1113))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B1093","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F1093:I1093,F1085:I1085)","v":0},{"$f":"F1124*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1124/F1083*365.25,IF(H1083=\"Months\",F1124/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1124/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1124/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1124/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1124/F1083/30.4375*I1122,\"\"))))","v":""}]
["B",{"$f":"B1094","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F1094:I1094,F1085:I1085)","v":0},{"$f":"F1125*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1125/F1083*365.25,IF(H1083=\"Months\",F1125/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1125/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1125/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1125/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1125/F1083/30.4375*I1122,\"\"))))","v":""}]
["C",{"$f":"B1095","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F1095:I1095,F1085:I1085)","v":0},{"$f":"F1126*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1126/F1083*365.25,IF(H1083=\"Months\",F1126/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1126/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1126/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1126/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1126/F1083/30.4375*I1122,\"\"))))","v":""}]
["D",{"$f":"B1096","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F1096:I1096,F1085:I1085)","v":0},{"$f":"F1127*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1127/F1083*365.25,IF(H1083=\"Months\",F1127/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1127/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1127/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1127/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1127/F1083/30.4375*I1122,\"\"))))","v":""}]
["E",{"$f":"B1097","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F1097:I1097,F1085:I1085)","v":0},{"$f":"F1128*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1128/F1083*365.25,IF(H1083=\"Months\",F1128/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1128/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1128/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1128/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1128/F1083/30.4375*I1122,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H1115=\"\",\"\",H1115)","v":""},{"$f":"IF(F1129=\"\",\"\",F1129*G1122)","v":""},{"$f":"IF(F1129=\"\",\"\",IF(H1083=\"Days\",F1129/F1083*365.25,IF(H1083=\"Months\",F1129/F1083*12,\"\")))","v":""},{"$f":"IF(F1129=\"\",\"\",IF(AND(H1083=\"Days\",I1123=\"Days\"),F1129/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1129/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1129/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1129/F1083/30.4375*I1122,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H1116=\"\",\"\",H1116)","v":""},{"$f":"IF(F1130=\"\",\"\",F1130*G1122)","v":""},{"$f":"IF(F1130=\"\",\"\",IF(H1083=\"Days\",F1130/F1083*365.25,IF(H1083=\"Months\",F1130/F1083*12,\"\")))","v":""},{"$f":"IF(F1130=\"\",\"\",IF(AND(H1083=\"Days\",I1123=\"Days\"),F1130/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1130/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1130/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1130/F1083/30.4375*I1122,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F1126:F1129)","v":0},{"$f":"SUM(G1126:G1129)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F1130=\"\",SUM(F1126+F1127),F1126+F1127+F1130)","v":0},{"$f":"IF(G1130=\"\",SUM(G1126+G1127),G1126+G1127+G1130)","v":0},{"$f":"IF(H1130=\"\",SUM(H1126+H1127),H1126+H1127+H1130)","v":{"$error":"#VALUE!"}},{"$f":"IF(I1130=\"\",SUM(I1126+I1127),I1126+I1127+I1130)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]

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[null,"• Table 1 on this tab will automatically populate from the 'Drug Acquisition Costs' tab for the comparators.\n• If the Applicant chooses to submit a commercial in confidence (CIC) patient access scheme (PAS)  at this stage,please input the cost of the intervention including the CIC PAS using the tables below. Please note that it is not a requirement to submit a CIC PAS at this stage but this tab should be used if a CIC PAS is included as part of the submission.\n• Cells in grey in Tables A-F for the intervention on this tab will automatically populate from the 'Drug Acquisition Costs' tab. Please select the purple drop-down cells manually.\n• For detailed instructions please see the 'Drug Acquistion Costs' tab.\n"]
[]
[null,null,null,null,null,null,null,null,null,null,"NCPE Drug Cost Guidelines"]
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[null,"Table 1"]
[null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,{"$f":"CONCATENATE(\"Intervention: \",InterventionINN)","v":"Intervention: "}]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E29=\"\",\"\",'Drug Acquisition Costs'!E29)","v":""},{"$f":"IF('Drug Acquisition Costs'!F29=\"\",\"\",'Drug Acquisition Costs'!F29)","v":""},{"$f":"IF('Drug Acquisition Costs'!G29=\"\",\"\",'Drug Acquisition Costs'!G29)","v":""},{"$f":"IF('Drug Acquisition Costs'!H29=\"\",\"\",'Drug Acquisition Costs'!H29)","v":""},{"$f":"IF('Drug Acquisition Costs'!I29=\"\",\"\",'Drug Acquisition Costs'!I29)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E30=\"\",\"\",'Drug Acquisition Costs'!E30)","v":""},{"$f":"IF('Drug Acquisition Costs'!F30=\"\",\"\",'Drug Acquisition Costs'!F30)","v":""},{"$f":"IF('Drug Acquisition Costs'!G30=\"\",\"\",'Drug Acquisition Costs'!G30)","v":""},{"$f":"IF('Drug Acquisition Costs'!H30=\"\",\"\",'Drug Acquisition Costs'!H30)","v":""},{"$f":"IF('Drug Acquisition Costs'!I30=\"\",\"\",'Drug Acquisition Costs'!I30)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E31=\"\",\"\",'Drug Acquisition Costs'!E31)","v":""},{"$f":"IF('Drug Acquisition Costs'!F31=\"\",\"\",'Drug Acquisition Costs'!F31)","v":""},{"$f":"IF('Drug Acquisition Costs'!G31=\"\",\"\",'Drug Acquisition Costs'!G31)","v":""},{"$f":"IF('Drug Acquisition Costs'!H31=\"\",\"\",'Drug Acquisition Costs'!H31)","v":""},{"$f":"IF('Drug Acquisition Costs'!I31=\"\",\"\",'Drug Acquisition Costs'!I31)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E32=\"\",\"\",'Drug Acquisition Costs'!E32)","v":""},{"$f":"IF('Drug Acquisition Costs'!F32=\"\",\"\",'Drug Acquisition Costs'!F32)","v":""},{"$f":"IF('Drug Acquisition Costs'!G32=\"\",\"\",'Drug Acquisition Costs'!G32)","v":""},{"$f":"IF('Drug Acquisition Costs'!H32=\"\",\"\",'Drug Acquisition Costs'!H32)","v":""},{"$f":"IF('Drug Acquisition Costs'!I32=\"\",\"\",'Drug Acquisition Costs'!I32)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E33=\"\",\"\",'Drug Acquisition Costs'!E33)","v":""},{"$f":"IF('Drug Acquisition Costs'!F33=\"\",\"\",'Drug Acquisition Costs'!F33)","v":""},{"$f":"IF('Drug Acquisition Costs'!G33=\"\",\"\",'Drug Acquisition Costs'!G33)","v":""},{"$f":"IF('Drug Acquisition Costs'!H33=\"\",\"\",'Drug Acquisition Costs'!H33)","v":""},{"$f":"IF('Drug Acquisition Costs'!I33=\"\",\"\",'Drug Acquisition Costs'!I33)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E34=\"\",\"\",'Drug Acquisition Costs'!E34)","v":""},{"$f":"IF('Drug Acquisition Costs'!F34=\"\",\"\",'Drug Acquisition Costs'!F34)","v":""},{"$f":"IF('Drug Acquisition Costs'!G34=\"\",\"\",'Drug Acquisition Costs'!G34)","v":""},{"$f":"IF('Drug Acquisition Costs'!H34=\"\",\"\",'Drug Acquisition Costs'!H34)","v":""},{"$f":"IF('Drug Acquisition Costs'!I34=\"\",\"\",'Drug Acquisition Costs'!I34)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E35=\"\",\"\",'Drug Acquisition Costs'!E35)","v":""},{"$f":"IF('Drug Acquisition Costs'!F35=\"\",\"\",'Drug Acquisition Costs'!F35)","v":""},{"$f":"IF('Drug Acquisition Costs'!G35=\"\",\"\",'Drug Acquisition Costs'!G35)","v":""},{"$f":"IF('Drug Acquisition Costs'!H35=\"\",\"\",'Drug Acquisition Costs'!H35)","v":""},{"$f":"IF('Drug Acquisition Costs'!I35=\"\",\"\",'Drug Acquisition Costs'!I35)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E36=\"\",\"\",'Drug Acquisition Costs'!E36)","v":""},{"$f":"IF('Drug Acquisition Costs'!F36=\"\",\"\",'Drug Acquisition Costs'!F36)","v":""},{"$f":"IF('Drug Acquisition Costs'!G36=\"\",\"\",'Drug Acquisition Costs'!G36)","v":""},{"$f":"IF('Drug Acquisition Costs'!H36=\"\",\"\",'Drug Acquisition Costs'!H36)","v":""},{"$f":"IF('Drug Acquisition Costs'!I36=\"\",\"\",'Drug Acquisition Costs'!I36)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E37=\"\",\"\",'Drug Acquisition Costs'!E37)","v":""},{"$f":"IF('Drug Acquisition Costs'!F37=\"\",\"\",'Drug Acquisition Costs'!F37)","v":""},{"$f":"IF('Drug Acquisition Costs'!G37=\"\",\"\",'Drug Acquisition Costs'!G37)","v":""},{"$f":"IF('Drug Acquisition Costs'!H37=\"\",\"\",'Drug Acquisition Costs'!H37)","v":""},{"$f":"IF('Drug Acquisition Costs'!I37=\"\",\"\",'Drug Acquisition Costs'!I37)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E38=\"\",\"\",'Drug Acquisition Costs'!E38)","v":""},{"$f":"IF('Drug Acquisition Costs'!F38=\"\",\"\",'Drug Acquisition Costs'!F38)","v":""},{"$f":"IF('Drug Acquisition Costs'!G38=\"\",\"\",'Drug Acquisition Costs'!G38)","v":""},{"$f":"IF('Drug Acquisition Costs'!H38=\"\",\"\",'Drug Acquisition Costs'!H38)","v":""},{"$f":"IF('Drug Acquisition Costs'!I38=\"\",\"\",'Drug Acquisition Costs'!I38)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E39=\"\",\"\",'Drug Acquisition Costs'!E39)","v":""},{"$f":"IF('Drug Acquisition Costs'!F39=\"\",\"\",'Drug Acquisition Costs'!F39)","v":""},{"$f":"IF('Drug Acquisition Costs'!G39=\"\",\"\",'Drug Acquisition Costs'!G39)","v":""},{"$f":"IF('Drug Acquisition Costs'!H39=\"\",\"\",'Drug Acquisition Costs'!H39)","v":""},{"$f":"IF('Drug Acquisition Costs'!I39=\"\",\"\",'Drug Acquisition Costs'!I39)","v":""}]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "},null,null,{"$f":"IF('Drug Acquisition Costs'!E40=\"\",\"\",'Drug Acquisition Costs'!E40)","v":""},{"$f":"IF('Drug Acquisition Costs'!F40=\"\",\"\",'Drug Acquisition Costs'!F40)","v":""},{"$f":"IF('Drug Acquisition Costs'!G40=\"\",\"\",'Drug Acquisition Costs'!G40)","v":""},{"$f":"IF('Drug Acquisition Costs'!H40=\"\",\"\",'Drug Acquisition Costs'!H40)","v":""},{"$f":"IF('Drug Acquisition Costs'!I40=\"\",\"\",'Drug Acquisition Costs'!I40)","v":""}]
[]
[]
[null,{"$f":"CONCATENATE(\"Intervention: \",InterventionINN)","v":"Intervention: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave the extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,{"$f":"IF('Drug Acquisition Costs'!F49=\"\",\"\",'Drug Acquisition Costs'!F49)","v":""},{"$f":"IF('Drug Acquisition Costs'!G49=\"\",\"\",'Drug Acquisition Costs'!G49)","v":""},{"$f":"IF('Drug Acquisition Costs'!H49=\"\",\"\",'Drug Acquisition Costs'!H49)","v":""},{"$f":"IF('Drug Acquisition Costs'!I49=\"\",\"\",'Drug Acquisition Costs'!I49)","v":""},null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,{"$f":"IF('Drug Acquisition Costs'!F51=\"\",\"\",'Drug Acquisition Costs'!F51)","v":""},{"$f":"IF('Drug Acquisition Costs'!G51=\"\",\"\",'Drug Acquisition Costs'!G51)","v":""},{"$f":"IF('Drug Acquisition Costs'!H51=\"\",\"\",'Drug Acquisition Costs'!H51)","v":""},{"$f":"IF('Drug Acquisition Costs'!I51=\"\",\"\",'Drug Acquisition Costs'!I51)","v":""},null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[null,"CIC PAS (%)",null,null,null,null,null,null,null,null," - NB Please input proposed PAS as % discount exclusive of current Framework Agreement rebate"]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,{"$f":"IF('Drug Acquisition Costs'!F61=\"\",\"\",'Drug Acquisition Costs'!F61)","v":""},null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B49","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F49),\"\",F49)","v":""},{"$f":"IF(ISBLANK(G49),\"\",G49)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,{"$f":"IF('Drug Acquisition Costs'!F63=\"\",\"\",'Drug Acquisition Costs'!F63)","v":""},{"$f":"IF('Drug Acquisition Costs'!G63=\"\",\"\",'Drug Acquisition Costs'!G63)","v":""},{"$f":"IF('Drug Acquisition Costs'!H63=\"\",\"\",'Drug Acquisition Costs'!H63)","v":""},{"$f":"IF('Drug Acquisition Costs'!I63=\"\",\"\",'Drug Acquisition Costs'!I63)","v":""},null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F49=\"\",\"\",F49)","v":""},{"$f":"IF(G49=\"\",\"\",G49)","v":""},{"$f":"IF(H49=\"\",\"\",H49)","v":""},{"$f":"IF(I49=\"\",\"\",I49)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F50=\"\",F51=\"\",F52=\"\"),\"\",IF(F50=\"Price to Wholesaler\",F51,IF(F50=\"Reimbursement Price\",(F74/(1+E73)*1),\"Error\")))","v":""},{"$f":"IF(OR(G50=\"\",G51=\"\",F52=\"\"),\"\",IF(G50=\"Price to Wholesaler\",G51,IF(G50=\"Reimbursement Price\",(G74/(1+E73)*1),\"Error\")))","v":""},{"$f":"IF(OR(H50=\"\",H51=\"\",F52=\"\"),\"\",IF(H50=\"Price to Wholesaler\",H51,IF(H50=\"Reimbursement Price\",(H74/(1+E73)*1),\"Error\")))","v":""},{"$f":"IF(OR(I50=\"\",I51=\"\",F52=\"\"),\"\",IF(I50=\"Price to Wholesaler\",I51,IF(I50=\"Reimbursement Price\",(I74/(1+E73)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F52=\"\"),\"\",IF(AND(F52=\"CDS\",F53=\"Yes\"),CYF,IF(AND(F52=\"CDS\",F53=\"No\"),CNF,IF(F52=\"HT\",CHT,IF(F52=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F52=\"\",F51=\"\",F50=\"\"),\"\",F72*E73)","v":""},{"$f":"IF(OR(F52=\"\",G51=\"\",G50=\"\"),\"\",G72*E73)","v":""},{"$f":"IF(OR(F52=\"\",H51=\"\",H50=\"\"),\"\",H72*E73)","v":""},{"$f":"IF(OR(F52=\"\",I51=\"\",I50=\"\"),\"\",I72*E73)","v":""}]
["C",{"$f":"IF(F52=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F50=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F50=\"Reimbursement Price\",F51,IF(ISBLANK(E73),\"\",IF(F50=\"Price to Wholesaler\",(F72+F73),IF(F50=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G50=\"Reimbursement Price\",G51,IF(ISBLANK(E73),\"\",IF(G50=\"Price to Wholesaler\",(G72+G73),IF(G50=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H50=\"Reimbursement Price\",H51,IF(ISBLANK(E73),\"\",IF(H50=\"Price to Wholesaler\",(H72+H73),IF(H50=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I50=\"Reimbursement Price\",I51,IF(ISBLANK(E73),\"\",IF(I50=\"Price to Wholesaler\",(I72+I73),IF(I50=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\")),\"\",IF(AND(F55=\"No\",F57=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F55=\"No\",F57=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F55=\"Yes\",F56=\"Biosimilar\"),\"None\",IF(AND(F55=\"Yes\",F56=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F55=\"Yes\",F56=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F55=\"Yes\",F56=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\"),F50=\"\",ISBLANK(F51)),\"\",IF(E75=\"None\",0,(E75*F72)))","v":""},{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\"),G50=\"\",ISBLANK(G51)),\"\",IF(E75=\"None\",0,(E75*G72)))","v":""},{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\"),H50=\"\",ISBLANK(H51)),\"\",IF(E75=\"None\",0,(E75*H72)))","v":""},{"$f":"IF(OR(F55=\"\",AND(F55=\"Yes\",F56=\"\"),AND(F55=\"No\",F57=\"\"),I50=\"\",ISBLANK(I51)),\"\",IF(E75=\"None\",0,(E75*I72)))","v":""}]
[null,null,null,"CIC PAS",{"$f":" IF(F58=\"\", \"\", -F58)","v":""},{"$f":"IF(F51=\"\", \"\", F72*$E76)","v":""},{"$f":"IF(G51=\"\", \"\", G72*$E76)","v":""},"",""]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F54=\"\",\"\",IF(F54=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B54=\"\",F51=\"\",ISBLANK(F51)),\"\",($E77*F74))","v":""},{"$f":"IF(OR($B54=\"\",G51=\"\",ISBLANK(G51)),\"\",($E77*G74))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack with CIC PAS including VAT",null,null,null,{"$f":"IF(OR(F50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(F74:F77))","v":""},{"$f":"IF(OR(G50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(G74:G77))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack with CIC PAS excluding VAT",null,null,null,{"$f":"IF(OR(F50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(F74:F76))","v":""},{"$f":"IF(OR(G50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(G74:G76))","v":""},{"$f":"IF(OR(H50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(H74:H76))","v":""},{"$f":"IF(OR(I50=\"\",$F52=\"\",$F54=\"\",$F55=\"\"),\"\",SUM(I74:I76))","v":""}]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F52=\"\",\"\",IF(F52=\"CDS\",\"per dispensing\",IF(F52=\"HT\",\"per month\",IF(F52=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F52=\"\",\"\",IF(F52=\"CDS\",DF,IF(F52=\"HT\",PC,IF(F52=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F52=\"\",F54=\"\"),\"\",IF(F52=\"Hosp\",\"No Fee\",IF(F52=\"HT\",\"No VAT\",IF(AND(F52=\"CDS\",F54=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F54=\"\",F52=\"Hosp\"),\"\",IF(OR(F54=\"Yes\",F52=\"HT\"),0,H86*G87))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F52=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F52=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,{"$f":"IF('Drug Acquisition Costs'!G90=\"\",\"\",'Drug Acquisition Costs'!G90)","v":""},{"$f":"IF('Drug Acquisition Costs'!H90=\"\",\"\",'Drug Acquisition Costs'!H90)","v":""}]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,{"$f":"IF('Drug Acquisition Costs'!G91=\"\",\"\",'Drug Acquisition Costs'!G91)","v":""},{"$f":"IF('Drug Acquisition Costs'!H91=\"\",\"\",'Drug Acquisition Costs'!H91)","v":""},null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,{"$f":"IF('Drug Acquisition Costs'!G92=\"\",\"\",'Drug Acquisition Costs'!G92)","v":""},{"$f":"IF('Drug Acquisition Costs'!H92=\"\",\"\",'Drug Acquisition Costs'!H92)","v":""},null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H92),\"\",SUM(H92:H94))","v":0}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H92),\"\",SUM(H92:H93))","v":0}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time required  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[null,null,null,null,null,null,{"$f":"IF('Drug Acquisition Costs'!G100=\"\",\"\",'Drug Acquisition Costs'!G100)","v":""},null,{"$f":"IF('Drug Acquisition Costs'!I100=\"\",\"\",'Drug Acquisition Costs'!I100)","v":""}]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B72","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F72:I72,F64:I64)","v":0},{"$f":"F104*G102","v":{"$error":"#VALUE!"}},{"$f":"IF(H62=\"Days\",F104/F62*365.25,IF(H62=\"Months\",F104/F62*12,\"\"))","v":""},{"$f":"IF(AND(H62=\"Days\",I103=\"Days\"),F104/F62*I102,IF(AND(H62=\"Months\",I103=\"Months\"),F104/F62*I102,IF(AND(H62=\"Days\",I103=\"Months\"),F104/F62*30.4375*I102,IF(AND(H62=\"Months\",I103=\"Days\"),F104/F62/30.4375*I102,\"\"))))","v":""}]
["B",{"$f":"B73","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F73:I73,F64:I64)","v":0},{"$f":"F105*G102","v":{"$error":"#VALUE!"}},{"$f":"IF(H62=\"Days\",F105/F62*365.25,IF(H62=\"Months\",F105/F62*12,\"\"))","v":""},{"$f":"IF(AND(H62=\"Days\",I103=\"Days\"),F105/F62*I102,IF(AND(H62=\"Months\",I103=\"Months\"),F105/F62*I102,IF(AND(H62=\"Days\",I103=\"Months\"),F105/F62*30.4375*I102,IF(AND(H62=\"Months\",I103=\"Days\"),F105/F62/30.4375*I102,\"\"))))","v":""}]
["C",{"$f":"B74","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F74:I74,F64:I64)","v":0},{"$f":"F106*G102","v":{"$error":"#VALUE!"}},{"$f":"IF(H62=\"Days\",F106/F62*365.25,IF(H62=\"Months\",F106/F62*12,\"\"))","v":""},{"$f":"IF(AND(H62=\"Days\",I103=\"Days\"),F106/F62*I102,IF(AND(H62=\"Months\",I103=\"Months\"),F106/F62*I102,IF(AND(H62=\"Days\",I103=\"Months\"),F106/F62*30.4375*I102,IF(AND(H62=\"Months\",I103=\"Days\"),F106/F62/30.4375*I102,\"\"))))","v":""}]
["D",{"$f":"B75","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F75:I75,F64:I64)","v":0},{"$f":"F107*G102","v":{"$error":"#VALUE!"}},{"$f":"IF(H62=\"Days\",F107/F62*365.25,IF(H62=\"Months\",F107/F62*12,\"\"))","v":""},{"$f":"IF(AND(H62=\"Days\",I103=\"Days\"),F107/F62*I102,IF(AND(H62=\"Months\",I103=\"Months\"),F107/F62*I102,IF(AND(H62=\"Days\",I103=\"Months\"),F107/F62*30.4375*I102,IF(AND(H62=\"Months\",I103=\"Days\"),F107/F62/30.4375*I102,\"\"))))","v":""}]
[null,"CIC PAS",null,null,null,{"$f":"SUMPRODUCT(F76:I76,F64:I64)","v":0},{"$f":" F108*G102","v":{"$error":"#VALUE!"}},{"$f":"IF(H62=\"Days\",F108/F62*365.25,IF(H62=\"Months\",F108/F62*12,\"\"))","v":""},{"$f":"IF(AND(H62=\"Days\",I103=\"Days\"),F108/F62*I102,IF(AND(H62=\"Months\",I103=\"Months\"),F108/F62*I102,IF(AND(H62=\"Days\",I103=\"Months\"),F108/F62*30.4375*I102,IF(AND(H62=\"Months\",I103=\"Days\"),F108/F62/30.4375*I102,\"\"))))","v":""}]
["E",{"$f":"B77","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F77:I77,F64:I64)","v":0},{"$f":"F109*G102","v":{"$error":"#VALUE!"}},{"$f":"IF(H62=\"Days\",F109/F62*365.25,IF(H62=\"Months\",F109/F62*12,\"\"))","v":""},{"$f":"IF(AND(H62=\"Days\",I103=\"Days\"),F109/F62*I102,IF(AND(H62=\"Months\",I103=\"Months\"),F109/F62*I102,IF(AND(H62=\"Days\",I103=\"Months\"),F109/F62*30.4375*I102,IF(AND(H62=\"Months\",I103=\"Days\"),F109/F62/30.4375*I102,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H95=\"\",\"\",H95)","v":0},{"$f":"IF(F110=\"\",\"\",F110*G102)","v":{"$error":"#VALUE!"}},{"$f":"IF(F110=\"\",\"\",IF(H62=\"Days\",F110/F62*365.25,IF(H62=\"Months\",F110/F62*12,\"\")))","v":""},{"$f":"IF(F110=\"\",\"\",IF(AND(H62=\"Days\",I103=\"Days\"),F110/F62*I102,IF(AND(H62=\"Months\",I103=\"Months\"),F110/F62*I102,IF(AND(H62=\"Days\",I103=\"Months\"),F110/F62*30.4375*I102,IF(AND(H62=\"Months\",I103=\"Days\"),F110/F62/30.4375*I102,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H96=\"\",\"\",H96)","v":0},{"$f":"IF(F111=\"\",\"\",F111*G102)","v":{"$error":"#VALUE!"}},{"$f":"IF(F111=\"\",\"\",IF(H62=\"Days\",F111/F62*365.25,IF(H62=\"Months\",F111/F62*12,\"\")))","v":""},{"$f":"IF(F111=\"\",\"\",IF(AND(H62=\"Days\",I103=\"Days\"),F111/F62*I102,IF(AND(H62=\"Months\",I103=\"Months\"),F111/F62*I102,IF(AND(H62=\"Days\",I103=\"Months\"),F111/F62*30.4375*I102,IF(AND(H62=\"Months\",I103=\"Days\"),F111/F62/30.4375*I102,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F106:F110)","v":0},{"$f":"SUM(G106:G110)","v":{"$error":"#VALUE!"}},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F111=\"\",SUM(F106+F107+F108),F106+F107+F108+F111)","v":0},{"$f":"IF(G111=\"\",SUM(G106+G107+G108),G106+G107+G108+G111)","v":{"$error":"#VALUE!"}},{"$f":"IF(H111=\"\",SUM(H106+H107+H108),H106+H107+H108+H111)","v":{"$error":"#VALUE!"}},{"$f":"IF(I111=\"\",SUM(I106+I107+I108),I106+I107+I108+I111)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B134","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F134),\"\",F134)","v":""},{"$f":"IF(ISBLANK(G134),\"\",G134)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F134=\"\",\"\",F134)","v":""},{"$f":"IF(G134=\"\",\"\",G134)","v":""},{"$f":"IF(H134=\"\",\"\",H134)","v":""},{"$f":"IF(I134=\"\",\"\",I134)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F135=\"\",F136=\"\",F137=\"\"),\"\",IF(F135=\"Price to Wholesaler\",F136,IF(F135=\"Reimbursement Price\",(F158/(1+E157)*1),\"Error\")))","v":""},{"$f":"IF(OR(G135=\"\",G136=\"\",F137=\"\"),\"\",IF(G135=\"Price to Wholesaler\",G136,IF(G135=\"Reimbursement Price\",(G158/(1+E157)*1),\"Error\")))","v":""},{"$f":"IF(OR(H135=\"\",H136=\"\",F137=\"\"),\"\",IF(H135=\"Price to Wholesaler\",H136,IF(H135=\"Reimbursement Price\",(H158/(1+E157)*1),\"Error\")))","v":""},{"$f":"IF(OR(I135=\"\",I136=\"\",F137=\"\"),\"\",IF(I135=\"Price to Wholesaler\",I136,IF(I135=\"Reimbursement Price\",(I158/(1+E157)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F137=\"\"),\"\",IF(AND(F137=\"CDS\",F138=\"Yes\"),CYF,IF(AND(F137=\"CDS\",F138=\"No\"),CNF,IF(F137=\"HT\",CHT,IF(F137=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F137=\"\",F136=\"\",F135=\"\"),\"\",F156*E157)","v":""},{"$f":"IF(OR(F137=\"\",G136=\"\",G135=\"\"),\"\",G156*E157)","v":""},{"$f":"IF(OR(F137=\"\",H136=\"\",H135=\"\"),\"\",H156*E157)","v":""},{"$f":"IF(OR(F137=\"\",I136=\"\",I135=\"\"),\"\",I156*E157)","v":""}]
["C",{"$f":"IF(F137=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F135=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F135=\"Reimbursement Price\",F136,IF(ISBLANK(E157),\"\",IF(F135=\"Price to Wholesaler\",(F156+F157),IF(F135=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G135=\"Reimbursement Price\",G136,IF(ISBLANK(E157),\"\",IF(G135=\"Price to Wholesaler\",(G156+G157),IF(G135=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H135=\"Reimbursement Price\",H136,IF(ISBLANK(E157),\"\",IF(H135=\"Price to Wholesaler\",(H156+H157),IF(H135=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I135=\"Reimbursement Price\",I136,IF(ISBLANK(E157),\"\",IF(I135=\"Price to Wholesaler\",(I156+I157),IF(I135=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\")),\"\",IF(AND(F140=\"No\",F142=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F140=\"No\",F142=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F140=\"Yes\",F141=\"Biosimilar\"),\"None\",IF(AND(F140=\"Yes\",F141=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F140=\"Yes\",F141=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F140=\"Yes\",F141=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\"),F135=\"\",ISBLANK(F136)),\"\",IF(E159=\"None\",0,(E159*F156)))","v":""},{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\"),G135=\"\",ISBLANK(G136)),\"\",IF(E159=\"None\",0,(E159*G156)))","v":""},{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\"),H135=\"\",ISBLANK(H136)),\"\",IF(E159=\"None\",0,(E159*H156)))","v":""},{"$f":"IF(OR(F140=\"\",AND(F140=\"Yes\",F141=\"\"),AND(F140=\"No\",F142=\"\"),I135=\"\",ISBLANK(I136)),\"\",IF(E159=\"None\",0,(E159*I156)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F139=\"\",\"\",IF(F139=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B139=\"\",F136=\"\",ISBLANK(F136)),\"\",($E160*F158))","v":""},{"$f":"IF(OR($B139=\"\",G136=\"\",ISBLANK(G136)),\"\",($E160*G158))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(F158:F160))","v":""},{"$f":"IF(OR(G135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(G158:G160))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(F158:F159))","v":""},{"$f":"IF(OR(G135=\"\",$F137=\"\",$F139=\"\",$F140=\"\"),\"\",SUM(G158:G159))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F137=\"\",\"\",IF(F137=\"CDS\",\"per dispensing\",IF(F137=\"HT\",\"per month\",IF(F137=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F137=\"\",\"\",IF(F137=\"CDS\",DF,IF(F137=\"HT\",PC,IF(F137=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F137=\"\",F139=\"\"),\"\",IF(F137=\"Hosp\",\"No Fee\",IF(F137=\"HT\",\"No VAT\",IF(AND(F137=\"CDS\",F139=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F139=\"\",F137=\"Hosp\"),\"\",IF(OR(F139=\"Yes\",F137=\"HT\"),0,H169*G170))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F137=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F137=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H175),\"\",SUM(H175:H177))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H175),\"\",SUM(H175:H176))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B156","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F156:I156,F148:I148)","v":0},{"$f":"F187*G185","v":0},{"$f":"IF(H146=\"Days\",F187/F146*365.25,IF(H146=\"Months\",F187/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F187/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F187/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F187/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F187/F146/30.4375*I185,\"\"))))","v":""}]
["B",{"$f":"B157","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F157:I157,F148:I148)","v":0},{"$f":"F188*G185","v":0},{"$f":"IF(H146=\"Days\",F188/F146*365.25,IF(H146=\"Months\",F188/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F188/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F188/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F188/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F188/F146/30.4375*I185,\"\"))))","v":""}]
["C",{"$f":"B158","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F158:I158,F148:I148)","v":0},{"$f":"F189*G185","v":0},{"$f":"IF(H146=\"Days\",F189/F146*365.25,IF(H146=\"Months\",F189/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F189/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F189/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F189/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F189/F146/30.4375*I185,\"\"))))","v":""}]
["D",{"$f":"B159","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F159:I159,F148:I148)","v":0},{"$f":"F190*G185","v":0},{"$f":"IF(H146=\"Days\",F190/F146*365.25,IF(H146=\"Months\",F190/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F190/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F190/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F190/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F190/F146/30.4375*I185,\"\"))))","v":""}]
["E",{"$f":"B160","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F160:I160,F148:I148)","v":0},{"$f":"F191*G185","v":0},{"$f":"IF(H146=\"Days\",F191/F146*365.25,IF(H146=\"Months\",F191/F146*12,\"\"))","v":""},{"$f":"IF(AND(H146=\"Days\",I186=\"Days\"),F191/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F191/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F191/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F191/F146/30.4375*I185,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H178=\"\",\"\",H178)","v":""},{"$f":"IF(F192=\"\",\"\",F192*G185)","v":""},{"$f":"IF(F192=\"\",\"\",IF(H146=\"Days\",F192/F146*365.25,IF(H146=\"Months\",F192/F146*12,\"\")))","v":""},{"$f":"IF(F192=\"\",\"\",IF(AND(H146=\"Days\",I186=\"Days\"),F192/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F192/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F192/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F192/F146/30.4375*I185,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H179=\"\",\"\",H179)","v":""},{"$f":"IF(F193=\"\",\"\",F193*G185)","v":""},{"$f":"IF(F193=\"\",\"\",IF(H146=\"Days\",F193/F146*365.25,IF(H146=\"Months\",F193/F146*12,\"\")))","v":""},{"$f":"IF(F193=\"\",\"\",IF(AND(H146=\"Days\",I186=\"Days\"),F193/F146*I185,IF(AND(H146=\"Months\",I186=\"Months\"),F193/F146*I185,IF(AND(H146=\"Days\",I186=\"Months\"),F193/F146*30.4375*I185,IF(AND(H146=\"Months\",I186=\"Days\"),F193/F146/30.4375*I185,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F189:F192)","v":0},{"$f":"SUM(G189:G192)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F193=\"\",SUM(F189+F190),F189+F190+F193)","v":0},{"$f":"IF(G193=\"\",SUM(G189+G190),G189+G190+G193)","v":0},{"$f":"IF(H193=\"\",SUM(H189+H190),H189+H190+H193)","v":{"$error":"#VALUE!"}},{"$f":"IF(I193=\"\",SUM(I189+I190),I189+I190+I193)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B219","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F219),\"\",F219)","v":""},{"$f":"IF(ISBLANK(G219),\"\",G219)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F219=\"\",\"\",F219)","v":""},{"$f":"IF(G219=\"\",\"\",G219)","v":""},{"$f":"IF(H219=\"\",\"\",H219)","v":""},{"$f":"IF(I219=\"\",\"\",I219)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F220=\"\",F221=\"\",F222=\"\"),\"\",IF(F220=\"Price to Wholesaler\",F221,IF(F220=\"Reimbursement Price\",(F243/(1+E242)*1),\"Error\")))","v":""},{"$f":"IF(OR(G220=\"\",G221=\"\",F222=\"\"),\"\",IF(G220=\"Price to Wholesaler\",G221,IF(G220=\"Reimbursement Price\",(G243/(1+E242)*1),\"Error\")))","v":""},{"$f":"IF(OR(H220=\"\",H221=\"\",F222=\"\"),\"\",IF(H220=\"Price to Wholesaler\",H221,IF(H220=\"Reimbursement Price\",(H243/(1+E242)*1),\"Error\")))","v":""},{"$f":"IF(OR(I220=\"\",I221=\"\",F222=\"\"),\"\",IF(I220=\"Price to Wholesaler\",I221,IF(I220=\"Reimbursement Price\",(I243/(1+E242)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F222=\"\"),\"\",IF(AND(F222=\"CDS\",F223=\"Yes\"),CYF,IF(AND(F222=\"CDS\",F223=\"No\"),CNF,IF(F222=\"HT\",CHT,IF(F222=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F222=\"\",F221=\"\",F220=\"\"),\"\",F241*E242)","v":""},{"$f":"IF(OR(F222=\"\",G221=\"\",G220=\"\"),\"\",G241*E242)","v":""},{"$f":"IF(OR(F222=\"\",H221=\"\",H220=\"\"),\"\",H241*E242)","v":""},{"$f":"IF(OR(F222=\"\",I221=\"\",I220=\"\"),\"\",I241*E242)","v":""}]
["C",{"$f":"IF(F222=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F220=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F220=\"Reimbursement Price\",F221,IF(ISBLANK(E242),\"\",IF(F220=\"Price to Wholesaler\",(F241+F242),IF(F220=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G220=\"Reimbursement Price\",G221,IF(ISBLANK(E242),\"\",IF(G220=\"Price to Wholesaler\",(G241+G242),IF(G220=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H220=\"Reimbursement Price\",H221,IF(ISBLANK(E242),\"\",IF(H220=\"Price to Wholesaler\",(H241+H242),IF(H220=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I220=\"Reimbursement Price\",I221,IF(ISBLANK(E242),\"\",IF(I220=\"Price to Wholesaler\",(I241+I242),IF(I220=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\")),\"\",IF(AND(F225=\"No\",F227=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F225=\"No\",F227=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F225=\"Yes\",F226=\"Biosimilar\"),\"None\",IF(AND(F225=\"Yes\",F226=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F225=\"Yes\",F226=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F225=\"Yes\",F226=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\"),F220=\"\",ISBLANK(F221)),\"\",IF(E244=\"None\",0,(E244*F241)))","v":""},{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\"),G220=\"\",ISBLANK(G221)),\"\",IF(E244=\"None\",0,(E244*G241)))","v":""},{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\"),H220=\"\",ISBLANK(H221)),\"\",IF(E244=\"None\",0,(E244*H241)))","v":""},{"$f":"IF(OR(F225=\"\",AND(F225=\"Yes\",F226=\"\"),AND(F225=\"No\",F227=\"\"),I220=\"\",ISBLANK(I221)),\"\",IF(E244=\"None\",0,(E244*I241)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F224=\"\",\"\",IF(F224=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B224=\"\",F221=\"\",ISBLANK(F221)),\"\",($E245*F243))","v":""},{"$f":"IF(OR($B224=\"\",G221=\"\",ISBLANK(G221)),\"\",($E245*G243))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(F243:F245))","v":""},{"$f":"IF(OR(G220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(G243:G245))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(F243:F244))","v":""},{"$f":"IF(OR(G220=\"\",$F222=\"\",$F224=\"\",$F225=\"\"),\"\",SUM(G243:G244))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F222=\"\",\"\",IF(F222=\"CDS\",\"per dispensing\",IF(F222=\"HT\",\"per month\",IF(F222=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F222=\"\",\"\",IF(F222=\"CDS\",DF,IF(F222=\"HT\",PC,IF(F222=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F222=\"\",F224=\"\"),\"\",IF(F222=\"Hosp\",\"No Fee\",IF(F222=\"HT\",\"No VAT\",IF(AND(F222=\"CDS\",F224=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F224=\"\",F222=\"Hosp\"),\"\",IF(OR(F224=\"Yes\",F222=\"HT\"),0,H254*G255))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F222=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F222=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H260),\"\",SUM(H260:H262))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H260),\"\",SUM(H260:H261))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B241","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F241:I241,F233:I233)","v":0},{"$f":"F272*G270","v":0},{"$f":"IF(H231=\"Days\",F272/F231*365.25,IF(H231=\"Months\",F272/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F272/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F272/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F272/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F272/F231/30.4375*I270,\"\"))))","v":""}]
["B",{"$f":"B242","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F242:I242,F233:I233)","v":0},{"$f":"F273*G270","v":0},{"$f":"IF(H231=\"Days\",F273/F231*365.25,IF(H231=\"Months\",F273/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F273/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F273/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F273/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F273/F231/30.4375*I270,\"\"))))","v":""}]
["C",{"$f":"B243","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F243:I243,F233:I233)","v":0},{"$f":"F274*G270","v":0},{"$f":"IF(H231=\"Days\",F274/F231*365.25,IF(H231=\"Months\",F274/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F274/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F274/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F274/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F274/F231/30.4375*I270,\"\"))))","v":""}]
["D",{"$f":"B244","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F244:I244,F233:I233)","v":0},{"$f":"F275*G270","v":0},{"$f":"IF(H231=\"Days\",F275/F231*365.25,IF(H231=\"Months\",F275/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F275/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F275/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F275/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F275/F231/30.4375*I270,\"\"))))","v":""}]
["E",{"$f":"B245","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F245:I245,F233:I233)","v":0},{"$f":"F276*G270","v":0},{"$f":"IF(H231=\"Days\",F276/F231*365.25,IF(H231=\"Months\",F276/F231*12,\"\"))","v":""},{"$f":"IF(AND(H231=\"Days\",I271=\"Days\"),F276/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F276/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F276/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F276/F231/30.4375*I270,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H263=\"\",\"\",H263)","v":""},{"$f":"IF(F277=\"\",\"\",F277*G270)","v":""},{"$f":"IF(F277=\"\",\"\",IF(H231=\"Days\",F277/F231*365.25,IF(H231=\"Months\",F277/F231*12,\"\")))","v":""},{"$f":"IF(F277=\"\",\"\",IF(AND(H231=\"Days\",I271=\"Days\"),F277/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F277/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F277/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F277/F231/30.4375*I270,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H264=\"\",\"\",H264)","v":""},{"$f":"IF(F278=\"\",\"\",F278*G270)","v":""},{"$f":"IF(F278=\"\",\"\",IF(H231=\"Days\",F278/F231*365.25,IF(H231=\"Months\",F278/F231*12,\"\")))","v":""},{"$f":"IF(F278=\"\",\"\",IF(AND(H231=\"Days\",I271=\"Days\"),F278/F231*I270,IF(AND(H231=\"Months\",I271=\"Months\"),F278/F231*I270,IF(AND(H231=\"Days\",I271=\"Months\"),F278/F231*30.4375*I270,IF(AND(H231=\"Months\",I271=\"Days\"),F278/F231/30.4375*I270,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F274:F277)","v":0},{"$f":"SUM(G274:G277)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F278=\"\",SUM(F274+F275),F274+F275+F278)","v":0},{"$f":"IF(G278=\"\",SUM(G274+G275),G274+G275+G278)","v":0},{"$f":"IF(H278=\"\",SUM(H274+H275),H274+H275+H278)","v":{"$error":"#VALUE!"}},{"$f":"IF(I278=\"\",SUM(I274+I275),I274+I275+I278)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B305","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F305),\"\",F305)","v":""},{"$f":"IF(ISBLANK(G305),\"\",G305)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F305=\"\",\"\",F305)","v":""},{"$f":"IF(G305=\"\",\"\",G305)","v":""},{"$f":"IF(H305=\"\",\"\",H305)","v":""},{"$f":"IF(I305=\"\",\"\",I305)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F306=\"\",F307=\"\",F308=\"\"),\"\",IF(F306=\"Price to Wholesaler\",F307,IF(F306=\"Reimbursement Price\",(F329/(1+E328)*1),\"Error\")))","v":""},{"$f":"IF(OR(G306=\"\",G307=\"\",F308=\"\"),\"\",IF(G306=\"Price to Wholesaler\",G307,IF(G306=\"Reimbursement Price\",(G329/(1+E328)*1),\"Error\")))","v":""},{"$f":"IF(OR(H306=\"\",H307=\"\",F308=\"\"),\"\",IF(H306=\"Price to Wholesaler\",H307,IF(H306=\"Reimbursement Price\",(H329/(1+E328)*1),\"Error\")))","v":""},{"$f":"IF(OR(I306=\"\",I307=\"\",F308=\"\"),\"\",IF(I306=\"Price to Wholesaler\",I307,IF(I306=\"Reimbursement Price\",(I329/(1+E328)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F308=\"\"),\"\",IF(AND(F308=\"CDS\",F309=\"Yes\"),CYF,IF(AND(F308=\"CDS\",F309=\"No\"),CNF,IF(F308=\"HT\",CHT,IF(F308=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F308=\"\",F307=\"\",F306=\"\"),\"\",F327*E328)","v":""},{"$f":"IF(OR(F308=\"\",G307=\"\",G306=\"\"),\"\",G327*E328)","v":""},{"$f":"IF(OR(F308=\"\",H307=\"\",H306=\"\"),\"\",H327*E328)","v":""},{"$f":"IF(OR(F308=\"\",I307=\"\",I306=\"\"),\"\",I327*E328)","v":""}]
["C",{"$f":"IF(F308=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F306=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F306=\"Reimbursement Price\",F307,IF(ISBLANK(E328),\"\",IF(F306=\"Price to Wholesaler\",(F327+F328),IF(F306=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G306=\"Reimbursement Price\",G307,IF(ISBLANK(E328),\"\",IF(G306=\"Price to Wholesaler\",(G327+G328),IF(G306=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H306=\"Reimbursement Price\",H307,IF(ISBLANK(E328),\"\",IF(H306=\"Price to Wholesaler\",(H327+H328),IF(H306=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I306=\"Reimbursement Price\",I307,IF(ISBLANK(E328),\"\",IF(I306=\"Price to Wholesaler\",(I327+I328),IF(I306=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\")),\"\",IF(AND(F311=\"No\",F313=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F311=\"No\",F313=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F311=\"Yes\",F312=\"Biosimilar\"),\"None\",IF(AND(F311=\"Yes\",F312=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F311=\"Yes\",F312=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F311=\"Yes\",F312=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\"),F306=\"\",ISBLANK(F307)),\"\",IF(E330=\"None\",0,(E330*F327)))","v":""},{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\"),G306=\"\",ISBLANK(G307)),\"\",IF(E330=\"None\",0,(E330*G327)))","v":""},{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\"),H306=\"\",ISBLANK(H307)),\"\",IF(E330=\"None\",0,(E330*H327)))","v":""},{"$f":"IF(OR(F311=\"\",AND(F311=\"Yes\",F312=\"\"),AND(F311=\"No\",F313=\"\"),I306=\"\",ISBLANK(I307)),\"\",IF(E330=\"None\",0,(E330*I327)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F310=\"\",\"\",IF(F310=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B310=\"\",F307=\"\",ISBLANK(F307)),\"\",($E331*F329))","v":""},{"$f":"IF(OR($B310=\"\",G307=\"\",ISBLANK(G307)),\"\",($E331*G329))","v":""},{"$f":"IF(OR($B310=\"\",H307=\"\",ISBLANK(H307)),\"\",($E331*H329))","v":""},{"$f":"IF(OR($B310=\"\",I307=\"\",ISBLANK(I307)),\"\",($E331*I329))","v":""}]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(F329:F331))","v":""},{"$f":"IF(OR(G306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(G329:G331))","v":""},{"$f":"IF(OR(H306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(H329:H331))","v":""},{"$f":"IF(OR(I306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(I329:I331))","v":""}]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(F329:F330))","v":""},{"$f":"IF(OR(G306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(G329:G330))","v":""},{"$f":"IF(OR(H306=\"\",$F308=\"\",$F310=\"\",$F311=\"\"),\"\",SUM(H329:H330))","v":""},""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F308=\"\",\"\",IF(F308=\"CDS\",\"per dispensing\",IF(F308=\"HT\",\"per month\",IF(F308=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F308=\"\",\"\",IF(F308=\"CDS\",DF,IF(F308=\"HT\",PC,IF(F308=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F308=\"\",F310=\"\"),\"\",IF(F308=\"Hosp\",\"No Fee\",IF(F308=\"HT\",\"No VAT\",IF(AND(F308=\"CDS\",F310=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F310=\"\",F308=\"Hosp\"),\"\",IF(OR(F310=\"Yes\",F308=\"HT\"),0,H340*G341))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F308=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F308=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H346),\"\",SUM(H346:H348))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H346),\"\",SUM(H346:H347))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B327","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F327:I327,F319:I319)","v":0},{"$f":"F358*G356","v":0},{"$f":"IF(H317=\"Days\",F358/F317*365.25,IF(H317=\"Months\",F358/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F358/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F358/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F358/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F358/F317/30.4375*I356,\"\"))))","v":""}]
["B",{"$f":"B328","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F328:I328,F319:I319)","v":0},{"$f":"F359*G356","v":0},{"$f":"IF(H317=\"Days\",F359/F317*365.25,IF(H317=\"Months\",F359/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F359/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F359/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F359/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F359/F317/30.4375*I356,\"\"))))","v":""}]
["C",{"$f":"B329","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F329:I329,F319:I319)","v":0},{"$f":"F360*G356","v":0},{"$f":"IF(H317=\"Days\",F360/F317*365.25,IF(H317=\"Months\",F360/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F360/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F360/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F360/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F360/F317/30.4375*I356,\"\"))))","v":""}]
["D",{"$f":"B330","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F330:I330,F319:I319)","v":0},{"$f":"F361*G356","v":0},{"$f":"IF(H317=\"Days\",F361/F317*365.25,IF(H317=\"Months\",F361/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F361/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F361/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F361/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F361/F317/30.4375*I356,\"\"))))","v":""}]
["E",{"$f":"B331","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F331:I331,F319:I319)","v":0},{"$f":"F362*G356","v":0},{"$f":"IF(H317=\"Days\",F362/F317*365.25,IF(H317=\"Months\",F362/F317*12,\"\"))","v":""},{"$f":"IF(AND(H317=\"Days\",I357=\"Days\"),F362/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F362/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F362/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F362/F317/30.4375*I356,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H349=\"\",\"\",H349)","v":""},{"$f":"IF(F363=\"\",\"\",F363*G356)","v":""},{"$f":"IF(F363=\"\",\"\",IF(H317=\"Days\",F363/F317*365.25,IF(H317=\"Months\",F363/F317*12,\"\")))","v":""},{"$f":"IF(F363=\"\",\"\",IF(AND(H317=\"Days\",I357=\"Days\"),F363/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F363/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F363/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F363/F317/30.4375*I356,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H350=\"\",\"\",H350)","v":""},{"$f":"IF(F364=\"\",\"\",F364*G356)","v":""},{"$f":"IF(F364=\"\",\"\",IF(H317=\"Days\",F364/F317*365.25,IF(H317=\"Months\",F364/F317*12,\"\")))","v":""},{"$f":"IF(F364=\"\",\"\",IF(AND(H317=\"Days\",I357=\"Days\"),F364/F317*I356,IF(AND(H317=\"Months\",I357=\"Months\"),F364/F317*I356,IF(AND(H317=\"Days\",I357=\"Months\"),F364/F317*30.4375*I356,IF(AND(H317=\"Months\",I357=\"Days\"),F364/F317/30.4375*I356,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F360:F363)","v":0},{"$f":"SUM(G360:G363)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F364=\"\",SUM(F360+F361),F360+F361+F364)","v":0},{"$f":"IF(G364=\"\",SUM(G360+G361),G360+G361+G364)","v":0},{"$f":"IF(H364=\"\",SUM(H360+H361),H360+H361+H364)","v":{"$error":"#VALUE!"}},{"$f":"IF(I364=\"\",SUM(I360+I361),I360+I361+I364)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B390","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F390),\"\",F390)","v":""},{"$f":"IF(ISBLANK(G390),\"\",G390)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F390=\"\",\"\",F390)","v":""},{"$f":"IF(G390=\"\",\"\",G390)","v":""},{"$f":"IF(H390=\"\",\"\",H390)","v":""},{"$f":"IF(I390=\"\",\"\",I390)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F391=\"\",F392=\"\",F393=\"\"),\"\",IF(F391=\"Price to Wholesaler\",F392,IF(F391=\"Reimbursement Price\",(F414/(1+E413)*1),\"Error\")))","v":""},{"$f":"IF(OR(G391=\"\",G392=\"\",F393=\"\"),\"\",IF(G391=\"Price to Wholesaler\",G392,IF(G391=\"Reimbursement Price\",(G414/(1+E413)*1),\"Error\")))","v":""},{"$f":"IF(OR(H391=\"\",H392=\"\",F393=\"\"),\"\",IF(H391=\"Price to Wholesaler\",H392,IF(H391=\"Reimbursement Price\",(H414/(1+E413)*1),\"Error\")))","v":""},{"$f":"IF(OR(I391=\"\",I392=\"\",F393=\"\"),\"\",IF(I391=\"Price to Wholesaler\",I392,IF(I391=\"Reimbursement Price\",(I414/(1+E413)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F393=\"\"),\"\",IF(AND(F393=\"CDS\",F394=\"Yes\"),CYF,IF(AND(F393=\"CDS\",F394=\"No\"),CNF,IF(F393=\"HT\",CHT,IF(F393=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F393=\"\",F392=\"\",F391=\"\"),\"\",F412*E413)","v":""},{"$f":"IF(OR(F393=\"\",G392=\"\",G391=\"\"),\"\",G412*E413)","v":""},{"$f":"IF(OR(F393=\"\",H392=\"\",H391=\"\"),\"\",H412*E413)","v":""},{"$f":"IF(OR(F393=\"\",I392=\"\",I391=\"\"),\"\",I412*E413)","v":""}]
["C",{"$f":"IF(F393=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F391=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F391=\"Reimbursement Price\",F392,IF(ISBLANK(E413),\"\",IF(F391=\"Price to Wholesaler\",(F412+F413),IF(F391=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G391=\"Reimbursement Price\",G392,IF(ISBLANK(E413),\"\",IF(G391=\"Price to Wholesaler\",(G412+G413),IF(G391=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H391=\"Reimbursement Price\",H392,IF(ISBLANK(E413),\"\",IF(H391=\"Price to Wholesaler\",(H412+H413),IF(H391=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I391=\"Reimbursement Price\",I392,IF(ISBLANK(E413),\"\",IF(I391=\"Price to Wholesaler\",(I412+I413),IF(I391=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\")),\"\",IF(AND(F396=\"No\",F398=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F396=\"No\",F398=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F396=\"Yes\",F397=\"Biosimilar\"),\"None\",IF(AND(F396=\"Yes\",F397=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F396=\"Yes\",F397=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F396=\"Yes\",F397=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\"),F391=\"\",ISBLANK(F392)),\"\",IF(E415=\"None\",0,(E415*F412)))","v":""},{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\"),G391=\"\",ISBLANK(G392)),\"\",IF(E415=\"None\",0,(E415*G412)))","v":""},{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\"),H391=\"\",ISBLANK(H392)),\"\",IF(E415=\"None\",0,(E415*H412)))","v":""},{"$f":"IF(OR(F396=\"\",AND(F396=\"Yes\",F397=\"\"),AND(F396=\"No\",F398=\"\"),I391=\"\",ISBLANK(I392)),\"\",IF(E415=\"None\",0,(E415*I412)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F395=\"\",\"\",IF(F395=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B395=\"\",F392=\"\",ISBLANK(F392)),\"\",($E416*F414))","v":""},{"$f":"IF(OR($B395=\"\",G392=\"\",ISBLANK(G392)),\"\",($E416*G414))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(F414:F416))","v":""},{"$f":"IF(OR(G391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(G414:G416))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(F414:F415))","v":""},{"$f":"IF(OR(G391=\"\",$F393=\"\",$F395=\"\",$F396=\"\"),\"\",SUM(G414:G415))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F393=\"\",\"\",IF(F393=\"CDS\",\"per dispensing\",IF(F393=\"HT\",\"per month\",IF(F393=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F393=\"\",\"\",IF(F393=\"CDS\",DF,IF(F393=\"HT\",PC,IF(F393=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F393=\"\",F395=\"\"),\"\",IF(F393=\"Hosp\",\"No Fee\",IF(F393=\"HT\",\"No VAT\",IF(AND(F393=\"CDS\",F395=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F395=\"\",F393=\"Hosp\"),\"\",IF(OR(F395=\"Yes\",F393=\"HT\"),0,H425*G426))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F393=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F393=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H431),\"\",SUM(H431:H433))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H431),\"\",SUM(H431:H432))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B412","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F412:I412,F404:I404)","v":0},{"$f":"F443*G441","v":0},{"$f":"IF(H402=\"Days\",F443/F402*365.25,IF(H402=\"Months\",F443/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F443/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F443/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F443/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F443/F402/30.4375*I441,\"\"))))","v":""}]
["B",{"$f":"B413","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F413:I413,F404:I404)","v":0},{"$f":"F444*G441","v":0},{"$f":"IF(H402=\"Days\",F444/F402*365.25,IF(H402=\"Months\",F444/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F444/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F444/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F444/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F444/F402/30.4375*I441,\"\"))))","v":""}]
["C",{"$f":"B414","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F414:I414,F404:I404)","v":0},{"$f":"F445*G441","v":0},{"$f":"IF(H402=\"Days\",F445/F402*365.25,IF(H402=\"Months\",F445/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F445/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F445/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F445/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F445/F402/30.4375*I441,\"\"))))","v":""}]
["D",{"$f":"B415","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F415:I415,F404:I404)","v":0},{"$f":"F446*G441","v":0},{"$f":"IF(H402=\"Days\",F446/F402*365.25,IF(H402=\"Months\",F446/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F446/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F446/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F446/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F446/F402/30.4375*I441,\"\"))))","v":""}]
["E",{"$f":"B416","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F416:I416,F404:I404)","v":0},{"$f":"F447*G441","v":0},{"$f":"IF(H402=\"Days\",F447/F402*365.25,IF(H402=\"Months\",F447/F402*12,\"\"))","v":""},{"$f":"IF(AND(H402=\"Days\",I442=\"Days\"),F447/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F447/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F447/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F447/F402/30.4375*I441,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H434=\"\",\"\",H434)","v":""},{"$f":"IF(F448=\"\",\"\",F448*G441)","v":""},{"$f":"IF(F448=\"\",\"\",IF(H402=\"Days\",F448/F402*365.25,IF(H402=\"Months\",F448/F402*12,\"\")))","v":""},{"$f":"IF(F448=\"\",\"\",IF(AND(H402=\"Days\",I442=\"Days\"),F448/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F448/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F448/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F448/F402/30.4375*I441,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H435=\"\",\"\",H435)","v":""},{"$f":"IF(F449=\"\",\"\",F449*G441)","v":""},{"$f":"IF(F449=\"\",\"\",IF(H402=\"Days\",F449/F402*365.25,IF(H402=\"Months\",F449/F402*12,\"\")))","v":""},{"$f":"IF(F449=\"\",\"\",IF(AND(H402=\"Days\",I442=\"Days\"),F449/F402*I441,IF(AND(H402=\"Months\",I442=\"Months\"),F449/F402*I441,IF(AND(H402=\"Days\",I442=\"Months\"),F449/F402*30.4375*I441,IF(AND(H402=\"Months\",I442=\"Days\"),F449/F402/30.4375*I441,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F445:F448)","v":0},{"$f":"SUM(G445:G448)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F449=\"\",SUM(F445+F446),F445+F446+F449)","v":0},{"$f":"IF(G449=\"\",SUM(G445+G446),G445+G446+G449)","v":0},{"$f":"IF(H449=\"\",SUM(H445+H446),H445+H446+H449)","v":{"$error":"#VALUE!"}},{"$f":"IF(I449=\"\",SUM(I445+I446),I445+I446+I449)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B476","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F476),\"\",F476)","v":""},{"$f":"IF(ISBLANK(G476),\"\",G476)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F476=\"\",\"\",F476)","v":""},{"$f":"IF(G476=\"\",\"\",G476)","v":""},{"$f":"IF(H476=\"\",\"\",H476)","v":""},{"$f":"IF(I476=\"\",\"\",I476)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F477=\"\",F478=\"\",F479=\"\"),\"\",IF(F477=\"Price to Wholesaler\",F478,IF(F477=\"Reimbursement Price\",(F500/(1+E499)*1),\"Error\")))","v":""},{"$f":"IF(OR(G477=\"\",G478=\"\",F479=\"\"),\"\",IF(G477=\"Price to Wholesaler\",G478,IF(G477=\"Reimbursement Price\",(G500/(1+E499)*1),\"Error\")))","v":""},{"$f":"IF(OR(H477=\"\",H478=\"\",F479=\"\"),\"\",IF(H477=\"Price to Wholesaler\",H478,IF(H477=\"Reimbursement Price\",(H500/(1+E499)*1),\"Error\")))","v":""},{"$f":"IF(OR(I477=\"\",I478=\"\",F479=\"\"),\"\",IF(I477=\"Price to Wholesaler\",I478,IF(I477=\"Reimbursement Price\",(I500/(1+E499)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F479=\"\"),\"\",IF(AND(F479=\"CDS\",F480=\"Yes\"),CYF,IF(AND(F479=\"CDS\",F480=\"No\"),CNF,IF(F479=\"HT\",CHT,IF(F479=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F479=\"\",F478=\"\",F477=\"\"),\"\",F498*E499)","v":""},{"$f":"IF(OR(F479=\"\",G478=\"\",G477=\"\"),\"\",G498*E499)","v":""},{"$f":"IF(OR(F479=\"\",H478=\"\",H477=\"\"),\"\",H498*E499)","v":""},{"$f":"IF(OR(F479=\"\",I478=\"\",I477=\"\"),\"\",I498*E499)","v":""}]
["C",{"$f":"IF(F479=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F477=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F477=\"Reimbursement Price\",F478,IF(ISBLANK(E499),\"\",IF(F477=\"Price to Wholesaler\",(F498+F499),IF(F477=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G477=\"Reimbursement Price\",G478,IF(ISBLANK(E499),\"\",IF(G477=\"Price to Wholesaler\",(G498+G499),IF(G477=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H477=\"Reimbursement Price\",H478,IF(ISBLANK(E499),\"\",IF(H477=\"Price to Wholesaler\",(H498+H499),IF(H477=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I477=\"Reimbursement Price\",I478,IF(ISBLANK(E499),\"\",IF(I477=\"Price to Wholesaler\",(I498+I499),IF(I477=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\")),\"\",IF(AND(F482=\"No\",F484=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F482=\"No\",F484=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F482=\"Yes\",F483=\"Biosimilar\"),\"None\",IF(AND(F482=\"Yes\",F483=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F482=\"Yes\",F483=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F482=\"Yes\",F483=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\"),F477=\"\",ISBLANK(F478)),\"\",IF(E501=\"None\",0,(E501*F498)))","v":""},{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\"),G477=\"\",ISBLANK(G478)),\"\",IF(E501=\"None\",0,(E501*G498)))","v":""},{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\"),H477=\"\",ISBLANK(H478)),\"\",IF(E501=\"None\",0,(E501*H498)))","v":""},{"$f":"IF(OR(F482=\"\",AND(F482=\"Yes\",F483=\"\"),AND(F482=\"No\",F484=\"\"),I477=\"\",ISBLANK(I478)),\"\",IF(E501=\"None\",0,(E501*I498)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F481=\"\",\"\",IF(F481=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B481=\"\",F478=\"\",ISBLANK(F478)),\"\",($E502*F500))","v":""},{"$f":"IF(OR($B481=\"\",G478=\"\",ISBLANK(G478)),\"\",($E502*G500))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(F500:F502))","v":""},{"$f":"IF(OR(G477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(G500:G502))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(F500:F501))","v":""},{"$f":"IF(OR(G477=\"\",$F479=\"\",$F481=\"\",$F482=\"\"),\"\",SUM(G500:G501))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F479=\"\",\"\",IF(F479=\"CDS\",\"per dispensing\",IF(F479=\"HT\",\"per month\",IF(F479=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F479=\"\",\"\",IF(F479=\"CDS\",DF,IF(F479=\"HT\",PC,IF(F479=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F479=\"\",F481=\"\"),\"\",IF(F479=\"Hosp\",\"No Fee\",IF(F479=\"HT\",\"No VAT\",IF(AND(F479=\"CDS\",F481=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F481=\"\",F479=\"Hosp\"),\"\",IF(OR(F481=\"Yes\",F479=\"HT\"),0,H511*G512))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F479=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F479=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H517),\"\",SUM(H517:H519))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H517),\"\",SUM(H517:H518))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B498","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F498:I498,F490:I490)","v":0},{"$f":"F529*G527","v":0},{"$f":"IF(H488=\"Days\",F529/F488*365.25,IF(H488=\"Months\",F529/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F529/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F529/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F529/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F529/F488/30.4375*I527,\"\"))))","v":""}]
["B",{"$f":"B499","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F499:I499,F490:I490)","v":0},{"$f":"F530*G527","v":0},{"$f":"IF(H488=\"Days\",F530/F488*365.25,IF(H488=\"Months\",F530/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F530/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F530/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F530/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F530/F488/30.4375*I527,\"\"))))","v":""}]
["C",{"$f":"B500","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F500:I500,F490:I490)","v":0},{"$f":"F531*G527","v":0},{"$f":"IF(H488=\"Days\",F531/F488*365.25,IF(H488=\"Months\",F531/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F531/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F531/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F531/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F531/F488/30.4375*I527,\"\"))))","v":""}]
["D",{"$f":"B501","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F501:I501,F490:I490)","v":0},{"$f":"F532*G527","v":0},{"$f":"IF(H488=\"Days\",F532/F488*365.25,IF(H488=\"Months\",F532/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F532/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F532/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F532/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F532/F488/30.4375*I527,\"\"))))","v":""}]
["E",{"$f":"B502","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F502:I502,F490:I490)","v":0},{"$f":"F533*G527","v":0},{"$f":"IF(H488=\"Days\",F533/F488*365.25,IF(H488=\"Months\",F533/F488*12,\"\"))","v":""},{"$f":"IF(AND(H488=\"Days\",I528=\"Days\"),F533/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F533/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F533/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F533/F488/30.4375*I527,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H520=\"\",\"\",H520)","v":""},{"$f":"IF(F534=\"\",\"\",F534*G527)","v":""},{"$f":"IF(F534=\"\",\"\",IF(H488=\"Days\",F534/F488*365.25,IF(H488=\"Months\",F534/F488*12,\"\")))","v":""},{"$f":"IF(F534=\"\",\"\",IF(AND(H488=\"Days\",I528=\"Days\"),F534/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F534/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F534/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F534/F488/30.4375*I527,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H521=\"\",\"\",H521)","v":""},{"$f":"IF(F535=\"\",\"\",F535*G527)","v":""},{"$f":"IF(F535=\"\",\"\",IF(H488=\"Days\",F535/F488*365.25,IF(H488=\"Months\",F535/F488*12,\"\")))","v":""},{"$f":"IF(F535=\"\",\"\",IF(AND(H488=\"Days\",I528=\"Days\"),F535/F488*I527,IF(AND(H488=\"Months\",I528=\"Months\"),F535/F488*I527,IF(AND(H488=\"Days\",I528=\"Months\"),F535/F488*30.4375*I527,IF(AND(H488=\"Months\",I528=\"Days\"),F535/F488/30.4375*I527,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F531:F534)","v":0},{"$f":"SUM(G531:G534)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F535=\"\",SUM(F531+F532),F531+F532+F535)","v":0},{"$f":"IF(G535=\"\",SUM(G531+G532),G531+G532+G535)","v":0},{"$f":"IF(H535=\"\",SUM(H531+H532),H531+H532+H535)","v":{"$error":"#VALUE!"}},{"$f":"IF(I535=\"\",SUM(I531+I532),I531+I532+I535)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Framework Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B561","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F561),\"\",F561)","v":""},{"$f":"IF(ISBLANK(G561),\"\",G561)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F561=\"\",\"\",F561)","v":""},{"$f":"IF(G561=\"\",\"\",G561)","v":""},{"$f":"IF(H561=\"\",\"\",H561)","v":""},{"$f":"IF(I561=\"\",\"\",I561)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F562=\"\",F563=\"\",F564=\"\"),\"\",IF(F562=\"Price to Wholesaler\",F563,IF(F562=\"Reimbursement Price\",(F585/(1+E584)*1),\"Error\")))","v":""},{"$f":"IF(OR(G562=\"\",G563=\"\",F564=\"\"),\"\",IF(G562=\"Price to Wholesaler\",G563,IF(G562=\"Reimbursement Price\",(G585/(1+E584)*1),\"Error\")))","v":""},{"$f":"IF(OR(H562=\"\",H563=\"\",F564=\"\"),\"\",IF(H562=\"Price to Wholesaler\",H563,IF(H562=\"Reimbursement Price\",(H585/(1+E584)*1),\"Error\")))","v":""},{"$f":"IF(OR(I562=\"\",I563=\"\",F564=\"\"),\"\",IF(I562=\"Price to Wholesaler\",I563,IF(I562=\"Reimbursement Price\",(I585/(1+E584)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F564=\"\"),\"\",IF(AND(F564=\"CDS\",F565=\"Yes\"),CYF,IF(AND(F564=\"CDS\",F565=\"No\"),CNF,IF(F564=\"HT\",CHT,IF(F564=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F564=\"\",F563=\"\",F562=\"\"),\"\",F583*E584)","v":""},{"$f":"IF(OR(F564=\"\",G563=\"\",G562=\"\"),\"\",G583*E584)","v":""},{"$f":"IF(OR(F564=\"\",H563=\"\",H562=\"\"),\"\",H583*E584)","v":""},{"$f":"IF(OR(F564=\"\",I563=\"\",I562=\"\"),\"\",I583*E584)","v":""}]
["C",{"$f":"IF(F564=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F562=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F562=\"Reimbursement Price\",F563,IF(ISBLANK(E584),\"\",IF(F562=\"Price to Wholesaler\",(F583+F584),IF(F562=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G562=\"Reimbursement Price\",G563,IF(ISBLANK(E584),\"\",IF(G562=\"Price to Wholesaler\",(G583+G584),IF(G562=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H562=\"Reimbursement Price\",H563,IF(ISBLANK(E584),\"\",IF(H562=\"Price to Wholesaler\",(H583+H584),IF(H562=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I562=\"Reimbursement Price\",I563,IF(ISBLANK(E584),\"\",IF(I562=\"Price to Wholesaler\",(I583+I584),IF(I562=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\")),\"\",IF(AND(F567=\"No\",F569=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F567=\"No\",F569=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F567=\"Yes\",F568=\"Biosimilar\"),\"None\",IF(AND(F567=\"Yes\",F568=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F567=\"Yes\",F568=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F567=\"Yes\",F568=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\"),F562=\"\",ISBLANK(F563)),\"\",IF(E586=\"None\",0,(E586*F583)))","v":""},{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\"),G562=\"\",ISBLANK(G563)),\"\",IF(E586=\"None\",0,(E586*G583)))","v":""},{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\"),H562=\"\",ISBLANK(H563)),\"\",IF(E586=\"None\",0,(E586*H583)))","v":""},{"$f":"IF(OR(F567=\"\",AND(F567=\"Yes\",F568=\"\"),AND(F567=\"No\",F569=\"\"),I562=\"\",ISBLANK(I563)),\"\",IF(E586=\"None\",0,(E586*I583)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F566=\"\",\"\",IF(F566=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B566=\"\",F563=\"\",ISBLANK(F563)),\"\",($E587*F585))","v":""},{"$f":"IF(OR($B566=\"\",G563=\"\",ISBLANK(G563)),\"\",($E587*G585))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(F585:F587))","v":""},{"$f":"IF(OR(G562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(G585:G587))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(F585:F586))","v":""},{"$f":"IF(OR(G562=\"\",$F564=\"\",$F566=\"\",$F567=\"\"),\"\",SUM(G585:G586))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F564=\"\",\"\",IF(F564=\"CDS\",\"per dispensing\",IF(F564=\"HT\",\"per month\",IF(F564=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F564=\"\",\"\",IF(F564=\"CDS\",DF,IF(F564=\"HT\",PC,IF(F564=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F564=\"\",F566=\"\"),\"\",IF(F564=\"Hosp\",\"No Fee\",IF(F564=\"HT\",\"No VAT\",IF(AND(F564=\"CDS\",F566=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F566=\"\",F564=\"Hosp\"),\"\",IF(OR(F566=\"Yes\",F564=\"HT\"),0,H596*G597))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F564=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F564=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H602),\"\",SUM(H602:H604))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H602),\"\",SUM(H602:H603))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B583","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F583:I583,F575:I575)","v":0},{"$f":"F614*G612","v":0},{"$f":"IF(H573=\"Days\",F614/F573*365.25,IF(H573=\"Months\",F614/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F614/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F614/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F614/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F614/F573/30.4375*I612,\"\"))))","v":""}]
["B",{"$f":"B584","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F584:I584,F575:I575)","v":0},{"$f":"F615*G612","v":0},{"$f":"IF(H573=\"Days\",F615/F573*365.25,IF(H573=\"Months\",F615/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F615/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F615/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F615/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F615/F573/30.4375*I612,\"\"))))","v":""}]
["C",{"$f":"B585","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F585:I585,F575:I575)","v":0},{"$f":"F616*G612","v":0},{"$f":"IF(H573=\"Days\",F616/F573*365.25,IF(H573=\"Months\",F616/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F616/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F616/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F616/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F616/F573/30.4375*I612,\"\"))))","v":""}]
["D",{"$f":"B586","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F586:I586,F575:I575)","v":0},{"$f":"F617*G612","v":0},{"$f":"IF(H573=\"Days\",F617/F573*365.25,IF(H573=\"Months\",F617/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F617/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F617/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F617/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F617/F573/30.4375*I612,\"\"))))","v":""}]
["E",{"$f":"B587","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F587:I587,F575:I575)","v":0},{"$f":"F618*G612","v":0},{"$f":"IF(H573=\"Days\",F618/F573*365.25,IF(H573=\"Months\",F618/F573*12,\"\"))","v":""},{"$f":"IF(AND(H573=\"Days\",I613=\"Days\"),F618/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F618/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F618/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F618/F573/30.4375*I612,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H605=\"\",\"\",H605)","v":""},{"$f":"IF(F619=\"\",\"\",F619*G612)","v":""},{"$f":"IF(F619=\"\",\"\",IF(H573=\"Days\",F619/F573*365.25,IF(H573=\"Months\",F619/F573*12,\"\")))","v":""},{"$f":"IF(F619=\"\",\"\",IF(AND(H573=\"Days\",I613=\"Days\"),F619/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F619/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F619/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F619/F573/30.4375*I612,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H606=\"\",\"\",H606)","v":""},{"$f":"IF(F620=\"\",\"\",F620*G612)","v":""},{"$f":"IF(F620=\"\",\"\",IF(H573=\"Days\",F620/F573*365.25,IF(H573=\"Months\",F620/F573*12,\"\")))","v":""},{"$f":"IF(F620=\"\",\"\",IF(AND(H573=\"Days\",I613=\"Days\"),F620/F573*I612,IF(AND(H573=\"Months\",I613=\"Months\"),F620/F573*I612,IF(AND(H573=\"Days\",I613=\"Months\"),F620/F573*30.4375*I612,IF(AND(H573=\"Months\",I613=\"Days\"),F620/F573/30.4375*I612,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F616:F619)","v":0},{"$f":"SUM(G616:G619)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F620=\"\",SUM(F616+F617),F616+F617+F620)","v":0},{"$f":"IF(G620=\"\",SUM(G616+G617),G616+G617+G620)","v":0},{"$f":"IF(H620=\"\",SUM(H616+H617),H616+H617+H620)","v":{"$error":"#VALUE!"}},{"$f":"IF(I620=\"\",SUM(I616+I617),I616+I617+I620)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B646","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F646),\"\",F646)","v":""},{"$f":"IF(ISBLANK(G646),\"\",G646)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F646=\"\",\"\",F646)","v":""},{"$f":"IF(G646=\"\",\"\",G646)","v":""},{"$f":"IF(H646=\"\",\"\",H646)","v":""},{"$f":"IF(I646=\"\",\"\",I646)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F647=\"\",F648=\"\",F649=\"\"),\"\",IF(F647=\"Price to Wholesaler\",F648,IF(F647=\"Reimbursement Price\",(F670/(1+E669)*1),\"Error\")))","v":""},{"$f":"IF(OR(G647=\"\",G648=\"\",F649=\"\"),\"\",IF(G647=\"Price to Wholesaler\",G648,IF(G647=\"Reimbursement Price\",(G670/(1+E669)*1),\"Error\")))","v":""},{"$f":"IF(OR(H647=\"\",H648=\"\",F649=\"\"),\"\",IF(H647=\"Price to Wholesaler\",H648,IF(H647=\"Reimbursement Price\",(H670/(1+E669)*1),\"Error\")))","v":""},{"$f":"IF(OR(I647=\"\",I648=\"\",F649=\"\"),\"\",IF(I647=\"Price to Wholesaler\",I648,IF(I647=\"Reimbursement Price\",(I670/(1+E669)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F649=\"\"),\"\",IF(AND(F649=\"CDS\",F650=\"Yes\"),CYF,IF(AND(F649=\"CDS\",F650=\"No\"),CNF,IF(F649=\"HT\",CHT,IF(F649=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F649=\"\",F648=\"\",F647=\"\"),\"\",F668*E669)","v":""},{"$f":"IF(OR(F649=\"\",G648=\"\",G647=\"\"),\"\",G668*E669)","v":""},{"$f":"IF(OR(F649=\"\",H648=\"\",H647=\"\"),\"\",H668*E669)","v":""},{"$f":"IF(OR(F649=\"\",I648=\"\",I647=\"\"),\"\",I668*E669)","v":""}]
["C",{"$f":"IF(F649=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F647=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F647=\"Reimbursement Price\",F648,IF(ISBLANK(E669),\"\",IF(F647=\"Price to Wholesaler\",(F668+F669),IF(F647=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G647=\"Reimbursement Price\",G648,IF(ISBLANK(E669),\"\",IF(G647=\"Price to Wholesaler\",(G668+G669),IF(G647=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H647=\"Reimbursement Price\",H648,IF(ISBLANK(E669),\"\",IF(H647=\"Price to Wholesaler\",(H668+H669),IF(H647=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I647=\"Reimbursement Price\",I648,IF(ISBLANK(E669),\"\",IF(I647=\"Price to Wholesaler\",(I668+I669),IF(I647=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\")),\"\",IF(AND(F652=\"No\",F654=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F652=\"No\",F654=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F652=\"Yes\",F653=\"Biosimilar\"),\"None\",IF(AND(F652=\"Yes\",F653=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F652=\"Yes\",F653=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F652=\"Yes\",F653=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\"),F647=\"\",ISBLANK(F648)),\"\",IF(E671=\"None\",0,(E671*F668)))","v":""},{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\"),G647=\"\",ISBLANK(G648)),\"\",IF(E671=\"None\",0,(E671*G668)))","v":""},{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\"),H647=\"\",ISBLANK(H648)),\"\",IF(E671=\"None\",0,(E671*H668)))","v":""},{"$f":"IF(OR(F652=\"\",AND(F652=\"Yes\",F653=\"\"),AND(F652=\"No\",F654=\"\"),I647=\"\",ISBLANK(I648)),\"\",IF(E671=\"None\",0,(E671*I668)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F651=\"\",\"\",IF(F651=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B651=\"\",F648=\"\",ISBLANK(F648)),\"\",($E672*F670))","v":""},{"$f":"IF(OR($B651=\"\",G648=\"\",ISBLANK(G648)),\"\",($E672*G670))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F647=\"\",$F649=\"\",$F651=\"\",$F652=\"\"),\"\",SUM(F670:F672))","v":""},{"$f":"IF(OR(G647=\"\",$F649=\"\",$F651=\"\",$F652=\"\"),\"\",SUM(G670:G672))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F647=\"\",$F649=\"\",$F651=\"\",$F652=\"\"),\"\",SUM(F670:F671))","v":""},{"$f":"IF(OR(G647=\"\",$F649=\"\",$F651=\"\",$F652=\"\"),\"\",SUM(G670:G671))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F649=\"\",\"\",IF(F649=\"CDS\",\"per dispensing\",IF(F649=\"HT\",\"per month\",IF(F649=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F649=\"\",\"\",IF(F649=\"CDS\",DF,IF(F649=\"HT\",PC,IF(F649=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F649=\"\",F651=\"\"),\"\",IF(F649=\"Hosp\",\"No Fee\",IF(F649=\"HT\",\"No VAT\",IF(AND(F649=\"CDS\",F651=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F651=\"\",F649=\"Hosp\"),\"\",IF(OR(F651=\"Yes\",F649=\"HT\"),0,H681*G682))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F649=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F649=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H687),\"\",SUM(H687:H689))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H687),\"\",SUM(H687:H688))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B668","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F668:I668,F660:I660)","v":0},{"$f":"F699*G697","v":0},{"$f":"IF(H658=\"Days\",F699/F658*365.25,IF(H658=\"Months\",F699/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F699/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F699/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F699/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F699/F658/30.4375*I697,\"\"))))","v":""}]
["B",{"$f":"B669","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F669:I669,F660:I660)","v":0},{"$f":"F700*G697","v":0},{"$f":"IF(H658=\"Days\",F700/F658*365.25,IF(H658=\"Months\",F700/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F700/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F700/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F700/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F700/F658/30.4375*I697,\"\"))))","v":""}]
["C",{"$f":"B670","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F670:I670,F660:I660)","v":0},{"$f":"F701*G697","v":0},{"$f":"IF(H658=\"Days\",F701/F658*365.25,IF(H658=\"Months\",F701/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F701/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F701/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F701/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F701/F658/30.4375*I697,\"\"))))","v":""}]
["D",{"$f":"B671","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F671:I671,F660:I660)","v":0},{"$f":"F702*G697","v":0},{"$f":"IF(H658=\"Days\",F702/F658*365.25,IF(H658=\"Months\",F702/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F702/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F702/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F702/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F702/F658/30.4375*I697,\"\"))))","v":""}]
["E",{"$f":"B672","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F672:I672,F660:I660)","v":0},{"$f":"F703*G697","v":0},{"$f":"IF(H658=\"Days\",F703/F658*365.25,IF(H658=\"Months\",F703/F658*12,\"\"))","v":""},{"$f":"IF(AND(H658=\"Days\",I698=\"Days\"),F703/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F703/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F703/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F703/F658/30.4375*I697,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H690=\"\",\"\",H690)","v":""},{"$f":"IF(F704=\"\",\"\",F704*G697)","v":""},{"$f":"IF(F704=\"\",\"\",IF(H658=\"Days\",F704/F658*365.25,IF(H658=\"Months\",F704/F658*12,\"\")))","v":""},{"$f":"IF(F704=\"\",\"\",IF(AND(H658=\"Days\",I698=\"Days\"),F704/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F704/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F704/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F704/F658/30.4375*I697,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H691=\"\",\"\",H691)","v":""},{"$f":"IF(F705=\"\",\"\",F705*G697)","v":""},{"$f":"IF(F705=\"\",\"\",IF(H658=\"Days\",F705/F658*365.25,IF(H658=\"Months\",F705/F658*12,\"\")))","v":""},{"$f":"IF(F705=\"\",\"\",IF(AND(H658=\"Days\",I698=\"Days\"),F705/F658*I697,IF(AND(H658=\"Months\",I698=\"Months\"),F705/F658*I697,IF(AND(H658=\"Days\",I698=\"Months\"),F705/F658*30.4375*I697,IF(AND(H658=\"Months\",I698=\"Days\"),F705/F658/30.4375*I697,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F701:F704)","v":0},{"$f":"SUM(G701:G704)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F705=\"\",SUM(F701+F702),F701+F702+F705)","v":0},{"$f":"IF(G705=\"\",SUM(G701+G702),G701+G702+G705)","v":0},{"$f":"IF(H705=\"\",SUM(H701+H702),H701+H702+H705)","v":{"$error":"#VALUE!"}},{"$f":"IF(I705=\"\",SUM(I701+I702),I701+I702+I705)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B731","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F731),\"\",F731)","v":""},{"$f":"IF(ISBLANK(G731),\"\",G731)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F731=\"\",\"\",F731)","v":""},{"$f":"IF(G731=\"\",\"\",G731)","v":""},{"$f":"IF(H731=\"\",\"\",H731)","v":""},{"$f":"IF(I731=\"\",\"\",I731)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F732=\"\",F733=\"\",F734=\"\"),\"\",IF(F732=\"Price to Wholesaler\",F733,IF(F732=\"Reimbursement Price\",(F755/(1+E754)*1),\"Error\")))","v":""},{"$f":"IF(OR(G732=\"\",G733=\"\",F734=\"\"),\"\",IF(G732=\"Price to Wholesaler\",G733,IF(G732=\"Reimbursement Price\",(G755/(1+E754)*1),\"Error\")))","v":""},{"$f":"IF(OR(H732=\"\",H733=\"\",F734=\"\"),\"\",IF(H732=\"Price to Wholesaler\",H733,IF(H732=\"Reimbursement Price\",(H755/(1+E754)*1),\"Error\")))","v":""},{"$f":"IF(OR(I732=\"\",I733=\"\",F734=\"\"),\"\",IF(I732=\"Price to Wholesaler\",I733,IF(I732=\"Reimbursement Price\",(I755/(1+E754)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F734=\"\"),\"\",IF(AND(F734=\"CDS\",F735=\"Yes\"),CYF,IF(AND(F734=\"CDS\",F735=\"No\"),CNF,IF(F734=\"HT\",CHT,IF(F734=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F734=\"\",F733=\"\",F732=\"\"),\"\",F753*E754)","v":""},{"$f":"IF(OR(F734=\"\",G733=\"\",G732=\"\"),\"\",G753*E754)","v":""},{"$f":"IF(OR(F734=\"\",H733=\"\",H732=\"\"),\"\",H753*E754)","v":""},{"$f":"IF(OR(F734=\"\",I733=\"\",I732=\"\"),\"\",I753*E754)","v":""}]
["C",{"$f":"IF(F734=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F732=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F732=\"Reimbursement Price\",F733,IF(ISBLANK(E754),\"\",IF(F732=\"Price to Wholesaler\",(F753+F754),IF(F732=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G732=\"Reimbursement Price\",G733,IF(ISBLANK(E754),\"\",IF(G732=\"Price to Wholesaler\",(G753+G754),IF(G732=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H732=\"Reimbursement Price\",H733,IF(ISBLANK(E754),\"\",IF(H732=\"Price to Wholesaler\",(H753+H754),IF(H732=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I732=\"Reimbursement Price\",I733,IF(ISBLANK(E754),\"\",IF(I732=\"Price to Wholesaler\",(I753+I754),IF(I732=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\")),\"\",IF(AND(F737=\"No\",F739=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F737=\"No\",F739=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F737=\"Yes\",F738=\"Biosimilar\"),\"None\",IF(AND(F737=\"Yes\",F738=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F737=\"Yes\",F738=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F737=\"Yes\",F738=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\"),F732=\"\",ISBLANK(F733)),\"\",IF(E756=\"None\",0,(E756*F753)))","v":""},{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\"),G732=\"\",ISBLANK(G733)),\"\",IF(E756=\"None\",0,(E756*G753)))","v":""},{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\"),H732=\"\",ISBLANK(H733)),\"\",IF(E756=\"None\",0,(E756*H753)))","v":""},{"$f":"IF(OR(F737=\"\",AND(F737=\"Yes\",F738=\"\"),AND(F737=\"No\",F739=\"\"),I732=\"\",ISBLANK(I733)),\"\",IF(E756=\"None\",0,(E756*I753)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F736=\"\",\"\",IF(F736=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B736=\"\",F733=\"\",ISBLANK(F733)),\"\",($E757*F755))","v":""},{"$f":"IF(OR($B736=\"\",G733=\"\",ISBLANK(G733)),\"\",($E757*G755))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F732=\"\",$F734=\"\",$F736=\"\",$F737=\"\"),\"\",SUM(F755:F757))","v":""},{"$f":"IF(OR(G732=\"\",$F734=\"\",$F736=\"\",$F737=\"\"),\"\",SUM(G755:G757))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F732=\"\",$F734=\"\",$F736=\"\",$F737=\"\"),\"\",SUM(F755:F756))","v":""},{"$f":"IF(OR(G732=\"\",$F734=\"\",$F736=\"\",$F737=\"\"),\"\",SUM(G755:G756))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F734=\"\",\"\",IF(F734=\"CDS\",\"per dispensing\",IF(F734=\"HT\",\"per month\",IF(F734=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F734=\"\",\"\",IF(F734=\"CDS\",DF,IF(F734=\"HT\",PC,IF(F734=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F734=\"\",F736=\"\"),\"\",IF(F734=\"Hosp\",\"No Fee\",IF(F734=\"HT\",\"No VAT\",IF(AND(F734=\"CDS\",F736=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F736=\"\",F734=\"Hosp\"),\"\",IF(OR(F736=\"Yes\",F734=\"HT\"),0,H766*G767))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F734=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F734=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H772),\"\",SUM(H772:H774))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H772),\"\",SUM(H772:H773))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B753","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F753:I753,F745:I745)","v":0},{"$f":"F784*G782","v":0},{"$f":"IF(H743=\"Days\",F784/F743*365.25,IF(H743=\"Months\",F784/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F784/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F784/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F784/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F784/F743/30.4375*I782,\"\"))))","v":""}]
["B",{"$f":"B754","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F754:I754,F745:I745)","v":0},{"$f":"F785*G782","v":0},{"$f":"IF(H743=\"Days\",F785/F743*365.25,IF(H743=\"Months\",F785/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F785/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F785/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F785/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F785/F743/30.4375*I782,\"\"))))","v":""}]
["C",{"$f":"B755","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F755:I755,F745:I745)","v":0},{"$f":"F786*G782","v":0},{"$f":"IF(H743=\"Days\",F786/F743*365.25,IF(H743=\"Months\",F786/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F786/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F786/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F786/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F786/F743/30.4375*I782,\"\"))))","v":""}]
["D",{"$f":"B756","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F756:I756,F745:I745)","v":0},{"$f":"F787*G782","v":0},{"$f":"IF(H743=\"Days\",F787/F743*365.25,IF(H743=\"Months\",F787/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F787/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F787/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F787/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F787/F743/30.4375*I782,\"\"))))","v":""}]
["E",{"$f":"B757","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F757:I757,F745:I745)","v":0},{"$f":"F788*G782","v":0},{"$f":"IF(H743=\"Days\",F788/F743*365.25,IF(H743=\"Months\",F788/F743*12,\"\"))","v":""},{"$f":"IF(AND(H743=\"Days\",I783=\"Days\"),F788/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F788/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F788/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F788/F743/30.4375*I782,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H775=\"\",\"\",H775)","v":""},{"$f":"IF(F789=\"\",\"\",F789*G782)","v":""},{"$f":"IF(F789=\"\",\"\",IF(H743=\"Days\",F789/F743*365.25,IF(H743=\"Months\",F789/F743*12,\"\")))","v":""},{"$f":"IF(F789=\"\",\"\",IF(AND(H743=\"Days\",I783=\"Days\"),F789/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F789/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F789/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F789/F743/30.4375*I782,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H776=\"\",\"\",H776)","v":""},{"$f":"IF(F790=\"\",\"\",F790*G782)","v":""},{"$f":"IF(F790=\"\",\"\",IF(H743=\"Days\",F790/F743*365.25,IF(H743=\"Months\",F790/F743*12,\"\")))","v":""},{"$f":"IF(F790=\"\",\"\",IF(AND(H743=\"Days\",I783=\"Days\"),F790/F743*I782,IF(AND(H743=\"Months\",I783=\"Months\"),F790/F743*I782,IF(AND(H743=\"Days\",I783=\"Months\"),F790/F743*30.4375*I782,IF(AND(H743=\"Months\",I783=\"Days\"),F790/F743/30.4375*I782,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F786:F789)","v":0},{"$f":"SUM(G786:G789)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F790=\"\",SUM(F786+F787),F786+F787+F790)","v":0},{"$f":"IF(G790=\"\",SUM(G786+G787),G786+G787+G790)","v":0},{"$f":"IF(H790=\"\",SUM(H786+H787),H786+H787+H790)","v":{"$error":"#VALUE!"}},{"$f":"IF(I790=\"\",SUM(I786+I787),I786+I787+I790)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B816","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F816),\"\",F816)","v":""},{"$f":"IF(ISBLANK(G816),\"\",G816)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F816=\"\",\"\",F816)","v":""},{"$f":"IF(G816=\"\",\"\",G816)","v":""},{"$f":"IF(H816=\"\",\"\",H816)","v":""},{"$f":"IF(I816=\"\",\"\",I816)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F817=\"\",F818=\"\",F819=\"\"),\"\",IF(F817=\"Price to Wholesaler\",F818,IF(F817=\"Reimbursement Price\",(F840/(1+E839)*1),\"Error\")))","v":""},{"$f":"IF(OR(G817=\"\",G818=\"\",F819=\"\"),\"\",IF(G817=\"Price to Wholesaler\",G818,IF(G817=\"Reimbursement Price\",(G840/(1+E839)*1),\"Error\")))","v":""},{"$f":"IF(OR(H817=\"\",H818=\"\",F819=\"\"),\"\",IF(H817=\"Price to Wholesaler\",H818,IF(H817=\"Reimbursement Price\",(H840/(1+E839)*1),\"Error\")))","v":""},{"$f":"IF(OR(I817=\"\",I818=\"\",F819=\"\"),\"\",IF(I817=\"Price to Wholesaler\",I818,IF(I817=\"Reimbursement Price\",(I840/(1+E839)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F819=\"\"),\"\",IF(AND(F819=\"CDS\",F820=\"Yes\"),CYF,IF(AND(F819=\"CDS\",F820=\"No\"),CNF,IF(F819=\"HT\",CHT,IF(F819=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F819=\"\",F818=\"\",F817=\"\"),\"\",F838*E839)","v":""},{"$f":"IF(OR(F819=\"\",G818=\"\",G817=\"\"),\"\",G838*E839)","v":""},{"$f":"IF(OR(F819=\"\",H818=\"\",H817=\"\"),\"\",H838*E839)","v":""},{"$f":"IF(OR(F819=\"\",I818=\"\",I817=\"\"),\"\",I838*E839)","v":""}]
["C",{"$f":"IF(F819=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F817=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F817=\"Reimbursement Price\",F818,IF(ISBLANK(E839),\"\",IF(F817=\"Price to Wholesaler\",(F838+F839),IF(F817=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G817=\"Reimbursement Price\",G818,IF(ISBLANK(E839),\"\",IF(G817=\"Price to Wholesaler\",(G838+G839),IF(G817=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H817=\"Reimbursement Price\",H818,IF(ISBLANK(E839),\"\",IF(H817=\"Price to Wholesaler\",(H838+H839),IF(H817=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I817=\"Reimbursement Price\",I818,IF(ISBLANK(E839),\"\",IF(I817=\"Price to Wholesaler\",(I838+I839),IF(I817=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\")),\"\",IF(AND(F822=\"No\",F824=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F822=\"No\",F824=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F822=\"Yes\",F823=\"Biosimilar\"),\"None\",IF(AND(F822=\"Yes\",F823=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F822=\"Yes\",F823=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F822=\"Yes\",F823=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\"),F817=\"\",ISBLANK(F818)),\"\",IF(E841=\"None\",0,(E841*F838)))","v":""},{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\"),G817=\"\",ISBLANK(G818)),\"\",IF(E841=\"None\",0,(E841*G838)))","v":""},{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\"),H817=\"\",ISBLANK(H818)),\"\",IF(E841=\"None\",0,(E841*H838)))","v":""},{"$f":"IF(OR(F822=\"\",AND(F822=\"Yes\",F823=\"\"),AND(F822=\"No\",F824=\"\"),I817=\"\",ISBLANK(I818)),\"\",IF(E841=\"None\",0,(E841*I838)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F821=\"\",\"\",IF(F821=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B821=\"\",F818=\"\",ISBLANK(F818)),\"\",($E842*F840))","v":""},{"$f":"IF(OR($B821=\"\",G818=\"\",ISBLANK(G818)),\"\",($E842*G840))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F817=\"\",$F819=\"\",$F821=\"\",$F822=\"\"),\"\",SUM(F840:F842))","v":""},{"$f":"IF(OR(G817=\"\",$F819=\"\",$F821=\"\",$F822=\"\"),\"\",SUM(G840:G842))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F817=\"\",$F819=\"\",$F821=\"\",$F822=\"\"),\"\",SUM(F840:F841))","v":""},{"$f":"IF(OR(G817=\"\",$F819=\"\",$F821=\"\",$F822=\"\"),\"\",SUM(G840:G841))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F819=\"\",\"\",IF(F819=\"CDS\",\"per dispensing\",IF(F819=\"HT\",\"per month\",IF(F819=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F819=\"\",\"\",IF(F819=\"CDS\",DF,IF(F819=\"HT\",PC,IF(F819=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F819=\"\",F821=\"\"),\"\",IF(F819=\"Hosp\",\"No Fee\",IF(F819=\"HT\",\"No VAT\",IF(AND(F819=\"CDS\",F821=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F821=\"\",F819=\"Hosp\"),\"\",IF(OR(F821=\"Yes\",F819=\"HT\"),0,H851*G852))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F819=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F819=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H857),\"\",SUM(H857:H859))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H857),\"\",SUM(H857:H858))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B838","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F838:I838,F830:I830)","v":0},{"$f":"F869*G867","v":0},{"$f":"IF(H828=\"Days\",F869/F828*365.25,IF(H828=\"Months\",F869/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F869/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F869/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F869/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F869/F828/30.4375*I867,\"\"))))","v":""}]
["B",{"$f":"B839","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F839:I839,F830:I830)","v":0},{"$f":"F870*G867","v":0},{"$f":"IF(H828=\"Days\",F870/F828*365.25,IF(H828=\"Months\",F870/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F870/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F870/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F870/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F870/F828/30.4375*I867,\"\"))))","v":""}]
["C",{"$f":"B840","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F840:I840,F830:I830)","v":0},{"$f":"F871*G867","v":0},{"$f":"IF(H828=\"Days\",F871/F828*365.25,IF(H828=\"Months\",F871/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F871/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F871/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F871/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F871/F828/30.4375*I867,\"\"))))","v":""}]
["D",{"$f":"B841","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F841:I841,F830:I830)","v":0},{"$f":"F872*G867","v":0},{"$f":"IF(H828=\"Days\",F872/F828*365.25,IF(H828=\"Months\",F872/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F872/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F872/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F872/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F872/F828/30.4375*I867,\"\"))))","v":""}]
["E",{"$f":"B842","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F842:I842,F830:I830)","v":0},{"$f":"F873*G867","v":0},{"$f":"IF(H828=\"Days\",F873/F828*365.25,IF(H828=\"Months\",F873/F828*12,\"\"))","v":""},{"$f":"IF(AND(H828=\"Days\",I868=\"Days\"),F873/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F873/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F873/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F873/F828/30.4375*I867,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H860=\"\",\"\",H860)","v":""},{"$f":"IF(F874=\"\",\"\",F874*G867)","v":""},{"$f":"IF(F874=\"\",\"\",IF(H828=\"Days\",F874/F828*365.25,IF(H828=\"Months\",F874/F828*12,\"\")))","v":""},{"$f":"IF(F874=\"\",\"\",IF(AND(H828=\"Days\",I868=\"Days\"),F874/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F874/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F874/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F874/F828/30.4375*I867,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H861=\"\",\"\",H861)","v":""},{"$f":"IF(F875=\"\",\"\",F875*G867)","v":""},{"$f":"IF(F875=\"\",\"\",IF(H828=\"Days\",F875/F828*365.25,IF(H828=\"Months\",F875/F828*12,\"\")))","v":""},{"$f":"IF(F875=\"\",\"\",IF(AND(H828=\"Days\",I868=\"Days\"),F875/F828*I867,IF(AND(H828=\"Months\",I868=\"Months\"),F875/F828*I867,IF(AND(H828=\"Days\",I868=\"Months\"),F875/F828*30.4375*I867,IF(AND(H828=\"Months\",I868=\"Days\"),F875/F828/30.4375*I867,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F871:F874)","v":0},{"$f":"SUM(G871:G874)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F875=\"\",SUM(F871+F872),F871+F872+F875)","v":0},{"$f":"IF(G875=\"\",SUM(G871+G872),G871+G872+G875)","v":0},{"$f":"IF(H875=\"\",SUM(H871+H872),H871+H872+H875)","v":{"$error":"#VALUE!"}},{"$f":"IF(I875=\"\",SUM(I871+I872),I871+I872+I875)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B901","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F901),\"\",F901)","v":""},{"$f":"IF(ISBLANK(G901),\"\",G901)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F901=\"\",\"\",F901)","v":""},{"$f":"IF(G901=\"\",\"\",G901)","v":""},{"$f":"IF(H901=\"\",\"\",H901)","v":""},{"$f":"IF(I901=\"\",\"\",I901)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F902=\"\",F903=\"\",F904=\"\"),\"\",IF(F902=\"Price to Wholesaler\",F903,IF(F902=\"Reimbursement Price\",(F925/(1+E924)*1),\"Error\")))","v":""},{"$f":"IF(OR(G902=\"\",G903=\"\",F904=\"\"),\"\",IF(G902=\"Price to Wholesaler\",G903,IF(G902=\"Reimbursement Price\",(G925/(1+E924)*1),\"Error\")))","v":""},{"$f":"IF(OR(H902=\"\",H903=\"\",F904=\"\"),\"\",IF(H902=\"Price to Wholesaler\",H903,IF(H902=\"Reimbursement Price\",(H925/(1+E924)*1),\"Error\")))","v":""},{"$f":"IF(OR(I902=\"\",I903=\"\",F904=\"\"),\"\",IF(I902=\"Price to Wholesaler\",I903,IF(I902=\"Reimbursement Price\",(I925/(1+E924)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F904=\"\"),\"\",IF(AND(F904=\"CDS\",F905=\"Yes\"),CYF,IF(AND(F904=\"CDS\",F905=\"No\"),CNF,IF(F904=\"HT\",CHT,IF(F904=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F904=\"\",F903=\"\",F902=\"\"),\"\",F923*E924)","v":""},{"$f":"IF(OR(F904=\"\",G903=\"\",G902=\"\"),\"\",G923*E924)","v":""},{"$f":"IF(OR(F904=\"\",H903=\"\",H902=\"\"),\"\",H923*E924)","v":""},{"$f":"IF(OR(F904=\"\",I903=\"\",I902=\"\"),\"\",I923*E924)","v":""}]
["C",{"$f":"IF(F904=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F902=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F902=\"Reimbursement Price\",F903,IF(ISBLANK(E924),\"\",IF(F902=\"Price to Wholesaler\",(F923+F924),IF(F902=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G902=\"Reimbursement Price\",G903,IF(ISBLANK(E924),\"\",IF(G902=\"Price to Wholesaler\",(G923+G924),IF(G902=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H902=\"Reimbursement Price\",H903,IF(ISBLANK(E924),\"\",IF(H902=\"Price to Wholesaler\",(H923+H924),IF(H902=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I902=\"Reimbursement Price\",I903,IF(ISBLANK(E924),\"\",IF(I902=\"Price to Wholesaler\",(I923+I924),IF(I902=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\")),\"\",IF(AND(F907=\"No\",F909=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F907=\"No\",F909=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F907=\"Yes\",F908=\"Biosimilar\"),\"None\",IF(AND(F907=\"Yes\",F908=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F907=\"Yes\",F908=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F907=\"Yes\",F908=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\"),F902=\"\",ISBLANK(F903)),\"\",IF(E926=\"None\",0,(E926*F923)))","v":""},{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\"),G902=\"\",ISBLANK(G903)),\"\",IF(E926=\"None\",0,(E926*G923)))","v":""},{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\"),H902=\"\",ISBLANK(H903)),\"\",IF(E926=\"None\",0,(E926*H923)))","v":""},{"$f":"IF(OR(F907=\"\",AND(F907=\"Yes\",F908=\"\"),AND(F907=\"No\",F909=\"\"),I902=\"\",ISBLANK(I903)),\"\",IF(E926=\"None\",0,(E926*I923)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F906=\"\",\"\",IF(F906=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B906=\"\",F903=\"\",ISBLANK(F903)),\"\",($E927*F925))","v":""},{"$f":"IF(OR($B906=\"\",G903=\"\",ISBLANK(G903)),\"\",($E927*G925))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F902=\"\",$F904=\"\",$F906=\"\",$F907=\"\"),\"\",SUM(F925:F927))","v":""},{"$f":"IF(OR(G902=\"\",$F904=\"\",$F906=\"\",$F907=\"\"),\"\",SUM(G925:G927))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F902=\"\",$F904=\"\",$F906=\"\",$F907=\"\"),\"\",SUM(F925:F926))","v":""},{"$f":"IF(OR(G902=\"\",$F904=\"\",$F906=\"\",$F907=\"\"),\"\",SUM(G925:G926))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F904=\"\",\"\",IF(F904=\"CDS\",\"per dispensing\",IF(F904=\"HT\",\"per month\",IF(F904=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F904=\"\",\"\",IF(F904=\"CDS\",DF,IF(F904=\"HT\",PC,IF(F904=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F904=\"\",F906=\"\"),\"\",IF(F904=\"Hosp\",\"No Fee\",IF(F904=\"HT\",\"No VAT\",IF(AND(F904=\"CDS\",F906=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F906=\"\",F904=\"Hosp\"),\"\",IF(OR(F906=\"Yes\",F904=\"HT\"),0,H936*G937))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F904=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F904=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H942),\"\",SUM(H942:H944))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H942),\"\",SUM(H942:H943))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B923","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F923:I923,F915:I915)","v":0},{"$f":"F954*G952","v":0},{"$f":"IF(H913=\"Days\",F954/F913*365.25,IF(H913=\"Months\",F954/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F954/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F954/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F954/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F954/F913/30.4375*I952,\"\"))))","v":""}]
["B",{"$f":"B924","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F924:I924,F915:I915)","v":0},{"$f":"F955*G952","v":0},{"$f":"IF(H913=\"Days\",F955/F913*365.25,IF(H913=\"Months\",F955/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F955/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F955/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F955/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F955/F913/30.4375*I952,\"\"))))","v":""}]
["C",{"$f":"B925","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F925:I925,F915:I915)","v":0},{"$f":"F956*G952","v":0},{"$f":"IF(H913=\"Days\",F956/F913*365.25,IF(H913=\"Months\",F956/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F956/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F956/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F956/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F956/F913/30.4375*I952,\"\"))))","v":""}]
["D",{"$f":"B926","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F926:I926,F915:I915)","v":0},{"$f":"F957*G952","v":0},{"$f":"IF(H913=\"Days\",F957/F913*365.25,IF(H913=\"Months\",F957/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F957/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F957/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F957/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F957/F913/30.4375*I952,\"\"))))","v":""}]
["E",{"$f":"B927","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F927:I927,F915:I915)","v":0},{"$f":"F958*G952","v":0},{"$f":"IF(H913=\"Days\",F958/F913*365.25,IF(H913=\"Months\",F958/F913*12,\"\"))","v":""},{"$f":"IF(AND(H913=\"Days\",I953=\"Days\"),F958/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F958/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F958/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F958/F913/30.4375*I952,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H945=\"\",\"\",H945)","v":""},{"$f":"IF(F959=\"\",\"\",F959*G952)","v":""},{"$f":"IF(F959=\"\",\"\",IF(H913=\"Days\",F959/F913*365.25,IF(H913=\"Months\",F959/F913*12,\"\")))","v":""},{"$f":"IF(F959=\"\",\"\",IF(AND(H913=\"Days\",I953=\"Days\"),F959/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F959/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F959/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F959/F913/30.4375*I952,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H946=\"\",\"\",H946)","v":""},{"$f":"IF(F960=\"\",\"\",F960*G952)","v":""},{"$f":"IF(F960=\"\",\"\",IF(H913=\"Days\",F960/F913*365.25,IF(H913=\"Months\",F960/F913*12,\"\")))","v":""},{"$f":"IF(F960=\"\",\"\",IF(AND(H913=\"Days\",I953=\"Days\"),F960/F913*I952,IF(AND(H913=\"Months\",I953=\"Months\"),F960/F913*I952,IF(AND(H913=\"Days\",I953=\"Months\"),F960/F913*30.4375*I952,IF(AND(H913=\"Months\",I953=\"Days\"),F960/F913/30.4375*I952,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F956:F959)","v":0},{"$f":"SUM(G956:G959)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F960=\"\",SUM(F956+F957),F956+F957+F960)","v":0},{"$f":"IF(G960=\"\",SUM(G956+G957),G956+G957+G960)","v":0},{"$f":"IF(H960=\"\",SUM(H956+H957),H956+H957+H960)","v":{"$error":"#VALUE!"}},{"$f":"IF(I960=\"\",SUM(I956+I957),I956+I957+I960)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B986","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F986),\"\",F986)","v":""},{"$f":"IF(ISBLANK(G986),\"\",G986)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F986=\"\",\"\",F986)","v":""},{"$f":"IF(G986=\"\",\"\",G986)","v":""},{"$f":"IF(H986=\"\",\"\",H986)","v":""},{"$f":"IF(I986=\"\",\"\",I986)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F987=\"\",F988=\"\",F989=\"\"),\"\",IF(F987=\"Price to Wholesaler\",F988,IF(F987=\"Reimbursement Price\",(F1010/(1+E1009)*1),\"Error\")))","v":""},{"$f":"IF(OR(G987=\"\",G988=\"\",F989=\"\"),\"\",IF(G987=\"Price to Wholesaler\",G988,IF(G987=\"Reimbursement Price\",(G1010/(1+E1009)*1),\"Error\")))","v":""},{"$f":"IF(OR(H987=\"\",H988=\"\",F989=\"\"),\"\",IF(H987=\"Price to Wholesaler\",H988,IF(H987=\"Reimbursement Price\",(H1010/(1+E1009)*1),\"Error\")))","v":""},{"$f":"IF(OR(I987=\"\",I988=\"\",F989=\"\"),\"\",IF(I987=\"Price to Wholesaler\",I988,IF(I987=\"Reimbursement Price\",(I1010/(1+E1009)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F989=\"\"),\"\",IF(AND(F989=\"CDS\",F990=\"Yes\"),CYF,IF(AND(F989=\"CDS\",F990=\"No\"),CNF,IF(F989=\"HT\",CHT,IF(F989=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F989=\"\",F988=\"\",F987=\"\"),\"\",F1008*E1009)","v":""},{"$f":"IF(OR(F989=\"\",G988=\"\",G987=\"\"),\"\",G1008*E1009)","v":""},{"$f":"IF(OR(F989=\"\",H988=\"\",H987=\"\"),\"\",H1008*E1009)","v":""},{"$f":"IF(OR(F989=\"\",I988=\"\",I987=\"\"),\"\",I1008*E1009)","v":""}]
["C",{"$f":"IF(F989=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F987=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F987=\"Reimbursement Price\",F988,IF(ISBLANK(E1009),\"\",IF(F987=\"Price to Wholesaler\",(F1008+F1009),IF(F987=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G987=\"Reimbursement Price\",G988,IF(ISBLANK(E1009),\"\",IF(G987=\"Price to Wholesaler\",(G1008+G1009),IF(G987=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H987=\"Reimbursement Price\",H988,IF(ISBLANK(E1009),\"\",IF(H987=\"Price to Wholesaler\",(H1008+H1009),IF(H987=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I987=\"Reimbursement Price\",I988,IF(ISBLANK(E1009),\"\",IF(I987=\"Price to Wholesaler\",(I1008+I1009),IF(I987=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\")),\"\",IF(AND(F992=\"No\",F994=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F992=\"No\",F994=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F992=\"Yes\",F993=\"Biosimilar\"),\"None\",IF(AND(F992=\"Yes\",F993=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F992=\"Yes\",F993=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F992=\"Yes\",F993=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\"),F987=\"\",ISBLANK(F988)),\"\",IF(E1011=\"None\",0,(E1011*F1008)))","v":""},{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\"),G987=\"\",ISBLANK(G988)),\"\",IF(E1011=\"None\",0,(E1011*G1008)))","v":""},{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\"),H987=\"\",ISBLANK(H988)),\"\",IF(E1011=\"None\",0,(E1011*H1008)))","v":""},{"$f":"IF(OR(F992=\"\",AND(F992=\"Yes\",F993=\"\"),AND(F992=\"No\",F994=\"\"),I987=\"\",ISBLANK(I988)),\"\",IF(E1011=\"None\",0,(E1011*I1008)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F991=\"\",\"\",IF(F991=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B991=\"\",F988=\"\",ISBLANK(F988)),\"\",($E1012*F1010))","v":""},{"$f":"IF(OR($B991=\"\",G988=\"\",ISBLANK(G988)),\"\",($E1012*G1010))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F987=\"\",$F989=\"\",$F991=\"\",$F992=\"\"),\"\",SUM(F1010:F1012))","v":""},{"$f":"IF(OR(G987=\"\",$F989=\"\",$F991=\"\",$F992=\"\"),\"\",SUM(G1010:G1012))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F987=\"\",$F989=\"\",$F991=\"\",$F992=\"\"),\"\",SUM(F1010:F1011))","v":""},{"$f":"IF(OR(G987=\"\",$F989=\"\",$F991=\"\",$F992=\"\"),\"\",SUM(G1010:G1011))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F989=\"\",\"\",IF(F989=\"CDS\",\"per dispensing\",IF(F989=\"HT\",\"per month\",IF(F989=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F989=\"\",\"\",IF(F989=\"CDS\",DF,IF(F989=\"HT\",PC,IF(F989=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F989=\"\",F991=\"\"),\"\",IF(F989=\"Hosp\",\"No Fee\",IF(F989=\"HT\",\"No VAT\",IF(AND(F989=\"CDS\",F991=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F991=\"\",F989=\"Hosp\"),\"\",IF(OR(F991=\"Yes\",F989=\"HT\"),0,H1021*G1022))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F989=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F989=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H1027),\"\",SUM(H1027:H1029))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H1027),\"\",SUM(H1027:H1028))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B1008","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F1008:I1008,F1000:I1000)","v":0},{"$f":"F1039*G1037","v":0},{"$f":"IF(H998=\"Days\",F1039/F998*365.25,IF(H998=\"Months\",F1039/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1039/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1039/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1039/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1039/F998/30.4375*I1037,\"\"))))","v":""}]
["B",{"$f":"B1009","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F1009:I1009,F1000:I1000)","v":0},{"$f":"F1040*G1037","v":0},{"$f":"IF(H998=\"Days\",F1040/F998*365.25,IF(H998=\"Months\",F1040/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1040/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1040/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1040/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1040/F998/30.4375*I1037,\"\"))))","v":""}]
["C",{"$f":"B1010","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F1010:I1010,F1000:I1000)","v":0},{"$f":"F1041*G1037","v":0},{"$f":"IF(H998=\"Days\",F1041/F998*365.25,IF(H998=\"Months\",F1041/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1041/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1041/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1041/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1041/F998/30.4375*I1037,\"\"))))","v":""}]
["D",{"$f":"B1011","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F1011:I1011,F1000:I1000)","v":0},{"$f":"F1042*G1037","v":0},{"$f":"IF(H998=\"Days\",F1042/F998*365.25,IF(H998=\"Months\",F1042/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1042/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1042/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1042/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1042/F998/30.4375*I1037,\"\"))))","v":""}]
["E",{"$f":"B1012","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F1012:I1012,F1000:I1000)","v":0},{"$f":"F1043*G1037","v":0},{"$f":"IF(H998=\"Days\",F1043/F998*365.25,IF(H998=\"Months\",F1043/F998*12,\"\"))","v":""},{"$f":"IF(AND(H998=\"Days\",I1038=\"Days\"),F1043/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1043/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1043/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1043/F998/30.4375*I1037,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H1030=\"\",\"\",H1030)","v":""},{"$f":"IF(F1044=\"\",\"\",F1044*G1037)","v":""},{"$f":"IF(F1044=\"\",\"\",IF(H998=\"Days\",F1044/F998*365.25,IF(H998=\"Months\",F1044/F998*12,\"\")))","v":""},{"$f":"IF(F1044=\"\",\"\",IF(AND(H998=\"Days\",I1038=\"Days\"),F1044/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1044/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1044/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1044/F998/30.4375*I1037,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H1031=\"\",\"\",H1031)","v":""},{"$f":"IF(F1045=\"\",\"\",F1045*G1037)","v":""},{"$f":"IF(F1045=\"\",\"\",IF(H998=\"Days\",F1045/F998*365.25,IF(H998=\"Months\",F1045/F998*12,\"\")))","v":""},{"$f":"IF(F1045=\"\",\"\",IF(AND(H998=\"Days\",I1038=\"Days\"),F1045/F998*I1037,IF(AND(H998=\"Months\",I1038=\"Months\"),F1045/F998*I1037,IF(AND(H998=\"Days\",I1038=\"Months\"),F1045/F998*30.4375*I1037,IF(AND(H998=\"Months\",I1038=\"Days\"),F1045/F998/30.4375*I1037,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F1041:F1044)","v":0},{"$f":"SUM(G1041:G1044)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F1045=\"\",SUM(F1041+F1042),F1041+F1042+F1045)","v":0},{"$f":"IF(G1045=\"\",SUM(G1041+G1042),G1041+G1042+G1045)","v":0},{"$f":"IF(H1045=\"\",SUM(H1041+H1042),H1041+H1042+H1045)","v":{"$error":"#VALUE!"}},{"$f":"IF(I1045=\"\",SUM(I1041+I1042),I1041+I1042+I1045)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "}]
[]
[]
[null,"Table A: Applicant Input Selection Table to calculate the cost per pack",null,null,null,null,null,null,null,null," - Please input all information requested in this table to automatically calculate the cost per pack in Table C. Up to four type of packs  can be accomodated in this table across columns F to I. If there are less than four packs, please leave extra columns blank. If there are more than four products, please contact bim@ncpe.ie. "]
[null,"Details required to calculate the cost per pack and pharmacy fee information"]
[null,null,null,null,null,"Strength/Pack Size"]
[null,"Pack Identification",null,null,null,null,null,null,null,null," - Enter identifying information (e.g. strength, pack size) for each pack. For example, column F: 40mgx28; column G: 20mgx28. "]
[null,"Calculation Starting Point",null,null,null,null,null,null,null,"\u0080"," - Enter whether the calculation starting point is the Price to Wholesaler (PTW) or Reimbursed Price. PTW is listed on the pricing application form (PAF) submitted to the HSE. Reimbursed price is listed on the PCRS website. "]
[null,"Price per Pack",null,null,null,null,null,null,null,null," - Enter the relevant pack price here.  "]
[null,"Drug Funding Arrangement",null,null,null,null,null,null,null,"\u0080"," - Choose the funding arrangements. CDS = Community Drug Schemes, HT = High Tech Drug Arrangements, Hosp = Hospital. "]
[null,"Fridge",null,null,null,null,null,null,null,"\u0080"," - Optional: fridge item status only required for the CDS as wholesale mark-up varies here. May leave blank for other schemes."]
[null,"Oral product (including inhalers)",null,null,null,null,null,null,null,"\u0080"," - Required for VAT. Oral products including inhalers are exempt from VAT."]
[null,"Biologic",null,null,null,null,null,null,null,"\u0080"," - Required for Frameowrk Agreement rebate calculation."]
[null,"If Biologic =Yes: Select  Biologic and Patent Exclusivity Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =Yes, select the biologic and patent exclusivity status from the drop down list. If Biologic =No, leave blank. Required for Framework Agreement rebate calculation."]
[null,"If Biologic =No,  select Non Biologic Patent Status",null,null,null,null,null,null,null,"\u0080"," - If Biologic =No, select the non-biologic patent status.  If Biologic =Yes, leave blank. Required for Framework Agreement rebate calculation."]
[]
[null,"Table B: Applicant Input Table to calculate the cost per treatment cycle",null,null,null,null,null,null,null,null," - Treatment cycle is the length of time between product dispensings. For example, many oral tablet products have a treatment cycle of 28 days. If a drug is administered every six months, the treatment cycle is six months."]
[null,"Details required to calculate  the cost per treatment cycle"]
[null,"Length of Treatment Cycle",null,null,null,null,null,null,null,null," - Enter treatment cycle length in column F and select unit of measurement (Days/Months) in column H.  For treatment cycles measured in weeks, convert the number of weeks to days (e.g. 4 weeks = 28 days). One month is not equivalent to four weeks. If there is confusion over whether a dose is administered every four weeks or every month, refer to the SPC. "]
[null,{"$f":"B1071","v":"Pack Identification"},null,null,null,{"$f":"IF(ISBLANK(F1071),\"\",F1071)","v":""},{"$f":"IF(ISBLANK(G1071),\"\",G1071)","v":""},"",""]
[null,"Number of packs required per treatment cycle",null,null,null,null,null,null,null,null," - Enter the number of packs of each pack presentation required per treatment cycle. For example if the treatment cycle is 28 days, and there are 14 days supply in one pack, enter \"2\" into column F.  Where each patient requires multiple products every treatment cycle, enter the number of packs of each pack type into the relevant column. For example,  where a patient requires 2 x Pack (F) and 1 x Pack (G) every 28 day treatment cycle, please enter 2 in column F and 1 in column G. Alternatively, where only a single pack is required by a patient each cycle but multiple strengths are available, a weighted average can be calculated by entering the relevant weight for each pack in every column. Ensure weights sum to 1. Add details of how weights are derived in notes section. "]
[]
[]
[]
[null,"Table C. Total Cost to the HSE per pack"]
["This table will fill automatically based on the information inserted above. This information in this table is used to calculate the costs in Table F."]
[null,null,null,null,null,"Strength Pack Size"]
[null,null,null,null,null,{"$f":"IF(F1071=\"\",\"\",F1071)","v":""},{"$f":"IF(G1071=\"\",\"\",G1071)","v":""},{"$f":"IF(H1071=\"\",\"\",H1071)","v":""},{"$f":"IF(I1071=\"\",\"\",I1071)","v":""}]
["A","Price to Wholesaler",null,null,null,{"$f":"IF(OR(F1072=\"\",F1073=\"\",F1074=\"\"),\"\",IF(F1072=\"Price to Wholesaler\",F1073,IF(F1072=\"Reimbursement Price\",(F1095/(1+E1094)*1),\"Error\")))","v":""},{"$f":"IF(OR(G1072=\"\",G1073=\"\",F1074=\"\"),\"\",IF(G1072=\"Price to Wholesaler\",G1073,IF(G1072=\"Reimbursement Price\",(G1095/(1+E1094)*1),\"Error\")))","v":""},{"$f":"IF(OR(H1072=\"\",H1073=\"\",F1074=\"\"),\"\",IF(H1072=\"Price to Wholesaler\",H1073,IF(H1072=\"Reimbursement Price\",(H1095/(1+E1094)*1),\"Error\")))","v":""},{"$f":"IF(OR(I1072=\"\",I1073=\"\",F1074=\"\"),\"\",IF(I1072=\"Price to Wholesaler\",I1073,IF(I1072=\"Reimbursement Price\",(I1095/(1+E1094)*1),\"Error\")))","v":""}]
["B","Wholesale Mark-up",null,null,{"$f":"IF(OR(F1074=\"\"),\"\",IF(AND(F1074=\"CDS\",F1075=\"Yes\"),CYF,IF(AND(F1074=\"CDS\",F1075=\"No\"),CNF,IF(F1074=\"HT\",CHT,IF(F1074=\"Hosp\",CHO,\"Error\")))))","v":""},{"$f":"IF(OR(F1074=\"\",F1073=\"\",F1072=\"\"),\"\",F1093*E1094)","v":""},{"$f":"IF(OR(F1074=\"\",G1073=\"\",G1072=\"\"),\"\",G1093*E1094)","v":""},{"$f":"IF(OR(F1074=\"\",H1073=\"\",H1072=\"\"),\"\",H1093*E1094)","v":""},{"$f":"IF(OR(F1074=\"\",I1073=\"\",I1072=\"\"),\"\",I1093*E1094)","v":""}]
["C",{"$f":"IF(F1074=\"Hosp\",\"Hospital Price\", \"Reimbursement Price\")","v":"Reimbursement Price"},null,null,{"$f":"IF(F1072=\"Price to Wholesaler\",\"A+B\",\"\")","v":""},{"$f":"IF(F1072=\"Reimbursement Price\",F1073,IF(ISBLANK(E1094),\"\",IF(F1072=\"Price to Wholesaler\",(F1093+F1094),IF(F1072=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(G1072=\"Reimbursement Price\",G1073,IF(ISBLANK(E1094),\"\",IF(G1072=\"Price to Wholesaler\",(G1093+G1094),IF(G1072=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(H1072=\"Reimbursement Price\",H1073,IF(ISBLANK(E1094),\"\",IF(H1072=\"Price to Wholesaler\",(H1093+H1094),IF(H1072=\"\",\"\",\"Error\"))))","v":""},{"$f":"IF(I1072=\"Reimbursement Price\",I1073,IF(ISBLANK(E1094),\"\",IF(I1072=\"Price to Wholesaler\",(I1093+I1094),IF(I1072=\"\",\"\",\"Error\"))))","v":""}]
["D","Framework Agreement Rebate",null,null,{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\")),\"\",IF(AND(F1077=\"No\",F1079=\"Patented Exclusive or Off Patent Exclusive and subject to clause 10 of Framework Agreement\"),MR,IF(AND(F1077=\"No\",F1079=\"Off Patent Non-Exclusive or Generic\"),\"None\",IF(AND(F1077=\"Yes\",F1078=\"Biosimilar\"),\"None\",IF(AND(F1077=\"Yes\",F1078=\"Patented or Off Patent Exclusive\"),MR,IF(AND(F1077=\"Yes\",F1078=\"Off Patent Non-Exclusive 12.5% Rebate incorporated into Price to Wholesaler\"),\"None\",IF(AND(F1077=\"Yes\",F1078=\"Off Patent Non-Exclusive 12.5% Rebate\"),MRB,\"Error\")))))))","v":""},{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\"),F1072=\"\",ISBLANK(F1073)),\"\",IF(E1096=\"None\",0,(E1096*F1093)))","v":""},{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\"),G1072=\"\",ISBLANK(G1073)),\"\",IF(E1096=\"None\",0,(E1096*G1093)))","v":""},{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\"),H1072=\"\",ISBLANK(H1073)),\"\",IF(E1096=\"None\",0,(E1096*H1093)))","v":""},{"$f":"IF(OR(F1077=\"\",AND(F1077=\"Yes\",F1078=\"\"),AND(F1077=\"No\",F1079=\"\"),I1072=\"\",ISBLANK(I1073)),\"\",IF(E1096=\"None\",0,(E1096*I1093)))","v":""}]
["E","VAT on Drug Cost ",null,null,{"$f":"IF(F1076=\"\",\"\",IF(F1076=\"Yes\",0,VT))","v":""},{"$f":"IF(OR($B1076=\"\",F1073=\"\",ISBLANK(F1073)),\"\",($E1097*F1095))","v":""},{"$f":"IF(OR($B1076=\"\",G1073=\"\",ISBLANK(G1073)),\"\",($E1097*G1095))","v":""},"",""]
["F(i)","Total Drug Cost to the HSE per pack including VAT",null,null,null,{"$f":"IF(OR(F1072=\"\",$F1074=\"\",$F1076=\"\",$F1077=\"\"),\"\",SUM(F1095:F1097))","v":""},{"$f":"IF(OR(G1072=\"\",$F1074=\"\",$F1076=\"\",$F1077=\"\"),\"\",SUM(G1095:G1097))","v":""},"",""]
["F(ii)","Total Drug Cost to the HSE per pack excluding VAT",null,null,null,{"$f":"IF(OR(F1072=\"\",$F1074=\"\",$F1076=\"\",$F1077=\"\"),\"\",SUM(F1095:F1096))","v":""},{"$f":"IF(OR(G1072=\"\",$F1074=\"\",$F1076=\"\",$F1077=\"\"),\"\",SUM(G1095:G1096))","v":""},"",""]
[null,null,null,null,null,null,null,null,null,null," "]
["Table D. Pharmacy Fees payable based on the type of product and reimbursement arrangements"]
[null,"For hospital drugs this table may be ignored."]
[null,"This table fills  automatically based on scheme and product information inputted above in Table A. "]
[]
[null,null,null,null,null,null,"Calculation ","Value"]
[null,"Pharmacy Fees excluding VAT",null,null,null,null,{"$f":"IF(F1074=\"\",\"\",IF(F1074=\"CDS\",\"per dispensing\",IF(F1074=\"HT\",\"per month\",IF(F1074=\"Hosp\",\"No Fee\", ERROR))))","v":""},{"$f":"IF(F1074=\"\",\"\",IF(F1074=\"CDS\",DF,IF(F1074=\"HT\",PC,IF(F1074=\"Hosp\",\"No Fee\",ERROR))))","v":""},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         "]
[null,"VAT on Pharmacy Fees",null,null,null,null,{"$f":"IF(OR(F1074=\"\",F1076=\"\"),\"\",IF(F1074=\"Hosp\",\"No Fee\",IF(F1074=\"HT\",\"No VAT\",IF(AND(F1074=\"CDS\",F1076=\"No\"),VT,\"No VAT\"))))","v":""},{"$f":"IF(OR(F1076=\"\",F1074=\"Hosp\"),\"\",IF(OR(F1076=\"Yes\",F1074=\"HT\"),0,H1106*G1107))","v":""}]
[]
[]
["Table E Pharmacy Fees per product treatment cycle. \n",null,null,null,null,null,null,null,null,null," - Based on the drug's dispensing regimen and the NCPE drug cost guidelines, please input the pharmacy fees per treatment cycle. Use data presented in Table D to generate an appropriate formula for Column H of Table E. Notes may be added in column G. "]
["This section may be ommited for hospital drugs",null,null,null,null,null,"Notes","Value",null,null,{"$f":"IF(F1074=\"HT\",\"For High tech, if a treatment cycle =28 days the corresponding pharmacy fee is =62.03*12/365.25*28.  The pharmacy fee remains the same regardless of the number of products dispensed that month.\",IF(F1074=\"CDS\",\"For CDS, if 2 packets of the same pack presentation are required per treatment cycle, one dispensing fee applies (€5.48). If multiple pack presentations are required, multiple dispensing fees apply\",\"\"))","v":""}]
["G","Pharmacy Fees per treatment cycle excluding VAT"]
["H","Non dispensed patient care fee per treatment cycle (High Tech only)",null,null,null,null,null,null,null,null," - Enter here if relevant. See NCPE drug cost guidelines for more information on non-dispensed patient care fees (High Tech only). "]
["I","VAT on pharmacy Fees",null,null,null,null,null,null,null,null," - Please input VAT payable on pharmacy fees if applicable based on the information presented in Table D. "]
["J (i)","Total pharmacy Fees per treatment cycle including VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H1112),\"\",SUM(H1112:H1114))","v":""}]
["J (ii)","Total pharmacy Fees per treatment cycle excluding VAT",null,null,null,null,null,{"$f":"IF(ISBLANK(H1112),\"\",SUM(H1112:H1113))","v":""}]
[]
[]
["Table F. Total Drug Costs to the HSE"]
[]
[null,null,null,null,null,"Total Cost per treatment Cycle","Total Cost per ","Total Cost per Year","Total Cost per unit time",null," - Calculate the cost for the budget impact model using  cost per number of cycles, per year or per unit time. Input the length of time requird  into the grey boxes where applicable. Irrelevant columns may be left blank. Use the drop down boxes to select days or months when calculate the cost per unit time."]
[]
[null,null,null,null,null,null,"number of cycles"]
["A",{"$f":"B1093","v":"Price to Wholesaler"},null,null,null,{"$f":"SUMPRODUCT(F1093:I1093,F1085:I1085)","v":0},{"$f":"F1124*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1124/F1083*365.25,IF(H1083=\"Months\",F1124/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1124/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1124/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1124/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1124/F1083/30.4375*I1122,\"\"))))","v":""}]
["B",{"$f":"B1094","v":"Wholesale Mark-up"},null,null,null,{"$f":"SUMPRODUCT(F1094:I1094,F1085:I1085)","v":0},{"$f":"F1125*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1125/F1083*365.25,IF(H1083=\"Months\",F1125/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1125/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1125/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1125/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1125/F1083/30.4375*I1122,\"\"))))","v":""}]
["C",{"$f":"B1095","v":"Reimbursement Price"},null,null,null,{"$f":"SUMPRODUCT(F1095:I1095,F1085:I1085)","v":0},{"$f":"F1126*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1126/F1083*365.25,IF(H1083=\"Months\",F1126/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1126/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1126/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1126/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1126/F1083/30.4375*I1122,\"\"))))","v":""}]
["D",{"$f":"B1096","v":"Framework Agreement Rebate"},null,null,null,{"$f":"SUMPRODUCT(F1096:I1096,F1085:I1085)","v":0},{"$f":"F1127*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1127/F1083*365.25,IF(H1083=\"Months\",F1127/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1127/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1127/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1127/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1127/F1083/30.4375*I1122,\"\"))))","v":""}]
["E",{"$f":"B1097","v":"VAT on Drug Cost "},null,null,null,{"$f":"SUMPRODUCT(F1097:I1097,F1085:I1085)","v":0},{"$f":"F1128*G1122","v":0},{"$f":"IF(H1083=\"Days\",F1128/F1083*365.25,IF(H1083=\"Months\",F1128/F1083*12,\"\"))","v":""},{"$f":"IF(AND(H1083=\"Days\",I1123=\"Days\"),F1128/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1128/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1128/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1128/F1083/30.4375*I1122,\"\"))))","v":""}]
["J(i)","Total Pharmacy Fee including VAT",null,null,null,{"$f":"IF(H1115=\"\",\"\",H1115)","v":""},{"$f":"IF(F1129=\"\",\"\",F1129*G1122)","v":""},{"$f":"IF(F1129=\"\",\"\",IF(H1083=\"Days\",F1129/F1083*365.25,IF(H1083=\"Months\",F1129/F1083*12,\"\")))","v":""},{"$f":"IF(F1129=\"\",\"\",IF(AND(H1083=\"Days\",I1123=\"Days\"),F1129/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1129/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1129/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1129/F1083/30.4375*I1122,\"\")))))","v":""}]
["J(ii)","Total Pharmacy Fee excluding VAT",null,null,null,{"$f":"IF(H1116=\"\",\"\",H1116)","v":""},{"$f":"IF(F1130=\"\",\"\",F1130*G1122)","v":""},{"$f":"IF(F1130=\"\",\"\",IF(H1083=\"Days\",F1130/F1083*365.25,IF(H1083=\"Months\",F1130/F1083*12,\"\")))","v":""},{"$f":"IF(F1130=\"\",\"\",IF(AND(H1083=\"Days\",I1123=\"Days\"),F1130/F1083*I1122,IF(AND(H1083=\"Months\",I1123=\"Months\"),F1130/F1083*I1122,IF(AND(H1083=\"Days\",I1123=\"Months\"),F1130/F1083*30.4375*I1122,IF(AND(H1083=\"Months\",I1123=\"Days\"),F1130/F1083/30.4375*I1122,\"\")))))","v":""}]
["K(i)","Total Drug Cost including Pharmacy Fees and VAT (Pro Rata)",null,null,null,{"$f":"SUM(F1126:F1129)","v":0},{"$f":"SUM(G1126:G1129)","v":0},0,0,null," - The relevant cost from this row should be manually inserted into the Table 1 above for budget impact calculations"]
["K(ii)","Total Drug Cost including pharmacy fees and excluding VAT (Pro Rata)",null,null,null,{"$f":"IF(F1130=\"\",SUM(F1126+F1127),F1126+F1127+F1130)","v":0},{"$f":"IF(G1130=\"\",SUM(G1126+G1127),G1126+G1127+G1130)","v":0},{"$f":"IF(H1130=\"\",SUM(H1126+H1127),H1126+H1127+H1130)","v":{"$error":"#VALUE!"}},{"$f":"IF(I1130=\"\",SUM(I1126+I1127),I1126+I1127+I1130)","v":{"$error":"#VALUE!"}},null," - These values are presented for information purposes only. They should not be included in the budget impact calculations"]
[]
[]
[null,"Notes"]

{"sheet":"Additional Costs","index":7,"n_rows":41,"n_cols":10,"rows_kept":41,"cut":false,"hidden":false,"merged":[[24,1,24,4],[29,1,29,4],[16,1,21,11]]}
[]
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[null,"Describe the potential for additional costs and cost-offsets which may impact the wider healthcare budget in this tab. Administration, monitoring, adverse event costs etc. can be included here. Please use the space below to show any working out, and insert the additional costs and cost-offsets in the cells below. If an additional worksheet is needed, please add into the excel file. If there is a cost offset, place a minus sign in front of the amount. Please note: it is beyond the scope of the Rapid Review process to appraise the impact of an intervention on wider health care budgets; the net budget impact is not required for Rapid Review submissions."]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,"Cost/cost-offset per patient per year"]
[]
[]
[]
[]
[null,"Notes"]
[]
[null,"Additional costs"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"Additional savings"]

{"sheet":"Results","index":8,"n_rows":154,"n_cols":14,"rows_kept":154,"cut":false,"hidden":false,"merged":[[118,1,121,2],[118,3,118,6],[119,3,119,6],[120,3,120,6],[121,3,121,6],[122,1,125,2],[122,3,122,6],[123,3,123,6],[124,3,124,6],[125,3,125,6],[133,3,133,6],[126,1,129,2],[126,3,126,6],[127,3,127,6],[128,3,128,6],[129,3,129,6],[67,3,67,6],[68,3,68,6],[138,1,141,2],[138,3,138,6],[139,3,139,6],[140,3,140,6],[141,3,141,6],[134,1,137,2],[134,3,134,6],[135,3,135,6],[136,3,136,6],[137,3,137,6],[130,1,133,2],[130,3,130,6],[131,3,131,6],[132,3,132,6],[73,1,76,2],[73,3,73,6],[74,3,74,6],[75,3,75,6],[76,3,76,6],[69,1,72,2],[69,3,69,6],[70,3,70,6],[71,3,71,6],[72,3,72,6],[65,1,68,2],[65,3,65,6],[66,3,66,6],[29,1,32,2],[29,3,29,6],[30,3,30,6],[31,3,31,6],[32,3,32,6],[94,3,94,6],[98,3,98,6],[102,3,102,6],[106,3,106,6],[95,3,95,6],[99,3,99,6],[103,3,103,6],[94,1,97,2],[40,1,40,6],[89,1,89,6],[43,3,43,6],[47,3,47,6],[81,1,84,2],[81,3,81,6],[82,3,82,6],[83,3,83,6],[84,3,84,6],[77,1,80,2],[77,3,77,6],[24,1,24,6],[21,1,21,6],[16,1,19,9],[27,1,27,6],[41,1,44,2],[33,1,33,6],[38,1,38,6],[35,1,35,6],[115,3,115,6],[41,3,41,6],[42,3,42,6],[45,3,45,6],[46,3,46,6],[49,3,49,6],[50,3,50,6],[53,3,53,6],[54,3,54,6],[57,3,57,6],[96,3,96,6],[104,3,104,6],[62,3,62,6],[61,3,61,6],[55,3,55,6],[59,3,59,6],[44,3,44,6],[48,3,48,6],[52,3,52,6],[56,3,56,6],[60,3,60,6],[64,3,64,6],[97,3,97,6],[101,3,101,6],[105,3,105,6],[100,3,100,6],[93,1,93,6],[63,3,63,6],[58,3,58,6],[45,1,48,2],[49,1,52,2],[53,1,56,2],[57,1,60,2],[61,1,64,2],[86,3,86,6],[87,3,87,6],[88,3,88,6],[78,3,78,6],[79,3,79,6],[80,3,80,6],[51,3,51,6],[85,1,88,2],[85,3,85,6],[98,1,101,2],[102,1,105,2],[106,1,109,2],[110,1,113,2],[114,1,117,2],[153,1,154,11],[142,1,142,6],[144,1,144,6],[147,1,147,6],[149,1,149,6],[151,1,151,6],[117,3,117,6],[108,3,108,6],[112,3,112,6],[116,3,116,6],[109,3,109,6],[113,3,113,6],[107,3,107,6],[110,3,110,6],[111,3,111,6],[114,3,114,6]]}
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null," The gross and net drug budget impacts are presented below, based on the inputs used throughout the rest of the model. Separately, a net budget impact accounting for costs and offsets outside of the drugs budget is presented.  Patients who died or stopped treatment are assumed to have received treatment for 6 months."]
[]
[]
[]
[]
[null,"Summary"]
[]
[null,null,null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5",null,"Cumulative"]
[null,"Eligible patient population",null,null,null,null,null,{"$f":"'Patient Population'!E36","v":0},{"$f":"'Patient Population'!F36","v":0},{"$f":"'Patient Population'!G36","v":0},{"$f":"'Patient Population'!H36","v":0},{"$f":"'Patient Population'!I36","v":0},null,{"$f":"SUM(H25:L25)","v":0}]
[]
[]
[null,"Gross Drug Budget Impact"]
[null,null,null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,{"$f":"CONCATENATE(\"Intervention: \",InterventionINN)","v":"Intervention: "},null,"Number of patients receiving intervention",null,null,null,{"$f":"'Patient Population'!E126","v":0},{"$f":"'Patient Population'!F126","v":0},{"$f":"'Patient Population'!G126","v":0},{"$f":"'Patient Population'!H126","v":0},{"$f":"'Patient Population'!I126","v":0}]
[null,null,null,"Cost of intervention each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E28","v":0},{"$f":" 'Drug Acquisition Costs'!F28","v":0},{"$f":" 'Drug Acquisition Costs'!G28","v":0},{"$f":" 'Drug Acquisition Costs'!H28","v":0},{"$f":" 'Drug Acquisition Costs'!I28","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E68*'Patient Population'!E88)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F68*'Patient Population'!F88)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G68*'Patient Population'!G88)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H68*'Patient Population'!H88)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I68*'Patient Population'!I88)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E68","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F68","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G68","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H68","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I68","v":0}]
[null,"Total cost of intervention",null,null,null,null,null,{"$f":"(H30*H31)+((0.5*H31)*(H32+H33))","v":0},{"$f":"(I30*I31)+((0.5*I31)*(I32+I33))","v":0},{"$f":"(J30*J31)+((0.5*J31)*(J32+J33))","v":0},{"$f":"(K30*K31)+((0.5*K31)*(K32+K33))","v":0},{"$f":"(L30*L31)+((0.5*L31)*(L32+L33))","v":0}]
[]
[null,"Gross Drug Budget Impact",null,null,null,null,null,{"$f":"H34","v":0},{"$f":"I34","v":0},{"$f":"J34","v":0},{"$f":"K34","v":0},{"$f":"L34","v":0},null,{"$f":"SUM(H36:L36)","v":0}]
[]
[]
[null,"Net Drug Budget Impact"]
[]
[null,"Comparator costs with new intervention in market",null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "},null,"Number of patients receiving comparator 1",null,null,null,{"$f":"'Patient Population'!E127","v":0},{"$f":"'Patient Population'!F127","v":0},{"$f":"'Patient Population'!G127","v":0},{"$f":"'Patient Population'!H127","v":0},{"$f":"'Patient Population'!I127","v":0}]
[null,null,null,"Cost of comparator 1 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E29","v":0},{"$f":" 'Drug Acquisition Costs'!F29","v":0},{"$f":" 'Drug Acquisition Costs'!G29","v":0},{"$f":" 'Drug Acquisition Costs'!H29","v":0},{"$f":" 'Drug Acquisition Costs'!I29","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E69*'Patient Population'!E89)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F69*'Patient Population'!F89)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G69*'Patient Population'!G89)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H69*'Patient Population'!H89)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I69*'Patient Population'!I89)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E69","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F69","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G69","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H69","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I69","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 2: \",NameComparator2)","v":"Comparator 2: "},null,"Number of patients receiving comparator 2",null,null,null,{"$f":"'Patient Population'!E128","v":0},{"$f":"'Patient Population'!F128","v":0},{"$f":"'Patient Population'!G128","v":0},{"$f":"'Patient Population'!H128","v":0},{"$f":"'Patient Population'!I128","v":0}]
[null,null,null,"Cost of comparator 2 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E30","v":0},{"$f":" 'Drug Acquisition Costs'!F30","v":0},{"$f":" 'Drug Acquisition Costs'!G30","v":0},{"$f":" 'Drug Acquisition Costs'!H30","v":0},{"$f":" 'Drug Acquisition Costs'!I30","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E70*'Patient Population'!E90)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F70*'Patient Population'!F90)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G70*'Patient Population'!G90)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H70*'Patient Population'!H90)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I70*'Patient Population'!I90)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E70","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F70","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G70","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H70","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I70","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "},null,"Number of patients receiving comparator 3",null,null,null,{"$f":"'Patient Population'!E129","v":0},{"$f":"'Patient Population'!F129","v":0},{"$f":"'Patient Population'!G129","v":0},{"$f":"'Patient Population'!H129","v":0},{"$f":"'Patient Population'!I129","v":0}]
[null,null,null,"Cost of comparator 3 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E31","v":0},{"$f":" 'Drug Acquisition Costs'!F31","v":0},{"$f":" 'Drug Acquisition Costs'!G31","v":0},{"$f":" 'Drug Acquisition Costs'!H31","v":0},{"$f":" 'Drug Acquisition Costs'!I31","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E71*'Patient Population'!E91)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F71*'Patient Population'!F91)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G71*'Patient Population'!G91)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H71*'Patient Population'!H91)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I71*'Patient Population'!I91)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E71","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F71","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G71","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H71","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I71","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "},null,"Number of patients receiving comparator 4",null,null,null,{"$f":"'Patient Population'!E130","v":0},{"$f":"'Patient Population'!F130","v":0},{"$f":"'Patient Population'!G130","v":0},{"$f":"'Patient Population'!H130","v":0},{"$f":"'Patient Population'!I130","v":0}]
[null,null,null,"Cost of comparator 4 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E32","v":0},{"$f":" 'Drug Acquisition Costs'!F32","v":0},{"$f":" 'Drug Acquisition Costs'!G32","v":0},{"$f":" 'Drug Acquisition Costs'!H32","v":0},{"$f":" 'Drug Acquisition Costs'!I32","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E72*'Patient Population'!E92)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F72*'Patient Population'!F92)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G72*'Patient Population'!G92)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H72*'Patient Population'!H92)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I72*'Patient Population'!I92)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E72","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F72","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G72","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H72","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I72","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "},null,"Number of patients receiving comparator 5",null,null,null,{"$f":"'Patient Population'!E131","v":0},{"$f":"'Patient Population'!F131","v":0},{"$f":"'Patient Population'!G131","v":0},{"$f":"'Patient Population'!H131","v":0},{"$f":"'Patient Population'!I131","v":0}]
[null,null,null,"Cost of comparator 5 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E33","v":0},{"$f":" 'Drug Acquisition Costs'!F33","v":0},{"$f":" 'Drug Acquisition Costs'!G33","v":0},{"$f":" 'Drug Acquisition Costs'!H33","v":0},{"$f":" 'Drug Acquisition Costs'!I33","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E73*'Patient Population'!E93)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F73*'Patient Population'!F93)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G73*'Patient Population'!G93)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H73*'Patient Population'!H93)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I73*'Patient Population'!I93)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E73","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F73","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G73","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H73","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I73","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "},null,"Number of patients receiving comparator 6",null,null,null,{"$f":"'Patient Population'!E132","v":0},{"$f":"'Patient Population'!F132","v":0},{"$f":"'Patient Population'!G132","v":0},{"$f":"'Patient Population'!H132","v":0},{"$f":"'Patient Population'!I132","v":0}]
[null,null,null,"Cost of comparator 6 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E34","v":0},{"$f":" 'Drug Acquisition Costs'!F34","v":0},{"$f":" 'Drug Acquisition Costs'!G34","v":0},{"$f":" 'Drug Acquisition Costs'!H34","v":0},{"$f":" 'Drug Acquisition Costs'!I34","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E74*'Patient Population'!E94)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F74*'Patient Population'!F94)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G74*'Patient Population'!G94)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H74*'Patient Population'!H94)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I74*'Patient Population'!I94)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E74","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F74","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G74","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H74","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I74","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "},null,"Number of patients receiving comparator 7",null,null,null,{"$f":"'Patient Population'!E133","v":0},{"$f":"'Patient Population'!F133","v":0},{"$f":"'Patient Population'!G133","v":0},{"$f":"'Patient Population'!H133","v":0},{"$f":"'Patient Population'!I133","v":0}]
[null,null,null,"Cost of comparator 7 each year",null,null,null,{"$f":"'Drug Acquisition Costs'!E35","v":0},{"$f":"'Drug Acquisition Costs'!F35","v":0},{"$f":"'Drug Acquisition Costs'!G35","v":0},{"$f":"'Drug Acquisition Costs'!H35","v":0},{"$f":"'Drug Acquisition Costs'!I35","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E75*'Patient Population'!E95)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F75*'Patient Population'!F95)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G75*'Patient Population'!G95)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H75*'Patient Population'!H95)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I75*'Patient Population'!I95)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E75","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F75","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G75","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H75","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I75","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "},null,"Number of patients receiving comparator 8",null,null,null,{"$f":"'Patient Population'!E134","v":0},{"$f":"'Patient Population'!F134","v":0},{"$f":"'Patient Population'!G134","v":0},{"$f":"'Patient Population'!H134","v":0},{"$f":"'Patient Population'!I134","v":0}]
[null,null,null,"Cost of comparator 8 each year",null,null,null,{"$f":"'Drug Acquisition Costs'!E36","v":0},{"$f":"'Drug Acquisition Costs'!F36","v":0},{"$f":"'Drug Acquisition Costs'!G36","v":0},{"$f":"'Drug Acquisition Costs'!H36","v":0},{"$f":"'Drug Acquisition Costs'!I36","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E76*'Patient Population'!E96)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F76*'Patient Population'!F96)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G76*'Patient Population'!G96)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H76*'Patient Population'!H96)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I76*'Patient Population'!I96)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E76","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F76","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G76","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H76","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I76","v":0}]
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[]
[]
[]
[null,"Comparator costs with no intervention in market",null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
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[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E54","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F54","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G54","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H54","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I54","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "},null,"Number of patients receiving comparator 7",null,null,null,{"$f":"'Patient Population'!E113","v":0},{"$f":"'Patient Population'!F113","v":0},{"$f":"'Patient Population'!G113","v":0},{"$f":"'Patient Population'!H113","v":0},{"$f":"'Patient Population'!I113","v":0}]
[null,null,null,"Cost of comparator 7 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E35","v":0},{"$f":" 'Drug Acquisition Costs'!F35","v":0},{"$f":" 'Drug Acquisition Costs'!G35","v":0},{"$f":" 'Drug Acquisition Costs'!H35","v":0},{"$f":" 'Drug Acquisition Costs'!I35","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E55*'Patient Population'!E95)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F55*'Patient Population'!F95)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G55*'Patient Population'!G95)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H55*'Patient Population'!H95)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I55*'Patient Population'!I95)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E55","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F55","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G55","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H55","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I55","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "},null,"Number of patients receiving comparator 8",null,null,null,{"$f":"'Patient Population'!E114","v":0},{"$f":"'Patient Population'!F114","v":0},{"$f":"'Patient Population'!G114","v":0},{"$f":"'Patient Population'!H114","v":0},{"$f":"'Patient Population'!I114","v":0}]
[null,null,null,"Cost of comparator 8 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E36","v":0},{"$f":" 'Drug Acquisition Costs'!F36","v":0},{"$f":" 'Drug Acquisition Costs'!G36","v":0},{"$f":" 'Drug Acquisition Costs'!H36","v":0},{"$f":" 'Drug Acquisition Costs'!I36","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E56*'Patient Population'!E96)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F56*'Patient Population'!F96)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G56*'Patient Population'!G96)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H56*'Patient Population'!H96)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I56*'Patient Population'!I96)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E56","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F56","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G56","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H56","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I56","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "},null,"Number of patients receiving comparator 9",null,null,null,{"$f":"'Patient Population'!E115","v":0},{"$f":"'Patient Population'!F115","v":0},{"$f":"'Patient Population'!G115","v":0},{"$f":"'Patient Population'!H115","v":0},{"$f":"'Patient Population'!I115","v":0}]
[null,null,null,"Cost of comparator 9 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E37","v":0},{"$f":" 'Drug Acquisition Costs'!F37","v":0},{"$f":" 'Drug Acquisition Costs'!G37","v":0},{"$f":" 'Drug Acquisition Costs'!H37","v":0},{"$f":" 'Drug Acquisition Costs'!I37","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E57*'Patient Population'!E97)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F57*'Patient Population'!F97)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G57*'Patient Population'!G97)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H57*'Patient Population'!H97)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I57*'Patient Population'!I97)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E57","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F57","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G57","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H57","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I57","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "},null,"Number of patients receiving comparator 10",null,null,null,{"$f":"'Patient Population'!E116","v":0},{"$f":"'Patient Population'!F116","v":0},{"$f":"'Patient Population'!G116","v":0},{"$f":"'Patient Population'!H116","v":0},{"$f":"'Patient Population'!I116","v":0}]
[null,null,null,"Cost of comparator 10 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E38","v":0},{"$f":" 'Drug Acquisition Costs'!F38","v":0},{"$f":" 'Drug Acquisition Costs'!G38","v":0},{"$f":" 'Drug Acquisition Costs'!H38","v":0},{"$f":" 'Drug Acquisition Costs'!I38","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E58*'Patient Population'!E98)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F58*'Patient Population'!F98)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G58*'Patient Population'!G98)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H58*'Patient Population'!H98)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I58*'Patient Population'!I98)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E58","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F58","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G58","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H58","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I58","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 11: \",NameComparator11)","v":"Comparator 11: "},null,"Number of patients receiving comparator 11",null,null,null,{"$f":"'Patient Population'!E117","v":0},{"$f":"'Patient Population'!F117","v":0},{"$f":"'Patient Population'!G117","v":0},{"$f":"'Patient Population'!H117","v":0},{"$f":"'Patient Population'!I117","v":0}]
[null,null,null,"Cost of comparator 11 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E39","v":0},{"$f":" 'Drug Acquisition Costs'!F39","v":0},{"$f":" 'Drug Acquisition Costs'!G39","v":0},{"$f":" 'Drug Acquisition Costs'!H39","v":0},{"$f":" 'Drug Acquisition Costs'!I39","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E59*'Patient Population'!E99)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F59*'Patient Population'!F99)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G59*'Patient Population'!G99)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H59*'Patient Population'!H99)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I59*'Patient Population'!I99)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E59","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F59","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G59","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H59","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I59","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "},null,"Number of patients receiving comparator 12",null,null,null,{"$f":"'Patient Population'!E118","v":0},{"$f":"'Patient Population'!F118","v":0},{"$f":"'Patient Population'!G118","v":0},{"$f":"'Patient Population'!H118","v":0},{"$f":"'Patient Population'!I118","v":0}]
[null,null,null,"Cost of comparator 12 each year",null,null,null,{"$f":" 'Drug Acquisition Costs'!E40","v":0},{"$f":" 'Drug Acquisition Costs'!F40","v":0},{"$f":" 'Drug Acquisition Costs'!G40","v":0},{"$f":" 'Drug Acquisition Costs'!H40","v":0},{"$f":" 'Drug Acquisition Costs'!I40","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E60*'Patient Population'!E100)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F60*'Patient Population'!F100)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G60*'Patient Population'!G100)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H60*'Patient Population'!H100)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I60*'Patient Population'!I100)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E60","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F60","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G60","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H60","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I60","v":0}]
[null,"Total cost of comparators",null,null,null,null,null,{"$f":"(H95*H96)+((H97+H98)*(0.5*H96))+(H99*H100)+((H101+H102)*(0.5*H100))+(H103*H104)+((H105+H106)*(0.5*H104))+(H107*H108)+((H109+H110)*(0.5*H108))+(H111*H112)+((H113+H114)*(0.5*H112))+(H115*H116)+((H117+H118)*(0.5*H116))+(H119*H120)+((H121+H122)*(0.5*H120))+(H123*H124)+((H125+H126)*(0.5*H124))+(H127*H128)+((H129+H130)*(0.5*H128))+(H131*H132)+((H133+H134)*(0.5*H132))+(H135*H136)+((H137+H138)*(0.5*H136))+(H139*H140)+((H141+H142)*(0.5*H140))","v":0},{"$f":"(I95*I96)+((I97+I98)*(0.5*I96))+(I99*I100)+((I101+I102)*(0.5*I100))+(I103*I104)+((I105+I106)*(0.5*I104))+(I107*I108)+((I109+I110)*(0.5*I108))+(I111*I112)+((I113+I114)*(0.5*I112))+(I115*I116)+((I117+I118)*(0.5*I116))+(I119*I120)+((I121+I122)*(0.5*I120))+(I123*I124)+((I125+I126)*(0.5*I124))+(I127*I128)+((I129+I130)*(0.5*I128))+(I131*I132)+((I133+I134)*(0.5*I132))+(I135*I136)+((I137+I138)*(0.5*I136))+(I139*I140)+((I141+I142)*(0.5*I140))","v":0},0,0,0,null,{"$f":"SUM(H143:L143)","v":0}]
[]
[null,"Net Drug Budget Impact",null,null,null,null,null,{"$f":"H36+H90-H143","v":0},{"$f":"I36+I90-I143","v":0},{"$f":"J36+J90-J143","v":0},{"$f":"K36+K90-K143","v":0},{"$f":"L36+L90-L143","v":0},null,{"$f":"SUM(H145:L145)","v":0}]
[]
[]
[null,"Net Budget Impact"]
[null,null,null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,"Cost/cost-offset per year",null,null,null,null,null,{"$f":"'Additional Costs'!F25*(H30-(0.5*(H32+H33)))","v":0},{"$f":"'Additional Costs'!G25*(I30-(0.5*(I32+I33)))","v":0},{"$f":"'Additional Costs'!H25*(J30-(0.5*(J32+J33)))","v":0},{"$f":"'Additional Costs'!I25*(K30-(0.5*(K32+K33)))","v":0},{"$f":"'Additional Costs'!J25*(L30-(0.5*(L32+L33)))","v":0}]
[]
[null,"Net Budget Impact",null,null,null,null,null,{"$f":"H145+H150","v":0},{"$f":"I145+I150","v":0},0,0,0,null,{"$f":"SUM(H152:L152)","v":0}]
[]
[null,"Please note: it is beyond the scope of the Rapid Review process to appraise the impact of an intervention on wider health care budgets; the net budget impact is not required for Rapid Review submissions."]

{"sheet":"Results (PAS)","index":9,"n_rows":154,"n_cols":14,"rows_kept":154,"cut":false,"hidden":false,"merged":[[144,1,144,6],[147,1,147,6],[149,1,149,6],[151,1,151,6],[153,1,154,11],[138,1,141,2],[138,3,138,6],[139,3,139,6],[140,3,140,6],[141,3,141,6],[142,1,142,6],[130,1,133,2],[130,3,130,6],[131,3,131,6],[132,3,132,6],[133,3,133,6],[134,1,137,2],[134,3,134,6],[135,3,135,6],[136,3,136,6],[137,3,137,6],[122,1,125,2],[122,3,122,6],[123,3,123,6],[124,3,124,6],[125,3,125,6],[126,1,129,2],[126,3,126,6],[127,3,127,6],[128,3,128,6],[129,3,129,6],[114,1,117,2],[114,3,114,6],[115,3,115,6],[116,3,116,6],[117,3,117,6],[118,1,121,2],[118,3,118,6],[119,3,119,6],[120,3,120,6],[121,3,121,6],[106,1,109,2],[106,3,106,6],[107,3,107,6],[108,3,108,6],[109,3,109,6],[110,1,113,2],[110,3,110,6],[111,3,111,6],[112,3,112,6],[113,3,113,6],[98,1,101,2],[98,3,98,6],[99,3,99,6],[100,3,100,6],[101,3,101,6],[102,1,105,2],[102,3,102,6],[103,3,103,6],[104,3,104,6],[105,3,105,6],[93,1,93,6],[94,1,97,2],[94,3,94,6],[95,3,95,6],[96,3,96,6],[97,3,97,6],[85,1,88,2],[85,3,85,6],[86,3,86,6],[87,3,87,6],[88,3,88,6],[89,1,89,6],[77,1,80,2],[77,3,77,6],[78,3,78,6],[79,3,79,6],[80,3,80,6],[81,1,84,2],[81,3,81,6],[82,3,82,6],[83,3,83,6],[84,3,84,6],[69,1,72,2],[69,3,69,6],[70,3,70,6],[71,3,71,6],[72,3,72,6],[73,1,76,2],[73,3,73,6],[74,3,74,6],[75,3,75,6],[76,3,76,6],[61,1,64,2],[61,3,61,6],[62,3,62,6],[63,3,63,6],[64,3,64,6],[65,1,68,2],[65,3,65,6],[66,3,66,6],[67,3,67,6],[68,3,68,6],[53,1,56,2],[53,3,53,6],[54,3,54,6],[55,3,55,6],[56,3,56,6],[57,1,60,2],[57,3,57,6],[58,3,58,6],[59,3,59,6],[60,3,60,6],[45,1,48,2],[45,3,45,6],[46,3,46,6],[47,3,47,6],[48,3,48,6],[49,1,52,2],[49,3,49,6],[50,3,50,6],[51,3,51,6],[52,3,52,6],[33,1,33,6],[35,1,35,6],[38,1,38,6],[40,1,40,6],[41,1,44,2],[41,3,41,6],[42,3,42,6],[43,3,43,6],[44,3,44,6],[16,1,19,9],[21,1,21,6],[24,1,24,6],[27,1,27,6],[29,1,32,2],[29,3,29,6],[30,3,30,6],[31,3,31,6],[32,3,32,6]]}
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null," The gross and net drug budget impacts are presented below, based on the inputs used throughout the rest of the model. Separately, a net budget impact accounting for costs and offsets outside of the drugs budget is presented.  Patients who died or stopped treatment are assumed to have received treatment for 6 months.\nPlease note that it is not a requirement to submit a CIC PAS at this stage but this tab should be used if a CIC PAS is included as part of the submission."]
[]
[]
[]
[]
[null,"Summary"]
[]
[null,null,null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5",null,"Cumulative"]
[null,"Eligible patient population",null,null,null,null,null,{"$f":"'Patient Population'!E36","v":0},{"$f":"'Patient Population'!F36","v":0},{"$f":"'Patient Population'!G36","v":0},{"$f":"'Patient Population'!H36","v":0},{"$f":"'Patient Population'!I36","v":0},null,{"$f":"SUM(H25:L25)","v":0}]
[]
[]
[null,"Gross Drug Budget Impact"]
[null,null,null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,{"$f":"CONCATENATE(\"Intervention: \",InterventionINN)","v":"Intervention: "},null,"Number of patients receiving intervention",null,null,null,{"$f":"'Patient Population'!E126","v":0},{"$f":"'Patient Population'!F126","v":0},{"$f":"'Patient Population'!G126","v":0},{"$f":"'Patient Population'!H126","v":0},{"$f":"'Patient Population'!I126","v":0}]
[null,null,null,"Cost of intervention each year",null,null,null,{"$f":"'Drug Acquisition Costs (PAS)'!E28","v":0},{"$f":"'Drug Acquisition Costs (PAS)'!F28","v":0},{"$f":"'Drug Acquisition Costs (PAS)'!G28","v":0},{"$f":"'Drug Acquisition Costs (PAS)'!H28","v":0},{"$f":"'Drug Acquisition Costs (PAS)'!I28","v":0}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E68*'Patient Population'!E88)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F68*'Patient Population'!F88)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G68*'Patient Population'!G88)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H68*'Patient Population'!H88)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I68*'Patient Population'!I88)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E68","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F68","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G68","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H68","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I68","v":0}]
[null,"Total cost of intervention",null,null,null,null,null,{"$f":"(H30*H31)+((0.5*H31)*(H32+H33))","v":0},{"$f":"(I30*I31)+((0.5*I31)*(I32+I33))","v":0},{"$f":"(J30*J31)+((0.5*J31)*(J32+J33))","v":0},{"$f":"(K30*K31)+((0.5*K31)*(K32+K33))","v":0},{"$f":"(L30*L31)+((0.5*L31)*(L32+L33))","v":0}]
[]
[null,"Gross Drug Budget Impact",null,null,null,null,null,{"$f":"H34","v":0},{"$f":"I34","v":0},{"$f":"J34","v":0},{"$f":"K34","v":0},{"$f":"L34","v":0},null,{"$f":"SUM(H36:L36)","v":0}]
[]
[]
[null,"Net Drug Budget Impact"]
[]
[null,"Comparator costs with new intervention in market",null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,{"$f":"CONCATENATE(\"Comparator 1: \",NameComparator1)","v":"Comparator 1: "},null,"Number of patients receiving comparator 1",null,null,null,{"$f":"'Patient Population'!E127","v":0},{"$f":"'Patient Population'!F127","v":0},{"$f":"'Patient Population'!G127","v":0},{"$f":"'Patient Population'!H127","v":0},{"$f":"'Patient Population'!I127","v":0}]
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[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E80*'Patient Population'!E100)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F80*'Patient Population'!F100)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G80*'Patient Population'!G100)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H80*'Patient Population'!H100)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I80*'Patient Population'!I100)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E80","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F80","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G80","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H80","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I80","v":0}]
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[]
[]
[]
[null,"Comparator costs with no intervention in market",null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
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[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E49*'Patient Population'!E89)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F49*'Patient Population'!F89)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G49*'Patient Population'!G89)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H49*'Patient Population'!H89)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I49*'Patient Population'!I89)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E49","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F49","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G49","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H49","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I49","v":0}]
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[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E50*'Patient Population'!E90)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F50*'Patient Population'!F90)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G50*'Patient Population'!G90)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H50*'Patient Population'!H90)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I50*'Patient Population'!I90)","v":0}]
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[null,{"$f":"CONCATENATE(\"Comparator 3: \",NameComparator3)","v":"Comparator 3: "},null,"Number of patients receiving comparator 3",null,null,null,{"$f":"'Patient Population'!E109","v":0},{"$f":"'Patient Population'!F109","v":0},{"$f":"'Patient Population'!G109","v":0},{"$f":"'Patient Population'!H109","v":0},{"$f":"'Patient Population'!I109","v":0}]
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[null,{"$f":"CONCATENATE(\"Comparator 4: \",NameComparator4)","v":"Comparator 4: "},null,"Number of patients receiving comparator 4",null,null,null,{"$f":"'Patient Population'!E110","v":0},{"$f":"'Patient Population'!F110","v":0},{"$f":"'Patient Population'!G110","v":0},{"$f":"'Patient Population'!H110","v":0},{"$f":"'Patient Population'!I110","v":0}]
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[null,{"$f":"CONCATENATE(\"Comparator 5: \",NameComparator5)","v":"Comparator 5: "},null,"Number of patients receiving comparator 5",null,null,null,{"$f":"'Patient Population'!E111","v":0},{"$f":"'Patient Population'!F111","v":0},{"$f":"'Patient Population'!G111","v":0},{"$f":"'Patient Population'!H111","v":0},{"$f":"'Patient Population'!I111","v":0}]
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[null,{"$f":"CONCATENATE(\"Comparator 6: \",NameComparator6)","v":"Comparator 6: "},null,"Number of patients receiving comparator 6",null,null,null,{"$f":"'Patient Population'!E112","v":0},{"$f":"'Patient Population'!F112","v":0},{"$f":"'Patient Population'!G112","v":0},{"$f":"'Patient Population'!H112","v":0},{"$f":"'Patient Population'!I112","v":0}]
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[null,{"$f":"CONCATENATE(\"Comparator 7: \",NameComparator7)","v":"Comparator 7: "},null,"Number of patients receiving comparator 7",null,null,null,{"$f":"'Patient Population'!E113","v":0},{"$f":"'Patient Population'!F113","v":0},{"$f":"'Patient Population'!G113","v":0},{"$f":"'Patient Population'!H113","v":0},{"$f":"'Patient Population'!I113","v":0}]
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[null,{"$f":"CONCATENATE(\"Comparator 8: \",NameComparator8)","v":"Comparator 8: "},null,"Number of patients receiving comparator 8",null,null,null,{"$f":"'Patient Population'!E114","v":0},{"$f":"'Patient Population'!F114","v":0},{"$f":"'Patient Population'!G114","v":0},{"$f":"'Patient Population'!H114","v":0},{"$f":"'Patient Population'!I114","v":0}]
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[null,{"$f":"CONCATENATE(\"Comparator 9: \",NameComparator9)","v":"Comparator 9: "},null,"Number of patients receiving comparator 9",null,null,null,{"$f":"'Patient Population'!E115","v":0},{"$f":"'Patient Population'!F115","v":0},{"$f":"'Patient Population'!G115","v":0},{"$f":"'Patient Population'!H115","v":0},{"$f":"'Patient Population'!I115","v":0}]
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[null,{"$f":"CONCATENATE(\"Comparator 10: \",NameComparator10)","v":"Comparator 10: "},null,"Number of patients receiving comparator 10",null,null,null,{"$f":"'Patient Population'!E116","v":0},{"$f":"'Patient Population'!F116","v":0},{"$f":"'Patient Population'!G116","v":0},{"$f":"'Patient Population'!H116","v":0},{"$f":"'Patient Population'!I116","v":0}]
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[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E59*'Patient Population'!E99)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F59*'Patient Population'!F99)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G59*'Patient Population'!G99)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H59*'Patient Population'!H99)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I59*'Patient Population'!I99)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E59","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F59","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G59","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H59","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I59","v":0}]
[null,{"$f":"CONCATENATE(\"Comparator 12: \",NameComparator12)","v":"Comparator 12: "},null,"Number of patients receiving comparator 12",null,null,null,{"$f":"'Patient Population'!E118","v":0},{"$f":"'Patient Population'!F118","v":0},{"$f":"'Patient Population'!G118","v":0},{"$f":"'Patient Population'!H118","v":0},{"$f":"'Patient Population'!I118","v":0}]
[null,null,null,"Cost of comparator 12 each year",null,null,null,{"$f":"'Drug Acquisition Costs (PAS)'!E40","v":""},{"$f":"'Drug Acquisition Costs (PAS)'!F40","v":""},{"$f":"'Drug Acquisition Costs (PAS)'!G40","v":""},{"$f":"'Drug Acquisition Costs (PAS)'!H40","v":""},{"$f":"'Drug Acquisition Costs (PAS)'!I40","v":""}]
[null,null,null,"Number of patients who discontinued",null,null,null,{"$f":"('Patient Population'!E36*'Patient Population'!E60*'Patient Population'!E100)","v":0},{"$f":"('Patient Population'!F36*'Patient Population'!F60*'Patient Population'!F100)","v":0},{"$f":"('Patient Population'!G36*'Patient Population'!G60*'Patient Population'!G100)","v":0},{"$f":"('Patient Population'!H36*'Patient Population'!H60*'Patient Population'!H100)","v":0},{"$f":"('Patient Population'!I36*'Patient Population'!I60*'Patient Population'!I100)","v":0}]
[null,null,null,"Number of patients who died",null,null,null,{"$f":"'Patient Population'!E30*'Patient Population'!E31*'Patient Population'!E33*'Patient Population'!E35*'Patient Population'!E60","v":0},{"$f":"'Patient Population'!F30*'Patient Population'!F31*'Patient Population'!F33*'Patient Population'!F35*'Patient Population'!F60","v":0},{"$f":"'Patient Population'!G30*'Patient Population'!G31*'Patient Population'!G33*'Patient Population'!G35*'Patient Population'!G60","v":0},{"$f":"'Patient Population'!H30*'Patient Population'!H31*'Patient Population'!H33*'Patient Population'!H35*'Patient Population'!H60","v":0},{"$f":"'Patient Population'!I30*'Patient Population'!I31*'Patient Population'!I33*'Patient Population'!I35*'Patient Population'!I60","v":0}]
[null,"Total cost of comparators",null,null,null,null,null,{"$f":"(H95*H96)+((H97+H98)*(0.5*H96))+(H99*H100)+((H101+H102)*(0.5*H100))+(H103*H104)+((H105+H106)*(0.5*H104))+(H107*H108)+((H109+H110)*(0.5*H108))+(H111*H112)+((H113+H114)*(0.5*H112))+(H115*H116)+((H117+H118)*(0.5*H116))+(H119*H120)+((H121+H122)*(0.5*H120))+(H123*H124)+((H125+H126)*(0.5*H124))+(H127*H128)+((H129+H130)*(0.5*H128))+(H131*H132)+((H133+H134)*(0.5*H132))+(H135*H136)+((H137+H138)*(0.5*H136))+(H139*H140)+((H141+H142)*(0.5*H140))","v":{"$error":"#VALUE!"}},{"$f":"(I95*I96)+((I97+I98)*(0.5*I96))+(I99*I100)+((I101+I102)*(0.5*I100))+(I103*I104)+((I105+I106)*(0.5*I104))+(I107*I108)+((I109+I110)*(0.5*I108))+(I111*I112)+((I113+I114)*(0.5*I112))+(I115*I116)+((I117+I118)*(0.5*I116))+(I119*I120)+((I121+I122)*(0.5*I120))+(I123*I124)+((I125+I126)*(0.5*I124))+(I127*I128)+((I129+I130)*(0.5*I128))+(I131*I132)+((I133+I134)*(0.5*I132))+(I135*I136)+((I137+I138)*(0.5*I136))+(I139*I140)+((I141+I142)*(0.5*I140))","v":{"$error":"#VALUE!"}},{"$error":"#VALUE!"},{"$error":"#VALUE!"},{"$error":"#VALUE!"},null,{"$f":"SUM(H143:L143)","v":{"$error":"#VALUE!"}}]
[]
[null,"Net Drug Budget Impact",null,null,null,null,null,{"$f":"H36+H90-H143","v":{"$error":"#VALUE!"}},{"$f":"I36+I90-I143","v":{"$error":"#VALUE!"}},{"$f":"J36+J90-J143","v":{"$error":"#VALUE!"}},{"$f":"K36+K90-K143","v":{"$error":"#VALUE!"}},{"$f":"L36+L90-L143","v":{"$error":"#VALUE!"}},null,{"$f":"SUM(H145:L145)","v":{"$error":"#VALUE!"}}]
[]
[]
[null,"Net Budget Impact"]
[null,null,null,null,null,null,null,"Year 1","Year 2","Year 3","Year 4","Year 5"]
[null,"Cost/cost-offset per year",null,null,null,null,null,{"$f":"'Additional Costs'!F25*(H30-(0.5*(H32+H33)))","v":0},{"$f":"'Additional Costs'!G25*(I30-(0.5*(I32+I33)))","v":0},{"$f":"'Additional Costs'!H25*(J30-(0.5*(J32+J33)))","v":0},{"$f":"'Additional Costs'!I25*(K30-(0.5*(K32+K33)))","v":0},{"$f":"'Additional Costs'!J25*(L30-(0.5*(L32+L33)))","v":0}]
[]
[null,"Net Budget Impact",null,null,null,null,null,{"$f":"H145+H150","v":{"$error":"#VALUE!"}},{"$f":"I145+I150","v":{"$error":"#VALUE!"}},{"$error":"#VALUE!"},{"$error":"#VALUE!"},{"$error":"#VALUE!"},null,{"$f":"SUM(H152:L152)","v":{"$error":"#VALUE!"}}]
[]
[null,"Please note: it is beyond the scope of the Rapid Review process to appraise the impact of an intervention on wider health care budgets; the net budget impact is not required for Rapid Review submissions."]

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["NCPE"]
["Ref 1","Central Statistics Office. https://www.cso.ie/en/statistics/population/regionalpopulationprojections.  Method M1F2 (Dublin inflow) is used. https://data.cso.ie/table/PEB07"]
["Ref 2","NCPE Guidelines for Inclusion of Drug Costs in Pharmacoeconomic Evaluation. http://www.ncpe.ie/submission-process/hta-guidelines/guidelines-for-inclusion-of-drug-costs/"]
["Other","HIQA Guidelines for the Budget Impact Analysis of Health Technologies in Ireland. https://www.hiqa.ie/reports-and-publications/health-technology-assessment/guidelines-budget-impact-analysis-health"]
[]
["Applicant"]
[null,"Please include any additional references here"]
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[]
[]
[]
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["Cost","Definitions used for the drug cost calculator (do not change)."]
[null,"Wholesale Mark-up for non-fridge items on the CDS",null,null,null,0.08]
[null,"Wholesale Mark-up for fridge items on the CDS",null,null,null,0.12]
[null,"Wholesale Mark-up for all tems on the HT",null,null,null,0.08]
[null,"Hospital Mark-up",null,null,null,0]
[null,"Framework Agreement Rebate",null,null,null,-8.5000000000000006E-2]
[null,"Framework Agreement Rebate Biologic",null,null,null,-0.125]
[null,"VAT",null,null,null,0.23]
[null,"Dispensing Fee",null,null,null,5.48]
[null,"High Tech Patient Care Fee",null,null,null,62.03]
[null,"Non Dispensing High Tech Fee",null,null,null,31.01]
[null,"Number of days in year",null,null,null,365.25]

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[null,"The impact of parameter uncertainty on the budget impact analysis should be explored using deterministic one-way sensitivity analysis for each parameter. Click the \"Run Sensitivity Analysis\" button to run the one-way sensitivity analysis for a set +/-20% on the parameters below. Please also provide any manual results in the grey boxes for any additional sensitivity analysis on appropriate individual parameters and any scenario analyses. Clear rationale for the range of values applied should be provided."]
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[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,"Lower Range Results",null,null,null,null,null,null,null,null,"Upper Range Results"]
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[null,{"$f":"'Patient Population'!B33:D33","v":"Patients eligible for the new intervention under the license (%)"},null,4,"Point estimates",-0.2,0.2,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0]
[null,{"$f":"'Patient Population'!B35:D35","v":"Sub-population of eligible patient population under consideration (%)"},null,5,"Point estimates",-0.2,0.2,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0]
[null,{"$f":"'Patient Population'!B65:G65","v":"Market share with intervention"},null,6,"Point estimates",-0.2,0.2,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0]
[null,{"$f":"'Patient Population'!B85:G85","v":"Discontinuation rates"},null,7,"Point estimates",-0.2,0.2,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0]
[null,"Cost of intervention",null,8,"Point estimates",-0.2,0.2,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0]
[null,"Cost of comparators",null,9,"Point estimates",-0.2,0.2,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0]
[null,{"$f":"'Additional Costs'!B25:E25","v":"Cost/cost-offset per patient per year"},null,10,"Point estimates",-0.2,0.2,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0]
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[]
[null,null,null,null,null,null,null,null,null,null,null,null,"Rank","Scenario","Lower","Upper","Difference",null,"Rank","Scenario","Lower","Upper","Difference",null,"Rank","Scenario","Lower","Upper","Difference"]
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