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What is the NCCN Drugs & Biologics Compendium?

By Edward C. Li, PharmD, BCOP
NCCN eBulletin Drugs & Biologics Editor

Some practitioners are unfamiliar with the term “compendium” and what information a drug compendium contains.  By definition, a compendium is an abstract or concise summary of a body of knowledge.  The etymology of the word is derived from Medieval Latin compendere, which means to “weigh together.”¹  A drug compendium, therefore, contains an index of drugs and their corresponding body of knowledge, evaluated and summarized in a concise format. The content of drug compendia differs according to an individual compendium’s purpose, but may include a drug’s pharmacologic and pharmacokinetic properties (dosing, adverse effects, and drug interactions) and the recommended indications, both FDA approved and beyond the FDA-approved label (ie, “off-label”).   

Compendia are available in both print and electronic formats, such as web-based or handheld Handheld compendia are widely popular, and many practitioners carry one on their smartphone or personal digital assistant (PDA). Many hospitals or health systems subscribe to a web-based compendium and provide access for their staff and physicians. Some compendia are even integrated into electronic health records (EHRs) to allow providers quick access to drug dosing, adverse reactions, and drug interactions at the point of care. 

In addition to providing clinicians with quick access to drug information, drug compendia have been used to inform off-label coverage decisions for private payors since the late 80s and for Medicare beneficiaries since the passage of the 1993 Onmibus Budget Reconcilation Act. Under this law, the Centers for Medicare and Medicaid Services (CMS) considers coverage for the off-label use of an anticancer drug if the use is listed in one of the approved compendia.² In 2008, CMS expanded its list of recognized compendia to four compendia, including the NCCN Drugs & Biologics Compendium^®. Because the NCCN Compendium is recognized and accepted by public and private payors, it is widely used by managed care medical directors and pharmacy benefit directors when making decisions that impact patient access to appropriate therapy.

The NCCN Compendium is intended to optimize the clinical decision-making process with view toward improving the care available to patients.  Based directly on the NCCN Clinical Practice Guidelines in Oncology^®, the NCCN Compendium contains authoritative, scientifically derived information designed to support decision-making about the appropriate use of drugs and biologics in patients with cancer. The NCCN Compendium identifies the pharmacologic characteristics of each drug or biological and includes information on pharmacologic class, route of administration, ICD-9 codes, and FDA indications for each drug and biologic, in addition to the NCCN-recommended uses in specific diseases. These recommended uses are derived from the NCCN Clinical Practice Guidelines in Oncology^®. Uses listed in the NCCN Compendium are based upon the evaluation of evidence from scientific literature integrated with expert judgment in an evidence-based process. Therefore, the NCCN Compendium lists both FDA-approved uses and appropriate uses beyond the FDA-approved label. To allow the user to find information rapidly, the NCCN Compendium is searchable by agent name (brand or generic), disease, NCCN disease indication, NCCN category of evidence, pharmacologic class, histology, and ICD-9 code. Uses are categorized in a systematic approach that describes the type of evidence available for and the degree of consensus underlying each recommendation.  All recommendations (at all category levels) in the NCCN Compendium constitute appropriate, medically necessary care. The NCCN Compendium also contains links to the FDA-approved labels and to the NCCN Chemotherapy Order Templates^®. The NCCN Order Templates provide supporting evidence for the drug or biologic for use in a particular indication and specific information on dose, safety, and supportive care in an effort to improve the quality and safety of care delivered to the patient.

Practices will find the NCCN Compendium useful in their daily practice, and they can have confidence that the drugs and biologics listed within the NCCN Compendium are considered medically appropriate and will be covered by the payors that accept and recognize the NCCN Compendium as a reference for coverage policy.

For more information visit the NCCN Drugs & Biologics Compendium™

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