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Aligning dm+d VMPP class medicinal products to the SNOMED International drug model

The scope of this work is the modelling of virtual medicinal product pack (VMPP) classes, their attributes, and their descriptions.

Page contents

Attribute generation patterns

Rules for grouped attributes in the SNOMED International model

Rule 1: Standard rule

  • The grouped attributes ('Contains clinical drug', 'Has pack size', 'Has pack size unit') originate from the corresponding VMPP node.
  • The following list of attributes, currently originating from the VMP will no longer be modelled in new VMPPs: 'Has NHS dm+d (dictionary of medicines and devices) controlled drug category', 'Has dispensed dose form', 'VMP non-availability indicator', 'VMP prescribing status'. 'Has VMP' will become 'Contains clinical drug'.

Rule 2: Combination packs

  • The grouped attributes originate from the sub-packs inside the combination pack.

Rule 3: Exception for identical sub-packs

  • If the combination pack contains multiple sub-packs of the same type, then the 'Has pack size' attribute is from the combination pack and not the sub-pack.
  • This indicates the total pack size of the VMP across the whole combination pack, rather than just the sub-packs.
New attributes

Is A – Medicinal Product Package 
Attribute ID: 116680003 
Mandatory: True 
Cardinality: 1..1 
Grouped: False 
Destination: 781405001 
Can be modified: False 
 

'Count of clinical drug type' 
Attribute ID: 1142143009 
Mandatory: True 
Cardinality: 1..1 
Grouped: False 
Value: Number of distinct clinical drugs in the pack(s) 
Can be modified: Yes 
 

'Contains clinical drug' 
Attribute ID: 774160008 
Mandatory: True 
Cardinality: [1..1] in group 
Grouped: True 
Destination: Taken from <VPID> as is 
Can be modified: Yes
 

'Has pack size' 
Attribute ID: 1142142004 
Mandatory: True 
Cardinality: [1..1] in group 
Grouped: True 
Value: Taken from <QTYVAL> as is 
Can be modified: Yes 
 

'Has pack size unit' 
Attribute ID: 774163005 
Mandatory: True 
Cardinality: [1..1] in group 
Grouped: True 
Destination: Taken from <QTY_UOMCD> as is 
Can be modified: Yes 

Removed attributes

'Has VMP'
Attribute ID: 10362601000001103 
Mandatory: True 
Cardinality: 1..1 
Grouped: False 
Destination: Taken from <VPID> as is 

Description generation patterns

Rules for the new description generation patterns:

FSN*: Will be updated according to the rules below

Preferred term: Will remain unchanged

Acceptable synonym: Will not be generated

Combination packs - Each clinical drug in each sub-pack will have a new SI-Style description

*The planned change by SNOMED International to increase the maximum length of fully specified name (FSN) and synonym descriptions, from 255 to 4096 characters, will impact FSNs created in the SNOMED CT UK Drug Extension.

dm+d terms will remain the length stated in the dm+d Technical Specification.

Single component packs 

FSN term pattern should be: 

Package containing <quantity> <unit_fsn> of <vmp_fsn> (packaged clinical drug) 

where 

<quantity> is the QTYVAL value taken as is 

<unit_fsn> is the NHS Pharmacy part FSN of the QTY_UOMCD concept (without semantic tag) 

<vmp_fsn> is the NHS Pharmacy part FSN of the VPID concept (with both the Product containing precisely prefix and the semantic tag removed) 

Example

The fully specified name of 8018511000001100 (with VMP 8016611000001102) should be:

Package containing 125 milliliter of ammonium chloride 20 milligram/1 milliliter and diphenhydramine 2.5 milligram/1 milliliter conventional release oral solution 5 milliliter spoonful sugar free (packaged clinical drug) 

Combination packs

FSN term pattern should be: 

Package containing <quantity> <unit_fsn> of <vmp_fsn> (packaged clinical drug) 

where 

the section underlined above is repeated for each subpack and joined together with ‘and’ 

<quantity> is the QTYVAL value taken as is from the subpack 

<unit_fsn> is the NHS Pharmacy part FSN of the QTY_UOMCD concept (without semantic tag) as taken from the subpack 

<vmp_fsn> is the NHS Pharmacy part FSN of the VPID concept (with both the Product containing precisely prefix and the semantic tag removed) as taken from the subpack 

Example

28391211000001105: Package containing 1 tablet of mifepristone 200 milligram/1 each conventional release oral tablet 1 tablet tablet and 4 tablet of misoprostol 200 microgram/1 each conventional release vaginal tablet 1 tablet tablet (packaged clinical drug) 

Note: Subpacks will be listed in alphabetical order in the FSN of the VMPP.

Examples of different VMPP modelling

1. Single drug

Example concept: 1050211000001102 | Clotrimazole 1% cream 15 gram (product) |

Current VMPP modelling and attributes visualisation

Download the current VMPP modelling and attributes visualisation for single drugs.

Image description

This diagram illustrates the primitive concept definition for ‘Clotrimazole 1% cream 15 gram (product)’ |1050211000001102|.

The numerical reference given with each concept and attribute is the SNOMED CT identifier.

‘Clotrimazole 1% cream 15 gram (product)' |1050211000001102|, has subtype relationships of:

  • the concept 'Virtual medicinal product pack (product)’ |8653601000001108|

‘Clotrimazole 1% cream 15 gram (product)' |1050211000001102|, has the defining attributes:

  • VMP non-availability indicator (attribute) |8940601000001102|, with concept 'Available (qualifier value)’ |8940901000001109|
  • Has VMP (attribute) |10362601000001103|, with defined concept 'Clotrimazole 1% cream (product)’ |41894811000001103|
  • Has NHS dm+d (dictionary of medicines and devices) controlled drug category (attribute) |13089101000001102|, with concept 'Controlled drug category No Controlled Drug Status (qualifier value)’|8481000001100|
  • Has dispensed dose form (attribute) |10362901000001105|, with defined concept 'Conventional release cutaneous cream (dose form)’ |421628006|
  • VMP prescribing status (attribute) |8940001000001105|, with concept 'VMP valid as a prescribable product (qualifier value)’ |8940201000001104|

New VMPP modelling and attributes visualisation

Download the new VMPP modelling and attributes visualisation for single drugs.

Image description

This diagram illustrates the defined concept definition for ‘Clotrimazole 1% cream 15 gram (product)’|1050211000001102|.

The numerical reference given with each concept and attribute is the SNOMED CT identifier.

‘Clotrimazole 1% cream 15 gram (product)’ |1050211000001102|, has subtype relationships of:

  • the concept 'Medicinal product package (product)’ |781405001|
  • the concept 'Virtual medicinal product pack (product)’ |8653601000001108|

‘Clotrimazole 1% cream 15 gram (product)’ |1050211000001102|, has the defining attributes:

  • Count of clinical drug type (attribute) |1142143009|, with the concrete value of 1

‘Clotrimazole 1% cream 15 gram (product)’ |1050211000001102|, also has an attribute group with the defining attributes:

  • Contains clinical drug (attribute) |774160008|, with defined concept ‘Clotrimazole 1% cream (product)’ |41894811000001103I
  • Has pack size unit (attribute) |774163005|, with concept ‘gram (qualifier value)’|258682000|
  • Has pack size (attribute) |1142142004|, with the concrete value of 15

2. Combination product with multiple sub-packs

Example concept: 42669211000001105 | Generic Ensure Plus Juce Starter Pack liquid 1320 ml (product) |

Current VMPP modelling and attributes visualisation

Download the current VMPP modelling and attributes visualisation for combination products with multiple sub-packs.

Image description

This diagram illustrates the primitive concept definition for ‘Generic Ensure Plus Juce Starter Pack liquid 1320 ml (product)’ | 42669211000001105|.

The numerical reference given with each concept and attribute is the SNOMED CT identifier.

‘Generic Ensure Plus Juce Starter Pack liquid 1320 ml (product)’ |42669211000001105|, has subtype relationships of:

  • the concept 'Virtual medicinal product pack (product)’ |8653601000001108|

‘Generic Ensure Plus Juce Starter Pack liquid 1320 ml (product)’ |42669211000001105|, has the defining attributes:

  • VMP non-availability indicator (attribute) |8940601000001102|, with concept 'Available (qualifier value)’ |8940901000001109|
  • Has NHS dm+d (dictionary of medicines and devices) controlled drug category (attribute) |13089101000001102|, with concept 'Controlled drug category No Controlled Drug Status (qualifier value)’ |8481000001100|
  • Has dispensed dose form (attribute) |10362901000001105|, with concept ‘Dose form not applicable (qualifier value)’ |3097611000001100|
  • Has VMP (attribute) |10362601000001103|, with defined concept ‘Generic Ensure Plus Juce Starter Pack liquid (product)’ |42683411000001109|
  • Has NHS dm+d (dictionary of medicines and devices) freeness indicator (attribute) |13089701000001101|, with concept ‘Gluten free (qualifier value)’ |13090001000001108|
  • VMP prescribing status (attribute) |8940001000001105|, with concept ‘Never valid to prescribe as a VMP (qualifier value)’ |8940401000001100|

New VMPP modelling and attributes visualisation

Download the new VMPP modelling and attributes for combination products with multiple sub-packs.

Image description

This diagram illustrates the defined concept definition for ‘Generic Ensure Plus Juce Starter Pack liquid 1320 ml (product)’ |42669211000001105|

The numerical reference given with each concept and attribute is the SNOMED CT identifier.

‘Generic Ensure Plus Juce Starter Pack liquid 1320 ml (product)’ |42669211000001105|, has subtype relationships of:

  • the concept 'Medicinal product package (product)’ |781405001|
  • the concept 'Virtual medicinal product pack (product)’ |8653601000001108|

‘Generic Ensure Plus Juce Starter Pack liquid 1320 ml (product)’ |42669211000001105|, has the defining attributes:

  • Count of clinical drug type (attribute) |1142143009|, with the concrete value of 1

‘Generic Ensure Plus Juce Starter Pack liquid 1320 ml (product)’ |42669211000001105|,also has an attribute group with the defining attributes:

  • Contains clinical drug (attribute) |774160008|, with defined concept ‘Generic Enlive Plus Liquid (product)’|7565411000001100|
  • Has pack size unit (attribute) |774163005|, with concept ‘milliliter (qualifier value)’ |258773002|
  • Has pack size (attribute) |1142142004|, with the concrete value of 1320

3. Combination product - clotrimazole

Example concept: 943311000001100 | Clotrimazole 10% cream and Clotrimazole 2% cream 2 component (product) |

Current VMPP modelling and attributes visualisation

Download the current VMPP modelling and attributes visualisation for combination products - clotrimazole.

Image description

This diagram illustrates the primitive concept definition for ‘Clotrimazole 10% cream and Clotrimazole 2% cream 2 component (product)’ |3943311000001100|.

The numerical reference given with each concept and attribute is the SNOMED CT identifier.

‘Clotrimazole 10% cream and Clotrimazole 2% cream 2 component' |3943311000001100|, has subtype relationships of:

  • the concept 'Virtual medicinal product pack (product)’ |8653601000001108|

‘Clotrimazole 10% cream and Clotrimazole 2% cream 2 component' |3943311000001100|, has the defining attributes:

  • Has VMP (attribute) |10362601000001103|, with defined concept 'Clotrimazole 10% cream and Clotrimazole 2% cream (product)’ |3947811000001103|
  • Has NHS dm+d (dictionary of medicines and devices) controlled drug category (attribute) |13089101000001102|, with concept 'Controlled drug category No Controlled Drug Status (qualifier value)’|8481000001100|
  • Has dispensed dose form (attribute) |10362901000001105|, with concept ‘Dose form not applicable (qualifier value)’ |3097611000001100|
  • VMP non-availability indicator (attribute) |8940601000001102|, with concept Re-introduced (qualifier value)’ |8940801000001103|
  • VMP prescribing status (attribute) |8940001000001105|, with concept 'VMP valid as a prescribable product (qualifier value)’ |8940201000001104|

New VMPP modelling and attributes visualisation

Download the new VMPP modelling and attributes visualisation for combination products - clotrimazole.

Image description

This diagram illustrates the defined concept definition for ‘Package containing 5 gram of clotrimazole 100 milligram/1 gram conventional release vaginal cream 1 applicator applicator’ |3943311000001100|

The numerical reference given with each concept and attribute is the SNOMED CT identifier.

‘Package containing 5 gram of clotrimazole 100 milligram/1 gram conventional release vaginal cream 1 applicator applicator’ |3943311000001100|, has subtype relationships of:

  • the concept 'Medicinal product package (product)’ |781405001|
  • the concept 'Virtual medicinal product pack (product)’ |8653601000001108|

‘Package containing 5 gram of clotrimazole 100 milligram/1 gram conventional release vaginal cream 1 applicator applicator’ |3943311000001100| has the defining attributes:

  • Count of clinical drug type (attribute) |1142143009|, with the concrete value of 2

‘Package containing 5 gram of clotrimazole 100 milligram/1 gram conventional release vaginal cream 1 applicator applicator’’ |3943311000001100|, also has attribute groups with the defining attributes:

  • Has pack size unit (attribute) |774163005|, with concept ‘gram (qualifier value) ‘|258682000|
  • Contains clinical drug (attribute) |774160008|, with defined concept ‘Product containing precisely clotrimazole 20 milligram/1 gram conventional release cutaneous cream  (clinical drug)’ |41894911000001108|
  • Has pack size (attribute) |1142142004|, with the concrete value of 10
  • Has pack size unit (attribute) |774163005|, with concept ‘gram (Qualifier Value) ‘|258682000|
  • Contains clinical drug (attribute) |774160008|, with defined concept ‘Product containing precisely clotrimazole 100 milligram/1 gram conventional release vaginal cream  1 applicator applicator’ |36565511000001102|
  • Has pack size (attribute) |1142142004|, with the concrete value of 5

4. Combination product - estriol

Example concept: 3194311000001106 | Estriol 0.01% vaginal cream with applicator 1 pack (product) |

Current VMPP modelling and attributes visualisation

Download the current VMPP modelling and attributes visualisation for combination products - estriol.

Image description

This diagram illustrates the primitive concept definition for ‘Estriol 0.01% vaginal cream with applicator 1 pack (product)’ |3194311000001106|.

The numerical reference given with each concept and attribute is the SNOMED CT identifier.

‘Estriol 0.01% vaginal cream with applicator 1 pack (product)’ |3194311000001106|, has subtype relationships of:

  • the concept 'Virtual medicinal product pack (product)’ |8653601000001108|

‘Estriol 0.01% vaginal cream with applicator 1 pack (product)’ |3194311000001106|, has the defining attributes:

  • VMP non-availability indicator (attribute) |8940601000001102|, with concept ‘Available (qualifier value)’ |8940901000001109|
  • Has NHS dm+d (dictionary of medicines and devices) controlled drug category (attribute) |13089101000001102|, with concept 'Controlled drug category No Controlled Drug Status (qualifier value)’|8481000001100|
  • Has dispensed dose form (attribute) |10362901000001105|, with concept ‘Dose form not applicable (qualifier value)’ |3097611000001100|
  • Has VMP (attribute) |10362601000001103|, with defined concept Estriol 0.01% vaginal cream with applicator (product)’ |3408711000001103|
  • VMP prescribing status (attribute) |8940001000001105|, with concept 'VMP valid as a prescribable product (qualifier value)’ |8940201000001104|

New VMPP modelling and attributes visualisation

Download the new VMPP modelling and attributes visualisation for combination products - estriol.

Image description

This diagram illustrates the primitive concept definition for ‘Estriol 0.01% vaginal cream with applicator 1 pack (product)’ |3194311000001106|

The numerical reference given with each concept and attribute is the SNOMED CT identifier.

‘Estriol 0.01% vaginal cream with applicator 1 pack (product)’ |3194311000001106|, has subtype relationships of:

  • the concept 'Medicinal product package (product)’ |781405001|
  • the concept 'Virtual medicinal product pack (product)’ |8653601000001108|

‘Estriol 0.01% vaginal cream with applicator 1 pack (product)’ |3194311000001106| has the defining attributes:

  • Count of clinical drug type (attribute) |1142143009|, with the concrete value of 2

‘Estriol 0.01% vaginal cream with applicator 1 pack (product)’ |3194311000001106|,also has attribute groups with the defining attributes:

  • Has pack size unit (attribute) |774163005|, with concept ‘gram (qualifier value) ‘|258682000|
  • Contains clinical drug (attribute) |774160008|, with defined concept ‘Product containing precisely estriol 100 microgram/1gram conventional release vaginal cream 1 applicator applicator (product)’ |41896711000001102|
  • Has pack size (attribute) |1142142004|, with the concrete value of 80
  • Has pack size unit (attribute) |774163005|, with concept ‘Applicator (unit of presentation)’ |732980001|
  • Contains clinical drug (attribute) |774160008|, with concept ‘Vaginal applicator type 1 (physical object)’ |3432211000001100
  • Has pack size (attribute) |1142142004|, with the concrete value of 1

Last edited: 9 January 2026 3:28 pm