Aligning the healthcare ecosystem for a successful 12-digit NDC transition

The Challenge


The NDC Rule, finalized by FDA in March 2026, establishes a single, uniform 12-digit format for FDA-assigned National Drug Codes (NDCs) beginning in 2033. Today, NDC codes exist in multiple 10-digit, and sometimes 11-digit, configurations that organizations interpret differently across systems. Transitioning to 12 digits requires coordinated changes across every part of the healthcare ecosystem, spanning manufacturers and distributors to providers, payers, and regulators.

  • Changes will span hundreds of systems and processes across every sector

  • Organizations must operate in a mixed 10-, 11-, and 12-digit environment for years

  • Critical dependencies exist across manufacturing, distribution, care delivery, payment, and regulatory

  • Success depends on synchronized execution across independent actors

The NDC Forum


The NDC Coordination and Implementation Forum is a cross-sector collaborative of manufacturers, distributors, pharmacies, health care providers, retailers, payers, technology providers, regulators, and other critical stakeholders working to ensure the entire drug ecosystem moves forward with shared insight, aligned priorities, and coordinated execution.

Accelerates
Cross-Sector
Learning

Creates a structured mechanism to share real-world challenges, surface emerging risks early, and translate lessons from one sector into action for others.

Aligns the Ecosystem Across Independent Efforts

Connects and amplifies the work of standards bodies, trade associations, and others, identifying gaps, overlaps, and dependencies to ensure a coherent, systemwide plan.

Serves as a Central Industry-Government Interface

Provides a trusted forum for dialogue with FDA, CMS, ONC, NIH, CDC, DEA, CBP, states, and other agencies, enabling real-time feedback loops on implementation challenges and surfacing areas where regulatory clarity or flexibility is needed.

Drives Rapid Alignment on Cross-Sector Issues

Establishes time-bound “strike forces” to resolve priority challenges as they arise, such as HIPAA alignment, testing models, and barcode strategy.

Coordinates Testing and Piloting Across the Ecosystem

Aligns stakeholders around shared testing approaches and timelines, ensuring cross-sector readiness ahead of the critical 2030-2032 testing window.

Consolidates Education, Guidance, and Resources

Creates a single access point for implementation materials, aligns messaging, and reduces duplication and confusion across the ecosystem.

Learn how the NDC Forum supports the NDC12 transition by helping stakeholders align, prepare, and coordinate across the healthcare ecosystem.

Why Participate


Early
Visibility

Gain early insight into risks emerging in other sectors

Reduce
Cost

Avoid rework and misalignment by coordinating implementation

Influence
Decisions

Shape how cross-sector issues and priorities are resolved

Engage
Regulators

Work directly with agencies defining the path forward

Stay
Aligned

Keep your organization synchronized with ecosystem progress

Quarterly
Coordinating Forum

Cross-sector leaders convene to share progress, align on priorities and dependencies, engage government stakeholders, and surface issues for Strike Force resolution.

Rapid
“Strike Forces”

Focused, time-bound teams tackle high-priority cross-sector issues and deliver actionable outputs in weeks, not years.

Central
Knowledge Hub

A shared platform with implementation roadmaps, dependency maps, testing frameworks, regulatory updates, and a directory of technical leaders and standards bodies.

Pilot Coordination

Planning and coordination to support essential cross-sector testing and piloting, including government collaboration.

Bringing Together the Full Healthcare Ecosystem


The NDC Coordination and Implementation Forum brings together stakeholders across all reaches of the health care ecosystem.

Manufacturing & Supply Chain

  • Rx, OTC, and animal drug manufacturers

  • Packaging, labeling, and importers

  • Wholesalers and distributors

Care Delivery

  • Pharmacies: retail, specialty, and hospital

  • Health systems and providers

  • Dental, long-term care, and carceral care settings

Technology & Data Infrastructure

  • EHRs, pharmacy systems, and ePrescribing platforms

  • Clinical decision support systems

  • Warehouse, traceability, and supply chain platforms

  • Drug compendia and data providers

Payers & Financial Systems

  • Payers and pharmacy benefit managers

  • Group purchasing organizations (GPOs)

  • Billing, claims, and revenue cycle organizations

Government & Standards

  • Federal and state regulators

  • Standards bodies

Other Key Stakeholders

  • Patient advocacy organizations

  • Research institutions and academic medical centers

Get Involved


Organizational Membership

Annual Membership
$5,000
per organization

  • Unlimited participants from your organization

  • Access to all quarterly forums, strike forces, and other events

  • Full access to tools, outputs, and shared resources

Per-Participant Access

Virtual
Quarterly Forums
$399
per person

In-Person
Forums
TBD
per person

Attend quarterly forums on a per-person basis, ideal for organizations exploring participation before committing to full membership.

September and December Forum dates and registration coming soon!

Strike force participation available to organizational members only.

The next several years will define implementation success. Join the effort, and become a member today.