About the LEMI
The List of Excluded Medicinal Items (LEMI) is a record of medicines that are legally excluded from meeting active ingredient prescribing (AIP) requirements. The legislation that supports the AIP initiative only applies to Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) prescriptions, so the LEMI only contains medicines listed on the PBS or RPBS. We cannot consider non-PBS items for inclusion in the LEMI.
Inclusion of medicines on the LEMI is based on a set of principles which are outlined in the user guide.
Prescribers should prescribe items on the LEMI by the brand name only for practical and/or safety purposes. Prescribing software programs will generally default to brand name only for items on the LEMI.
We review the LEMI 3 times a year. Anyone can make a request for us to consider a medicine for inclusion in, or removal from, the LEMI at any time by emailing us with appropriate evidence.
About the LMBC
Under the AIP initiative, prescribers can include the medicine’s brand name after the active ingredient name if they consider it appropriate. The List of Medicines for Brand Consideration (LMBC) is a resource for health professionals to support safe prescribing and dispensing of medicines which may be of higher risk.
The LMBC includes a list of recommended medicines for further consideration by prescribers prior to deciding whether to prescribe by brand and active ingredient, or by active ingredient alone.
The LMBC is not mandated and is not a legal document, so there is no requirement for prescribers to include a brand name for prescription medicines included in the LMBC. Prescribers must decide on the additional specification of a particular brand of medicine as part of shared decision making with the patient.
The principles for inclusion of medicines on the LMBC are detailed in the user guide.
Review of specific medicines
The Department’s Active Ingredient Prescribing Working Group (AIPWG) reviews medicines against the principles in the Active Ingredient Prescribing User Guide to derive the List of Excluded Medicinal Items (LEMI) and List of Medicines for Brand Consideration (LMBC).
The specific medicines reviewed for inclusion in the LEMI or LMBC depend on:
- requests that the AIPWG receives
- any new or deleted entries in the Australian Register of Therapeutic Goods (ARTG) that have been identified.
All requests to consider medicines for inclusion in the LMBC additionally require the initiator to provide evidence of expert clinical advice in support of the request with respect to the principles set out in Box 2 of the user guide.
The outcomes of these reviews are summarised in the Active Ingredient Prescribing Outcomes Register. The outcomes register replaces the AIP Issues Register developed by the Australian Commission on Safety and Quality in Health Care (ACSQHC). The issues register includes past recommendations and actions by the ACSQHC before December 2022. The issues register is available on request from the ACSQHC.
All records of the AIPWG’s review of specific medicines from 1 January 2023 are included in the outcomes register.