Presenters
Penny Shakespeare, Deputy Secretary, Health Resourcing, Department of Health and Aged Care.
Adriana Platona, First Assistant Secretary, Technology Assessment and Access Division, Department of Health and Aged Care.
Kirsten Buckingham, Director, Opioid Dependence Treatment, Department of Health and Aged Care
Live Captions are available for this webinar.
Questions unanswered in session
Will the 60 day dispensing be updated on e-scripts?
The policy change which enables 60 day prescription dispensing will not impact electronic prescribing. The content of electronic prescriptions will not change.
Some chemist have "forgotten" to provide repeat tokens to patients, will there be a way to circumvent this?
A key pillar of electronic prescribing is patient choice, where patients are able to take their prescriptions to any pharmacy of their choice for dispense including repeat prescriptions. There are online training modules available for pharmacists on the Australian Digital Health Agency website regarding how to send repeat tokens.
Pharmacies are required to keep a copy of the dispense record of a prescription for audit purposes, but they are not able to withhold a prescription or repeat from a patient unless:
- the patient has requested the pharmacy to do so, and given their consent
- there is a safety risk or potential for harm to occur.
To assist in managing electronic prescription tokens patients can approach their chosen pharmacy to create an Active Script List (ASL) on their behalf. An ASL is a token management system that provides a list of a patient’s active prescriptions. It can display all current active electronic prescriptions any time a prescriber/pharmacist accesses the patient's ASL, removing the need to track of multiple tokens.
Patients are able to elect which prescriptions are sent to their ASL and which prescribers and pharmacists can view their ASL. From this list, the pharmacist can dispense electronic prescriptions, including those that were issued before the ASL was registered, and issue repeats. If a patient registers for an ASL they can request for all of their prescriptions to be listed on it. This allows patients to keep an accurate record of their prescriptions and easily move between pharmacies for dispense of medicines if required. If patients would like to register a complaint about a pharmacist they can contact the Australian Health Practitioner Regulation Agency (AHPRA) through their ‘Raise a concern’ portal. Alternatively, if a patient would like to complain about a pharmacy they can contact their local authority listed on the Pharmacy Council Australia website.
Why are only some medical conditions eligible for 60-day prescriptions of the same medicine?
In December 2022, the independent, expert Pharmaceutical Benefits Advisory Committee (PBAC) considered medicines listed on the Pharmaceutical Benefits Scheme (PBS) for stable, chronic, medical conditions and made recommendations about which medicines were clinically safe and suitable for listing with the option to prescribe in higher quantities (60 days’ supply). The decision to write a 60-day script will be made by the doctor based on their clinical judgement. The option to prescribe one month supply remains, if the doctors thinks a two month supply presents any risk for the patient.
In making its recommendations, the PBAC excluded medicines that are prescribed for the short term management of symptoms in chronic diseases. The PBAC also excluded medicines requiring regular adjustment (dose titration), close monitoring or with a potential risk to safety if stockpiled. For some instances, only certain medical conditions (indications) or forms of a medicine (e.g. certain strengths) were considered suitable to be prescribed in higher quantities, to ensure patient safety and minimise medicine wastage. For example, pramipexole (Sifrol®, Simipex®) is currently listed on the PBS for two indications: Parkinson disease and primary severe restless legs syndrome.
Based on PBAC advice, pramipexole is included in the 60-day dispensing policy for Parkinson disease only. The 60-day items will be added to the PBS in three stages. Pramipexole was not included in Stage 1 and will be implemented in a later stage on or prior to 1 September 2024. According to Australian Therapeutic Guidelines, the symptoms of restless legs and periodic limb movements of sleep/wakefulness may get worse after treatment, which may require adjustment in usage, taking a break from using the medicine or using an alternative medicine.
About the webinar
From 1 September 2023, many patients living with an ongoing health condition will be able to receive twice the medication for the cost of a single prescription.
This will apply to more than 300 common medicines listed on the PBS and will be implemented in 3 stages over 12 months.
When fully implemented on 1 September 2024, the changes will mean millions of Australians with ongoing health conditions will save money and time with 60-day prescriptions.
Further information on the 60-day prescription policy, including reinvestments into community pharmacies , can be found at: https://www.health.gov.au/our-work/60-day-dispensing.
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