Education guide - Authorised nurse practitioners - writing PBS prescriptions
Information about writing PBS prescriptions for authorised nurse practitioners.
The Pharmaceutical Benefits Scheme (PBS) is a system of subsidising the cost of many prescription medicines. The subsidies are available to all Australian residents and eligible overseas visitors.
As an authorised nurse practitioner you can only prescribe PBS medicines listed in the Schedule of Pharmaceutical Benefits (the Schedule), which are identified by the 'NP' symbol.
Eligible veterans, war widows and dependents are entitled to medicines through the Repatriation Pharmaceutical Benefits Scheme (RPBS) which is administered by the Department of Veterans' Affairs (DVA). Currently there are no medicines listed in the Repatriation Schedule that authorised nurse practitioners can prescribe.
It is important to prescribe within your scope of practice, prescribing accreditation and in accordance with your state or territory legislation. It is your responsibility to adhere to state or territory law as well as PBS requirements for prescriptions to be eligible for PBS subsidy. You must also ensure your patient satisfies PBS entitlement requirements and meets eligibility criteria in the Schedule for supply of the medicine under the PBS.
There are 3 broad categories of pharmaceutical benefits:
|Unrestricted||Medicine that can be prescribed through the PBS and RPBS without restrictions on the therapeutic use|
|Restricted||Medicine that can be prescribed through the PBS and RPBS only if the prescriber is satisfied that the patient's clinical condition matches the therapeutic uses listed in the Schedule. These medicines are identified in the Schedule as a restricted benefit|
|Authority required||Authority listed medicine falls into two categories:
To prescribe PBS medicines you must have collaborative arrangements in place. A collaborative arrangement can include:
- being employed or engaged by a medical practice that has at least one medical practitioner
- receiving patients on referral from a medical practitioner
- having a single agreement with a medical practitioner
- maintaining written records that show you work collaboratively with a medical practitioner
Certain medicines may also have additional conditions for prescribing by authorised nurse practitioners. These medicines are identified in the Schedule as Continuing Therapy Only (CTO) or Shared Care Model (SCM). You can identify if a medicine is CTO or SCM by clicking the 'Note' information in the Schedule listed with the medicine. If you are prescribing under CTO or SCM you are not required to indicate this information on the prescription.
CTO - where a medical practitioner starts treatment and prescribing of a medicine but an authorised nurse practitioner continues prescribing.
SCM - where an authorised nurse practitioner and a medical practitioner share the care of a patient with an agreed management plan.
You are required to prescribe PBS medicines using approved PBS stationery. Authorised nurse practitioner stationery is orange in colour.
Unrestricted and restricted PBS medicines - prescribe using standard personalised or non-personalised authorised nurse practitioner prescriptions.
Authority required or Authority required (STREAMLINED) medicines - prescribe using personalised or non-personalised authorised nurse practitioner authority prescriptions.
- prescriptions must include your PBS prescriber number and indicate your profession by marking the NP box or writing the letters 'NP' on the prescription
- you cannot prescribe more than 1 PBS prescription for the same medicine for the same person on the same day
- regulation 24 (where the original supply and all repeat supplies are provided on one occasion) prescribing is permitted
- you can prescribe up to 3 medicines on a standard PBS prescription. For Authority required or Authority required (STREAMLINED) medicines, you can only prescribe 1 medicine on the prescription
- you can prescribe up to 10 medicines on a hospital prescription and these medicines can be a mixture of PBS, non-PBS, Authority required and Authority required (STREAMLINED) medicines
- when prescribing Authority required medicines, you must obtain prior approval from us or DVA unless it is an Authority required (STREAMLINED) medicine. Prior approval is also required from us or DVA for increased quantities or additional repeats above those specified in the Schedule
- prescriber name
- practice address. Prescriber number and an indication that you are an authorised nurse practitioner
- patient's name and address
- indicate the box that is relevant to your patient - PBS or RPBS
- name, strength and form of medicine
- dose or instructions for use
- quantity and number of repeats - no abbreviations
- your signature
- date prescription is written - forward or back dating is not permitted
- if appropriate, tick 'Brand substitution not permitted' box
- Medicare, concession and veterans' card numbers
Additional requirements for Authority prescriptions:
- Authority prescription number - used by the pharmacy as a reference when dispensing an authority approved prescription, and repeats of that prescription. You will be required to quote the authority prescription number when applying for telephone approvals
- Authority approval number - this is the approval number given by us or DVA and is only needed for Authority required medicines. For Authority required (STREAMLINED) medicines, write the four digit streamlined authority code from the Schedule
Authorised nurse practitioner standard PBS prescription
Authorised nurse practitioner authority prescription
The standard or computerised PBS prescription may be used to write a non-PBS prescription. However, you must cross out the PBS and RPBS boxes and endorse the prescription as 'non-PBS'.
You must write a non-PBS prescription to prescribe:
- outside the PBS restrictions - when your patient's clinical condition does not match the indications listed in the Schedule
- a quantity or number of repeats exceeding the maximum PBS quantity without an approved authority
- a medicine or form and strength of a medicine not listed in the Schedule
- for a patient not entitled to PBS medicines
- for a medicine outside its PBS manner of administration. For example, a PBS eye ointment for topical non-ophthalmic use
- PBS website to view the Schedule
- Education services for health professionals to access other education resources
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