Education guide - Continued Dispensing Initiative - PBS requirements

Information for pharmacists about supplying and claiming under the Continued Dispensing of PBS Medicines in Defined Circumstances initiative.

This information should be read with the Guidelines for the Continued Dispensing of eligible prescribed medicines by pharmacists 2012 (PSA Guidelines).

Continued Dispensing allows pharmacists to supply eligible Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) medicines when there is an immediate need for the medicine, but it is not practical for the patient to get a prescription. A follow up prescription from the prescriber is not needed either. The initiative complements existing supply provisions, including urgent communicated prescriptions under the PBS and state or territory legislation for emergency supply. A patient cannot receive more than 1 supply under the Continued Dispensing initiative every 12 months, per eligible medicine.

It is your responsibility to make sure you're complying with necessary PBS and state or territory legislation before undertaking a Continued Dispensing supply.

Eligibility requirements

Category Description
Supplier Only community pharmacies, under section 90 and section 90A approved suppliers, can supply PBS medicines under Continued Dispensing
Patient

The pharmacist must confirm that the patient is an Australian resident with a current Medicare card, or is from a country with which Australia has a Reciprocal Health Care Agreement

Medicine

Eligible medicines, including medication brand, are outlined in the National Health (Continued Dispensing) Determination 2012 National Health Act 1953. Some of these medicines include:

  • oral hormonal contraceptives
  • lipid modifying agents (HMG CoA reductase inhibitors) 'statins'

To be eligible for PBS or RPBS subsidy the medicine must be listed in the Schedule of Pharmaceutical Benefits (the Schedule).

The following are not allowed under Continued Dispensing:

  • Closing the Gap PBS Co-Payment Measure benefits
  • dispensing Authority required or Authority required (STREAMLINED) medicines
  • dispensing quantities greater than listed in the Schedule, even if the patient has previously had authority for an increased quantity, and
  • repeat authorisations

Determining if Continued Dispensing is appropriate

Before a patient can receive medicine under Continued Dispensing, you must be satisfied that:

  • the medicine
    • is eligible for supply under Continued Dispensing
    • has been supplied to the patient within the last 6 months and their condition is stable
    • is safe and appropriate for the patient
    • hasn't been supplied to the patient by any pharmacy as a Continued Dispensing medicine in the past 12 months
  • there is an immediate need for the medicine and circumstances have prevented the patient from getting a prescription from their prescriber, and
  • it is not practical to obtain a prescription or communicated supply from the patient's prescriber

Make sure you document the information used to support your decision to supply medicine under Continued Dispensing and keep it for 2 years from the date of supply. These records should be consistent with other dispensing and medicine supply records and must comply with state or territory and Commonwealth legislation.

Dispensing details

When dispensing, use pharmacy dispensing software (PDS) to record:

  • that the medicine is being supplied under Continued Dispensing - this will vary depending on your PDS
  • the Australian Health Practitioner Regulation Agency (AHPRA) registration number of the pharmacist who supplied the medicine - this is not the AHPRA registration number of the approved supplier for the pharmacy or the pharmacist in charge

Online Claiming for PBS

Continued Dispensing is subject to online claiming for PBS and there are specific reason codes you need to use.

Online claiming for PBS should not be relied upon for clinical decision making purposes.

Your PDS will generate 2 forms:

Form 1 - Modified repeat authorisation form

This form is used:

  • to capture the details of the Continued Dispensing supply, and
  • for the patient, or their agent, to sign they have received the medicine

Form 2 - Consumer declaration and prescriber notification form

This form is used to:

  • demonstrate that the patient, or their agent, understands that the supply has been undertaken without consultation from their prescriber
  • notify the patient's prescriber that a Continued Dispensing supply has been given, and
  • notify the most recent prescriber in writing, within 24 hours that the medicine has been supplied - a prescriber's practice can be notified where the specific prescriber cannot be found or is not available

Completing the forms

If the patient or their agent is unable to sign, the pharmacist can certify supply on the Modified repeat authorisation form and the Consumer declaration and prescriber notification form.

The pharmacy must keep a copy of all completed and signed forms for 2 years from the date of supply.

Important information

Medicines supplied under Continuing Dispensing are subject to:

  • PBS patient contributions and refund requirements
  • Regulation 25 - immediate supply 20 day and 4 day rule

The medicine also contributes to the patient's PBS Safety Net threshold.

More information

Online:

Contact us at PBS general enquiries.

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Page last updated: 7 October 2016

This information was printed Friday 9 December 2016 from humanservices.gov.au/health-professionals/enablers/education-guide-continued-dispensing-initiative-pbs-requirements It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.