Revised arrangements for the efficient funding of chemotherapy medicines

Revised arrangements for prescribers and pharmacists aim to minimise waste and reduce expenditure on intravenous chemotherapy medicines.

This initiative was introduced to minimise waste and reduce PBS expenditure on chemotherapy medicines used in the treatment of cancer and administered through intravenous infusion or injection.

Revised arrangements for prescribers

For health professionals who prescribe chemotherapy medicines:

  • prescriptions will need to be dose-specific and written in milligrams or other unit of measure as appropriate
  • patients will generally pay no more than 1 co-payment per cycle of treatment - for example, a co-payment will be paid on each original prescription, but not on each repeat
  • 1 prescription is required, either an original or repeat if needed per infusion or injection

The number of repeats on the prescription must be clinically appropriate for the treatment protocol that the patient is undergoing and within the parameters set by the Pharmaceutical Benefits Advisory Committee (PBAC). If additional repeats are required, an authority will need to be sought.

Revised arrangements for pharmacies

For approved pharmacies that dispense chemotherapy medicines:

  • pharmacies will only be paid for the most cost-efficient combination of vials that make up a patient's dose, and
  • the specialist nature of preparing chemotherapy medicines will be acknowledged with a series of new dispensing fees depending on where the medicines are claimed

These fees include one or more of the following:

  • distribution fee
  • diluent fee
  • preparation fee, or
  • dispensing fee

All medicine that meets the criteria for inclusion in the measure, including trastuzumab (Herceptin®), is subject to the new prescribing, dispensing and claiming arrangements.

Page last updated: 22 February 2019