In Australia, pharmaceutical benefits can only be prescribed by doctors and other health professionals who are approved to prescribe Pharmaceutical Benefits Scheme (PBS) medicines under the National Health Act 1953.
Pharmaceutical benefits in Australia fall under different categories: unrestricted benefits, restricted benefits and authority required benefits. Prior approval is required from the Department of Human Services to prescribe all PBS items. This includes Section 100 items; short-term use items; and items with an increased potential for misuse, abuse or adverse effects.
PBS authority prescription approval is usually obtained by phoning the Telephone Authority Applications Freecall service or the Department of Veterans Affairs Authority Freecall service where appropriate.
Doctors are required to cite information including the patient’s Medicare number, name and address, the doctor’s prescriber number and information about the drug required. Some items don’t require telephone or written approval prior to prescription except where quantities and/or addition repeats are above those specified in the PBS schedule.
Certain medicines used to treat chronic conditions, such as cancer, need written approval or they will not be funded under the PBS.
Around 6.8 million prescription approval requests were made over the phone last financial year. To support improved processes for the administration of the PBS, a Bill to amend the National Health Act 1953 was introduced to Parliament on 24 Nov.
The amendment allows for computer programs to be used to make decisions and take other administrative actions, this may allow for the majority of such prescription approvals to be done online in future in the hope that it reduces errors and saves time through a more efficient automated process.
The Bill states that “Computer decision-making will support implementation of streamlined processes such as fully automated online processing of PBS claims and prescribing approvals.” The reason given for the amendment is that online PBS authority prescription approvals for certain medications will reduce administrative workload for prescribers and save time during consultations.
The Bill also seeks to make it easier for pharmacists to operate from alternative premises following a disaster or exceptional circumstance by reducing administrative requirements, and also to amend a definition to ensure that PBS entitlements for concessional beneficiaries and their dependants will apply until midnight on the date of date rather than ceasing one day prior.
The full Bill can be read on the Federal Register of Legislation website. Further information about the prescribing, dispensing or claiming of PBS drugs can be obtained from the Department of Human Services.