60 day prescribing questions answered

3 minute read

Update your prescribing software or risk ending up behind the 8-ball on Friday.

Come Friday, GPs can write extended prescriptions for 90 medicines for the first time.

Here’s how it will work.

The first step will be ensuring that the practice prescribing software gets updated by 1 September, similar to when new items are listed on the PBS.

There should be a tranche of new PBS item codes that will sit alongside the current codes for each of the 90 eligible medicines.

Searching for one of the medicines, e.g. apixaban, will now yield two results, one at the regular 30-day quantity and one at the new 60-day quantity.

Handwritten prescriptions will work the same way.

Speaking at a webinar for primary care prescribers earlier today, Department of Health and Aged Care health resourcing deputy secretary Penny Shakespeare advised prescribers to double-check that their prescribing software had been updated if the new codes did not immediately appear.

Prescribers still have discretion over whether to select for one- or two-month supplies.

DoHAC technology assessment first assistant secretary Adriana Platona said that while it was up to the doctor or nurse practitioner to decide what was best for each patient, the intent of the policy was to relieve cost-of-living pressures.

“Cost-of-living pressures arise not only from visits to pharmacy that could be avoided but also from visits to medical practitioners that could also be avoided,” she said.

“Putting your patients’ interests first both clinically and financially is required for everybody to act in the most ethical and best intended way.”

If the pharmacist believes that a script is inappropriate for a patient, Ms Shakespeare said they were expected to place a call to the prescribing doctor and address the issue, rather than flat-out refusing to issue a script.

“We need to consider whether or not we’ve got people complying with their conditions of approval as pharmacists, if they’re refusing to issue scripts,” she said.

“If anything like that does happen, we suggest that you get in contact with the department.”

Current prescriptions for eligible medicines will not automatically update to a 60-day supply; patients will have to return for a specific 60-day script in order to access the scheme.

To prevent hoarding and wastage, the PBS safety net 20-day rule will be extended to 50 days on 60-day prescriptions.

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The 20-day rule, also known as the early supply rule, means that when people present to a pharmacy for a repeat supply of medicine within 20 days of filling their original script, the transaction falls outside the safety net: their payment does not count to toward their safety net threshold, nor can they access the medicine at the safety net price if they have already reached the threshold.

Even in these situations, the most they will pay is the regular PBS co-payment.

For IT reasons, Ms Platona said, the 50-day rule will not be visible on prescribing software on Friday. This will be remedied soon, she assured the audience.

The medicines to be included in the second and third phases of 60-day dispensing are still being finalised.

These will take place in March and September 2024.

Eagle-eyed doctors may note that, originally, 92 medicines were set to be included in the first phase of the rollout. Between the time the medicines were recommended and now, two have dropped off the PBS.

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