The Pharmaceutical Benefits Scheme (PBS) website contains a new consolidated list of palliative care medications (see www.pbs.gov.au/html/healthpro/browseby/palliative-care). This list is for use in conjunction with the general PBS listings section, which also contains many drugs used in palliative care.
For the purposes of prescribing these medicines, a patient receiving palliative care is defined as 'a patient with an active, progressive, far-advanced disease for whom the prognosis is limited and the focus of care is the quality of life'.
All of the drugs on this list (see box) are 'Authority required'. Prescribers can request an initial authority for up to four months of treatment. When continuing treatment is required, the prescriber must confirm that a palliative care physician or palliative care service has been consulted about the care of the patient.
Authority approvals can be obtained by phoning 1800 888 333 for general benefits and 1800 552 580 for repatriation benefits.
Prescribers must heed state and territory laws when prescribing narcotic drugs and must notify, or receive approval from, the appropriate health authority.
When a palliative care authority application is for a drug of addiction, the following guidelines apply:
- the maximum quantity authorised is generally for 1 month
- where supply for a longer period is warranted, quantities are for up to 3 months
- telephone approvals are limited to 1 month's therapy.
Doctors should also state (on the prescription) the interval of repeat where repeats are called for, and ensure state and territory health authorities are notified about ongoing treatment.