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Palliative care items: simplified PBS listings and restriction changes

  • 2 min read
  • 25 May 2016

 

This document has been updated since its initial release [Details]

 

Simplified listings

From 1 June the PBS listings for all palliative care items will be simplified.

Medicines currently dual-listed for initial and continuing treatment phases (with two associated item codes) will be merged into one phase.

The item codes currently listed for initial treatment phase will be retained; the item codes for continuing treatment phase will be deleted.

The PBS website has a full list of item codes at Browse by Palliative Care.1

To minimise disruption to patients, the Department of Human Services (DHS) will honour existing prescriptions written before 1 June 2016 using the deleted item codes for a period of 12 months.

Queries relating to the PBS can be made to the DHS (telephone 132 290 open 24 hours a day, 7 days a week).

 

Changed restriction levels

In addition to the listing simplification, the restriction levels for some palliative care items will be changed from Authority required to either Streamlined or Restricted benefit from 1 June (see table).

TABLE Palliative care items changes from 1 June 2016a

Drug

New restriction level

Bisacodyl

Restricted benefit

Diclofenac

Restricted benefit

Ibuprofen

Restricted benefit

Indomethacin

Restricted benefit

Methylnaltrexone

Authority required (Streamlined)

Naproxen

Restricted benefit

Paracetamol

Restricted benefit

Rhamnus frangula + Sterculia

Restricted benefit

Sorbitol + citrate + lauryl sulfoacetate sodium

Restricted benefit

  1. Palliative care items not listed above incur no change to restriction level. The PBS website has a full list of items at Browse by Palliative Care
 

How to claim scripts written before 1 June 2016

The DHS will honour existing prescriptions written before 1 June 2016 using the deleted item codes for a period of 12 months.

Hospital and community pharmacies have two options:

  • claim the item code that will be retained (initial-treatment-phase code) and, when applicable, use the associated streamline code valid for this item code at the date of prescribing; or
  • claim the item code that will be deleted (continuing-treatment-phase code) and, when applicable, use the associated streamline code valid for this item code at the date of prescribing.

For example, when claiming a prescription written in January 2016 for continuing treatment of benzydamine mouthwash, either:

  • use item code 5385K (initial-treatment-phase item code) and Authority required (Streamlined) code 5622 (associated initial-treatment-phase streamlined code). Both the initial-treatment-phase item code and the streamlined code will be retained from 1 June 2016; or
  • use item code 5386L (continuing-treatment-phase item code) and Authority required (Streamlined) code 5651 (associated continuing-treatment-phase streamlined code). Both the continuing-treatment-phase item code and the streamlined code will be available from 1 June 2016 for dispensing use only.

Note: Your dispensing software may only allow you to choose one of these options. Please consult with your dispensing software vendor should you require further guidance.

 

How to claim scripts written from 1 June 2016

Prescriptions should be dispensed using the retained item code and authority streamlined code that are valid from 1 June 2016.
 

References

  1. Australian Government Department of Health, Pharmaceutical Benefits Scheme. Browse by Palliative Care: Pharmaceutical Benefits for Palliative Care. Canberra: DoH, 2016.maceutical Benefits for Palliative Care. Canberra: DoH, 2016.
  2. Australian Government Department of Health, Pharmaceutical Benefits Scheme. Summary of Changes. Canberra: DoH, 2016..
 

Revision history

Updated 31 May 2016 with additional information on how to claim scripts written before and after 1 June 2016.

First published 25 May 2016.