Expansion of Pharmaceutical Benefits Scheme Continued Dispensing Arrangements to Support Australians Affected by the Bushfire Crisis

Frequently Asked Questions

Page last updated: 16 January 2020

The Australian Government has expanded existing Continued Dispensing arrangements to support people affected by the bushfire crisis to continue to access their essential medicines at the usual Pharmaceutical Benefits Scheme (PBS) or Repatriation Pharmaceutical Benefits Scheme (RPBS) cost.

From 13 January 2020, Continued Dispensing arrangements will be extended to most PBS/RPBS medicines supplied through community pharmacies. This means that Australians who have lost their medicines and/or prescriptions can obtain a one-off standard quantity of eligible PBS/RPBS medicines subsidised under the PBS without a prescription. The patient must previously have been prescribed this medicine and the pharmacist must be satisfied that it is urgently needed and it is not practicable to obtain a new prescription due to the impacts of bushfires.

These arrangements will be in place until 31 March 2020, and complement emergency supply provisions available under state and territory legislation. This includes “owing prescription” arrangements, which enable a prescriber to direct a pharmacist to supply a medicine to a patient in an emergency situation, and then provide a paper prescription to the pharmacy. These provisions should be considered before utilising Continued Dispensing arrangements.

For Patients

What should I do if I have lost my medicines and/or prescriptions due to the bushfires?

If you are unable to see a doctor to obtain new prescriptions, you should talk to your pharmacist to discuss your options. If possible, take along anything that documents what medicines you are taking (e.g. the medicine pack).

Do I have to see my doctor to get a follow-up prescription to give to the pharmacist?

You will not need to obtain a follow-up prescription for those medicines that can be supplied under these new temporary arrangements, which includes medicines used for asthma, lung disease, diabetes, heart disease, and mental illness. However, you will need to see a doctor to get a prescription for any future supplies of these medicines.

What medicines can I get?

These new temporary arrangements will apply to most PBS/RPBS medicines supplied by community pharmacies, which represent more than 70 per cent of all PBS listed items, including medicines used for asthma, lung disease, diabetes, heart disease, and mental illness. Please note that medicines supplied under section 100 Special Supply Arrangements are not available under these arrangements. This includes Human Immunodeficiency Viruses (HIV) medicines available through the Highly Specialised Drugs Program.

What will I have to pay for these medicines?

You will have to pay the relevant PBS/RPBS copayment, depending on your concessional status. The current copayment levels are $6.60 for concessional persons and up to $41.00 for general persons.

Will these medicines count towards my PBS/RPBS Safety Net?

Yes.

What do I do if I have lost my Medicare or Concession Card?

The pharmacist can contact Services Australia for assistance on getting this information. Alternatively, members of the general public can contact Services Australia on 132 011.

The pharmacist already provided me with a small amount of my medicines before 13 January and I had to pay for them. Can I get this reimbursed?

No. However, you can now get a one-off standard quantity of eligible medicines (usually one month) subsidised under the PBS/RPBS without a prescription.

Will I be able to get my next supply of PBS medicines without a prescription?

A Continued Dispensing medicine can only be supplied once in a 12 month period. You will need to ensure that you speak to a doctor to get a prescription for any future supplies of these medicines.

For Pharmacists

Please note that the Pharmaceutical Society of Australia (PSA) has guidance on the supply of medicines under the Continued Dispensing arrangements. You should read the Guidelines for the continued dispensing of eligible prescribed medicines by pharmacists before supplying medicines under these arrangements. The Guidelines are available from the PSA website.

The Pharmacy Guild of Australia also has fact sheets on the emergency supply of medicines, and Services Australia provides an Education guide on the Continued Dispensing Initiative.

What do I need to do before I can dispense a medicine under these arrangements?

Before considering supply of medicines under Continued Dispensing arrangements, you should make sure that:

• the person has an immediate need for the medicine;
• circumstances prevented the person from getting a prescription;
• it is not possible to obtain approval for an “owing prescription” from a prescriber;
• the medicine is eligible for supply under the arrangements (including under relevant state/territory legislation);
• the person has been supplied the medicine in the last six months and their condition is stable;
• the medicine has not been supplied under Continued Dispensing arrangements to the person by any pharmacy within the 12 months before the requested supply; and
• it is safe and appropriate for the person to obtain the medicine.

Does my pharmacy need to be in a bushfire affected area?

No. You just need to meet the requirements for dispensing under the Continued Dispensing arrangements, including confirming that the person has an immediate need for the medicine and is not able to obtain a prescription from a doctor due to impacts of the bushfires.

Do I have to get the person to sign anything?

Yes. You are required to get the person to sign a declaration acknowledging that they have been supplied with medicines under these arrangements.

Your pharmacy dispensing software (PDS) will generate a Modified Repeat Authorisation Form, which you can use to record:

•  the details of the Continued Dispensing supply; and
• the person’s signature to show they received the medicine.

Your PDS will also generate a Consumer Declaration and Prescriber Notification Form, which you can use to:

• show that the person understands they were supplied without consultation from their prescriber; and
• notify the person's most recent prescriber, or clinical practice, that a Continued Dispensing supply was given.

Do I only need to comply with Commonwealth legislation or my state/territory legislation?

No. You also need to consider your relevant state and territory legislation.

What documentation do I need to keep?

You must record the information used to support your decision to supply medicine under Continued Dispensing. You must:

• keep records for two (2) years from the date of supply
• keep your records consistent with other records
• comply with state or territory and Commonwealth legislation.

What medicines can I dispense under this new arrangement?

PBS items that can be supplied under Continued Dispensing arrangements will be flagged in dispensing software and PBS Online. These items include medicines used for asthma, lung disease, diabetes, heart disease, and mental illness. You also need to consider your relevant state and territory legislation. Please note that medicines supplied under section 100 Special Supply Arrangements are not available under these arrangements. This includes Human Immunodeficiency Viruses (HIV) medicines available through the Highly Specialised Drugs Program.

Can I dispense Schedule 8 medicines under this arrangement?

Yes, provided you are compliant with your relevant state or territory legislation and accord with professional standards. Please note that some states and territories do not allow supply of Schedule 8 medicines without a valid prescription.

Does the person or prescriber need to provide a PBS prescription before I can make my PBS claim?

No. However, you should notify the person’s most recent prescriber, or their practice, in writing that a Continued Dispensing supply has been given to the person.

I know the person’s previous prescription was for an increased quantity. Can I supply that amount instead of the standard PBS/RPBS quantity?

Yes, provided you are compliant with your relevant state or territory legislation. If your state and territory legislation allows, your pharmacy dispensing software will explain how to process a previous authority supply for an increased quantity as Continued Dispensing.

While the temporary Commonwealth provisions do not prohibit the Continued Dispensing for an increased quantity, state and territory provisions may not allow an emergency supply that is in excess of a standard PBS/RPBS quantity in the absence of a prescription.

Will I be able to make claims for streamlined or authority required items?

You will be able to make claims for any Continued Dispensing medicines, including those that are Authority Required (Streamlined) and Authority Required. However, timeframes for claims for Authority Required items may take longer than other claims. However, timeframes for lodging claims for Authority Required (Streamlined) and Authority Required PBS/RPBS medicines will be impacted by implementation of required changes to claiming and pharmacy dispensing systems.

When will my PBS claim be paid?

Services Australia will process all eligible PBS/RPBS claims made by pharmacists for supplies made from 13 January 2020. However, timeframes for claiming Authority Required (Streamlined) and Authority Required PBS/RPBS medicines will be impacted by implementation of required changes to claiming and pharmacy dispensing systems and Services Australia system changes. Further advice will be provided on 1 February 2020.

What should I do if the Continued Dispensing claim has been rejected?

If you have submitted a Continued Dispensing claim for an Authority Required medicine, ensure that your claim meets the legislative requirements (including your relevant state or territory legislative requirements) and guidelines and re-submit the claim following the further advice which will be available on 1 February 2020.

If a Continued Dispensing claim for unrestricted or restricted medicine has been rejected, follow the advice provided by your pharmacy dispensing software (PDS). If you require further support, contact the PBS general enquiries line on 132 290 (Option 2).

What do I do if the person does not have their Medicare or health care card?

If persons do not have their Medicare, DVA or Centrelink card you should ring the PBS general enquiries line 132 290 (press option 1), for assistance.

For Prescribers

What are the requirements for my patient to be supplied PBS medicines without a prescription under Continued Dispensing arrangements?

Before dispensing medicines under these Continued Dispensing arrangements, the pharmacist must be satisfied that:

• the person has an immediate need for the medicine;
• circumstances prevented the person from getting a prescription;
• it is not possible to obtain approval for an “owing prescription” from a prescriber;
• the medicine is eligible for supply under the arrangements (including under relevant state/territory legislation);
• the person has been supplied the medicine in the last six months and their condition is stable;
• the medicine has not been supplied under Continued Dispensing arrangements to the person by any pharmacy within the 12 months before the requested supply; and
• it is safe and appropriate for the person to obtain the medicine.

Will my patient continue to be able to get these medicines without a prescription?

No. A Continued Dispensing medicine can only be supplied once in a 12 month period. Your patient will need to ensure they obtain a prescription for any future supplies of their medicines.

I have received a notification that a person has been provided PBS medicines under the Continued Dispensing arrangements. Do I need to provide a follow-up prescription?

No. However, you may wish to engage with the person to ensure they obtain prescriptions for any future supplies of these medicines.

For Software Vendors

Will I require a Notice of Integration (NOI) from Services Australia?

A NOI will not be required for this change.

Will there be a Software Vendor Testing (SVT) Environment?

Software Vendor Testing environment will be available if you wish to conduct testing, however, it is not mandatory for this change.

Technical documentation on changes required in Dispensing Software will be available from Medical Software Industry Association (MSIA). Alternatively, software vendors can contact Online Technical Support at Services Australia on 1300 550 115 (Monday to Friday 8.30 am to 5.00 pm AEST).

General PBS Enquiries

For general PBS enquiries, members of the public can phone the Department of Health PBS information Line on 1800 020 613, or alternatively email the Department of Health at pbs@health.gov.au