Original: November 2011
In RxOne Dispense, when selecting a streamline authority drug, a window appears with a drop down selection of pre-defined/accepted streamline authority numbers to choose from (e.g. Plavix = 6 streamline authority options). There is also a free text input box to enter the authority script number (directly below the streamline authority drop down).
The Pharmacist can also choose to type the streamline authority in a free text box, or ignore the streamline authority selection and treat as a normal authority (phone authority script) if the script is prescribed for the first time, or for an increased quantity or number of repeats)
Authority Prescriptions
Some medications listed on the PBS are covered by the schedule for specific authorised indications. The patient must meet the criteria as stated in the Schedule in order to qualify for these authority prescriptions.
Authority prescriptions may also be issued by a prescriber in the case of the quantity required/prescribed for a patient’s medication to last a full month is greater than the maximum listed in the PBS Schedule.
E.g. Somac 40mg bd for qty 60 (qty 30 covered by PBS)
The prescriber is responsible for ensuring that the patient meets the PBS criteria as listed in the Schedule before prescribing authority medicine.
PBS authority prescriptions must be written in one of two ways. Either:
Handwritten by the prescriber on an authority required PBS prescription form, or
Using a prescription writing software and printed on a computer prescription form provided by Medicare Australia.
There are two categories of authority medicine:
Authority required medicine require telephone or written approval from Medicare Australia or DVA prior to prescribing.
Authority required (STREAMLINED) medicine do not require telephone or written approval from Medicare Australia or DVA prior to prescribing. Streamlined authority medicine are identified in the Schedule with the heading Authority required (STREAMLINED) and a predetermined, four-digit streamlined authority code for each restriction.
There are three steps that must be completed by the prescriber for a streamlined authority medicine:
The patient MUST meet the PBS restriction criteria for the medicine
The prescription MUST be written on an authority prescription form
The prescription MUST include the streamlined authority code corresponding to the PBS restriction that your patient meets.
Prior approval must be obtained from Medicare Australia or DVA for increased quantities and/or additional repeats above those specified in the Schedule. For some items increased quantities and repeats will not be approved and may mean the prescription is no longer covered under the schedule.
If a pharmacist is presented with an authority PBS prescription and is not sure if it has been approved, he or she should contact Medicare Australia. Please note that Medicare Australia will not provide clinical information.
If the authority PBS/RPBS prescription is for an Authority required (STREAMLINED) item the pharmacist should ensure that the prescriber has written the four digit streamlined authority code on the prescription, this enables the pharmacist to supply the item as a PBS benefit.
Telephone approvals for narcotic preparations only allow for a maximum of one month supply. A three month supply may be granted upon approval of a written authority application.
For patients requiring narcotic analgesic treatment beyond 12 months, additional authority requirements for increased quantities and/or repeats include a pain management review by another practitioner. This needs to be conducted within three months of the authority request.
The authority process also applies to the following situations:
SPX: special patient contribution exemption approvals
TPX: therapeutic group premium exemption approvals
HSD: section 100 (highly specialised drugs) approvals
PLC: palliative care section approvals
CPAP approvals associated with the Chemotherapy Pharmaceutical Access Program.
Streamline Authority
From 1 December 2011 pharmacy dispensing software captures a code for Authority Required (STREAMLINED) drugs.
Where available, this field must be completed by suppliers/pharmacies when claiming. This is the case for all PBS Authority Required (STREAMLINED) medicines, and not just cancer chemotherapy medicines. Where software has not yet been updated to provide this field, pharmacies will receive a series of warnings.
From 1 April 2012 the capture of the streamlined authority code for Authority Required (STREAMLINED) drugs is mandatory.
The streamlined authority code for Authority Required (STREAMLINED) medicines will enable the Government to capture data on the indication for which the medicine is being prescribed. This will provide the Government with data to better manage the sustainability of the Pharmaceutical Benefits Scheme (PBS).
Prescribers are already required to include the streamlined authority code on every prescription for Authority Required (STREAMLINED) drugs.
How this affects pharmacies?
From 1 December 2011, where the field is available in software, the streamlined authority code must be included in claims for all PBS Authority Required (STREAMLINED) drugs dispensed within listed maximum quantities/amounts and repeats.
This means for all Streamline Authority prescriptions the pharmacist must record
The authority prescription number (same as present)
AND
The streamline authority number (4 digit number used for patients who have been prescribed the same authority medication for the same indication previously with NO increase to repeats or quantity)
Both numbers must be entered into the dispensing software at the time of dispense. Both numbers must print on the repeat prescription.
If an authority prescription is written for an increased number of repeats/qty etc it cannot be issued with a streamline authority number and requires the standard phone approval number. (obtained by the prescriber either by phone or mail from Canberra). Phone approval number is a mixture of both alpha and numeric and is generally in the format of z1234c (for example)
Additional Notes
[July 2014]
Streamlined authority The Department of Human Services has reminded pharmacists that prior to dispensing an Authority Required STREAMLINED item, the appropriate streamlined authority code must be present on the Authority Prescription form. A complete list of Authority Required (STREAMLINED) medicines is available on the PBS schedule at http://www.pbs.gov.au . Other valid authority approval types include an electronic Authority number, a telephone approval number, or a Human Service stamp for Authority prescriptions submitted by mail.
Emergency Authority Number
[May 2015]
From 1 April 2015, the department has introduced a generic Authority Approval Number P9999RX. This means under Emergency provisions your doctor may write P9999RX on the prescription in the event an authority approval cannot be obtained, due to the department not being contactable.
Please note: increases in quantity and / or repeats is not permissible under the emergency provisions. Please visit the Changes to PBS and RPBS claiming arrangements from 1 April 2015 for more information about Emergency Authority Number.