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Government moves to temporarily ease PBS authority restrictions during pandemic crisis

The Australian Government is implementing a temporary measure that allows flexibility around PBS restrictions for eligible PBS medicines to ensure continued treatment during the COVID-19 crisis.

From 1 May when a treating medical professional considers that a patient taking an eligible PBS medicine should be exempt from any specific Authority Required PBS restriction, a request for exemption for that restriction requirement will be able to be lodged with Services Australia (Medicare).

This request can be submitted if the medical professional considers that they patient may otherwise be at increased risk of contracting COVID-19, or the restriction cannot be completed due to social distancing or isolation requirements.

The request for exemption needs to be included with the authority request through the normal process.

Among the medicines included are: Adalimumab, Lenalidomide, Montelukast, Riociguat, Somatropin and Tadalafil

“This measure will only apply to continuation prescriptions for patients who have previously received a script for the eligible PBS medicine, and all other PBS restriction criteria that are not affected by the COVID-19 pandemic will still apply,” the PBS release says.

It is a legal requirement that the prescriber note the reasons for the proposed waiver and how it relates to the COVID-19 pandemic.

Some examples of situations that may result in the prescriber seeking the exemption include:

  • a patient not being able to attend an outpatient clinic to perform a test, because the patient is required to quarantine,
  • where a prescriber considers it would not be appropriate for an immunocompromised patient to attend a clinic for a consultation and the information cannot be obtained in a telehealth consultation.

This measure is being implemented based on the advice of the expert Pharmaceutical Benefits Advisory Committee in light of the current COVID-19 pandemic. The measure will be repealed by 30 September 2020.

The full list of eligible PBS medicines is available here

 

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