Disaster dispensing rules to be changed

The National Health Amendments (Pharmaceutical Benefits) Bill 2016 has been read for the second time, proposing changes which will make life easier for PBS pharmacies affected by disaster.

Flexibility regarding the location rules is required for exceptional events such as flood or fire, the Bill says.

“Refusing to allow a pharmacy to move to other premises could make an already difficult situation worse and would not be in the interests of the local community,” the Bill reads.

It highlights that under the current legislation, a PBS-approved pharmacist can supply PBS medicines from other premises prior to obtaining PBS approval with claims paid at 90% of the full amount until approval for the other premises is obtained.

It says the current requirement to obtain PBS approval for the new site—including needing to submit a relocation application with full documentation— can be “onerous” in a disaster situation.

“The pharmacy proprietor may need to recover in conditions where local government services and other businesses are also disrupted.

“It may be weeks before the required information can be compiled. This compounds the losses for the pharmacy as the flat 10% reduction on payments for PBS claims continues until the approval is in place. The lost PBS subsidies cannot be recovered later.

“Moving back to the original pharmacy means repeating the process in reverse.

“Overall, two full applications and two new PBS approval numbers are involved. For each new approval number, dispensing labels and pharmacy stationery need to be reprinted and a new public key infrastructure software certification is required for claiming.

“The process carries high administrative overheads in a stressful situation and for what is usually a temporary move.”

Another problem with the current situation is that the provisions are occasionally used when a PBS pharmacy is relocating for any reason; in these situations the supply of PBS medicines begins at the unapproved premises while the approved pharmacy continues to operate.

“PBS claims are made from the approved pharmacy at the full rate, and from the unapproved premises at the 90% rate, using the same PBS approval number.

“This continues until an application for PBS approval at the new site is successful, which may take several months. Use of a PBS approval number at two sites simultaneously in this way is contrary to the policy intention of the current law.”

The new arrangements are intended to streamline the process for PBS pharmacies genuinely affected by disaster and will allow an affected pharmacy’s PBS approval number to be used to supply PBS medicines at alternative premises in substantially the same locality for up to six months, until either supply resumes at the original pharmacy, or a new PBS approval number is obtained for a different site.

The provisions are explicitly only intended to apply for disaster or other exceptional circumstances.

“The pharmacist will be required to provide information to the secretary of the Department of Health regarding the disaster or event, the reasons the approved pharmacy is beyond use, and the nature and location of the alternative premises.

“The secretary will be responsible for determining whether exceptional circumstances and locality requirements are met and for granting permission for up to six months. A permission can be extended for an additional period via a similar process if clean-up or repairs take longer than expected.”

The amendments also repeal entirely the current provisions regarding supply of PBS medicines at other premises prior to PBS approval.

“This will mean that the only situation in which it is legal to supply PBS medicines at alternative premises is when the approved pharmacy cannot operate due to disaster or exceptional circumstances, and only for as long as necessary due to the disaster.”

A spokesman for the Pharmacy Guild called the amendments “a common sense measure and supported by us”.

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