Fact Sheet: Streamlined Authorities

Page last updated: 29 June 2012

On 1 July 2007, a large number of Pharmaceutical Benefits Scheme (PBS) subsidised medicines that previously required an authority approval before being prescribed moved to a new streamlined authority process.

The streamlined authority process is designed to reduce the administrative burden on prescribers, as they don’t need to seek prior telephone or written approval from the Department of Human Services (DHS) or the Department of Veterans’ Affairs (DVA) to prescribe some PBS Authority required items.

Streamlined authorities give prescribers more time for patient care, without compromising the integrity and intent of the authority system.

To prescribe a streamlined authority item, a prescriber is required to include a ‘streamlined authority code’ on the authority prescription.  To claim a streamlined authority item, an approved supplier is required to include the ‘streamlined authority code’ on the PBS claim.

1. What is the difference between Authority required items?

  • Authority required items continue to require telephone or written approval from DHS or DVA prior to prescribing. This category includes short-term-use items, Section 100 items, and items with an increased potential for misuse, abuse or adverse effects.
  • Authority required (STREAMLINED) items don’t require telephone or written approval from DHS or DVA prior to prescribing. Instead, doctors are required to include a streamlined authority code on the authority prescription. However, to prescribe quantities and/or additional repeats above those specified in the PBS schedule, the item will be treated as an Authority required item.

2. How does the streamlined authority process work?

Streamlined authority items are identified in the PBS Schedule with the heading Authority required (STREAMLINED).

A predetermined, four-digit streamlined authority code applies to each restriction for a streamlined authority item. The streamlined authority code replaces the authority approval number provided by DHS or DVA (eg. z1234ab).

To prescribe a streamlined authority item, a prescriber is required to include the streamlined authority code on the authority prescription. To claim a streamlined authority item, an approved supplier is required to include the ‘streamlined authority code’ on the PBS claim.

Streamlined authority codes are listed in the PBS Schedule. The schedule is available on the PBS website www.pbs.gov.au.  Prescribing software also includes streamlined authority codes.  Streamlined authority codes by drug are also listed on the PBS website, under “Browse the PBS” (orange box), Streamlined Authorities.

3. How do I prescribe a streamlined authority item?

There are three steps to be completed to prescribe a streamlined authority item:

  • Your patient MUST meet the PBS restriction criteria for the item
  • 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.

If you are uncertain about the appropriate code to use, you may contact DHS or DVA (if applicable) for support.

4. How do I prescribe increased quantities and/or additional repeats of a streamlined authority item?

For an increased quantity of the item, or for additional repeats above those specified in the PBS schedule, it is necessary to contact DHS or DVA to obtain an authority approval number.

5. How do I prescribe items that are only listed in the Repatriation Schedule of Pharmaceutical Benefits (RSPB)?

The RSPB is a separate section of items published at the back of the Pharmaceutical Benefits Schedule (or with separate item numbers on the PBS website). The introduction of the streamlined authority process will not change the way in which RSPB items are prescribed. To prescribe Authority required items from the RSPB, it is necessary to contact DVA to obtain an authority approval number.

6. How do I prescribe Authority required items which are not streamlined?

Authority required items require telephone or written approval from DHS or DVA prior to prescribing.

7. Does this mean that streamlined authority items can be prescribed more readily?

No. Patients must still meet the PBS restriction criteria to receive the item.

Prescribers are still required to prescribe in accordance with the PBS restriction criteria and keep evidence of compliance and patient eligibility on patient records. To prescribe a streamlined authority item, a prescriber is required to include the streamlined authority code on the authority prescription.

8. How does the streamlined authority process impact on pharmacists?

Pharmacists are required to check that the four digit streamlined authority code has been entered onto the prescription. Pharmacists may wish to verify the code, which can be done via the PBS Schedule at www.pbs.gov.au.

Since 1 December 2011, the code must be entered by approved suppliers when claiming all PBS Authority Required (STREAMLINED) medicines, as it enables the Government to capture data on the indication for which the medicine is being prescribed.

From 1 July 2012, any claim submitted for a streamlined authority medicine with an invalid streamlined authority code or without a streamlined authority code will be rejected.  The approved supplier will have the opportunity to insert the correct code and resubmit the claim.

Pharmacists must be aware that all prescriptions requesting increased quantities or additional repeats above the specified PBS amount must be accompanied by a DHS- or DVA-issued authority number. The streamlined authority code will not be sufficient in these circumstances.

Prescriptions and claims containing an authority approval number issued by DHS or DVA are still valid for the purpose of the streamlined authority process.

For more information go to www.humanservices.gov.au/healthprofessionals.

9. Will new items be added to the streamlined authority list?

New items recommended for listing on the PBS by the Pharmaceutical Benefits Advisory Committee (PBAC) may be considered appropriate for inclusion in the streamlined authority process. Addition of such items to the streamlined authority list will be assessed on a case-by-case basis.

10. Where can I get more information?

For more information about the prescribing, dispensing or claiming of PBS drugs, please call DHS on 132290 or visit the DHS or PBS websites:

www.humanservices.gov.au or www.pbs.gov.au

General questions about the PBS should be directed to the PBS general enquiry line on 1800 020 613 or email to pbs@health.gov.au.

Information about the Repatriation Schedule of Pharmaceutical Benefits can be found at: www.dva.gov.au.