New measure to reduce repeat prescription requirements for patients with chronic conditions

Page last updated: 1 November 2008

What is the initiative?

As part of the 2008-09 Federal Budget, the Government has extended the period for which a repeat prescription can be written for patients with chronic conditions from six to 12 months for certain medicines.  

Patients whose care is managed under a General Practitioner (GP) Management Plan (Medicare items 721 and 725) or Team Care Arrangements (Medicare items 723 and 727) will be eligible to receive up to 12 months supply of these medications, dispensed at regular intervals, in accord with the clinical discretion of their doctor. 

Why is this initiative important?

This measure will provide greater flexibility in the requirements for access to repeat prescriptions of medications for patients with a chronic disease. 

The measure is designed to ease the burden on patients with chronic conditions by simplifying medication requirements and reducing the need for medical appointments just to fill a “script” for these medicines.  There are a range of existing programs and Medicare items designed to improve the care provided to patients with chronic conditions, and this measure will complement such initiatives.

It is expected that this measure will lead to efficiencies in the Medicare Benefits Scheme by reducing the overall number of visits that some patients with chronic conditions will need to make with the GP to obtain a prescription medicine.

Who is involved and who will benefit?

• Patients with chronic conditions whose care is managed under a GP Management Plan or Team Care Arrangements will be eligible to receive up to 12 months supply of some medications.  The decision is based on the clinical judgment of the GP, in consultation with the patient.
• This measure reduces the need for patients to see a GP purely for administrative purposes, that is, to get a new script.  However, the nature of chronic conditions requires careful management by a GP and regular monitoring. 
• The initiative does not reduce the need for regular review of a person’s condition.  It is recommended that reviews under a GP Management Plan or Team Care Arrangement are undertaken every six months.
• The measure allows a GP to decide whether to write a prescription enabling 12 months supply of an eligible medicine if a patient is considered well-managed and stable.  A GP, in consultation with the patient, may decide not to take advantage of writing 12 months supply in particular circumstances. 

Why is the initiative only available to patients on a GP Management Plan or Team Care Arrangement?

A patient must be managed under a GP Management Plan or Team Care Arrangement to be eligible for repeat prescriptions for eligible chronic condition medicines.  This requirement ensures patient safety or clinical quality are not jeopardised for patients with chronic conditions.  As mentioned above, it is recommended that for patients managed under a GP Management Plan or Team Care Arrangement undergo a review by a GP every six months.

What medicines are available for 12 month prescription from 1 January 2009?

The following medicines or groups of medicines are eligible for increased repeat prescriptions from 1 January 2009:

Used for blood and urine glucose monitoring:

• 9251X COPPER SULFATE (Clinitest®); 
• 9252Y 9253B GLUCOSE INDICATOR—URINE (Clinistix®, Diastix®);
• 9254C 9255D GLUCOSE and KETONE INDICATOR—URINE (Keto-Diabur-Test 5000®,
  Keto-Diastix®);
• GLUCOSE INDICATOR—BLOOD (FreeStyle®, FreeStyle Lite®, Optium glucose®, SofTact®, TrueSense®, Accu-Chek Performa®, Advantage II®, Freestyle Papillon®, Glucoboy®, Glucocard 01 Sensor®, GlucoCare Super Sensor®, GlucoOz®, MWD Pen Sensor Strips®, Omnitest EZ®, Omnitest Plus®, Optium Omega®,  TrueTrack®,
  Accu-Chek Active®, Accu-Chek Go®, Betachek®, Betachek® G5, CareSens®,
  Glucoflex-R®, Glucostix®, SensoCard®, Accu-Chek Integra®).

In addition, the following medicines or groups of medicines became eligible for increased repeat prescriptions from -

1 December 2008:

Used in the treatment of cystic fibrosis:

• 9225M, 9226N, 9227P PANCREATIC EXTRACT (Creon 10,000®, Creon 5000®, Creon 25,000®); and
• 9228Q, 9229R PANCRELIPASE (Panzytrat® 25000. Cotazym-S Forte®).

Used in the treatment of high cholesterol levels:

• 9230T, 9231W, 9232X, 9233Y ATORVASTATIN CALCUIM (Lipitor®);
• 9234B, 9235C, 9236D FLUVASTATIN SODIUM (Lescol®, Lescol XL®, Vastin®);
• 9237E, 9238F, 9239G, 9240H PRAVASTATIN SODIUM (Chem mart® Pravastatin, Cholstat®, GenRx® Pravastatin, Lipostat®, Liprachol®, Pravastatin, Pravastatin generichealth®, Pravastatin Pharmacor®, Pravastatin-DP®, Pravastatin-GA®, Pravastatin Winthrop®, Terry White Chemists® Pravastatin, Pravachol®, Vastoran®);
• 9241J, 9242K, 9243L, 9244M, 9245N SIMVASTATIN (Chem mart® Simvastatin, GenRx® Simvastatin, Lipex®, Ransim®,
  Simvabell®, Simvahexal®, Simvar®, Simvastatin-DP®, Simvastatin generichealth®, Simvastatin Winthrop®, Simvasyn®, Terry White Chemists® Simvastatin, Zimstat®, GN® brand, Zocor® );
• 9246P, 9247Q FENOFIBRATE (Lipidil®);
• 9248R GEMFIBROZIL (Ausgem®, Chem mart® Gemfibrozil, Gemhexal®, GenRx® Gemfibrozil, Jezil®, Lipazil® 600 mg, Pharmacor® Gemfibrozil 600, Terry White Chemists® Gemfibrozil, Lopid®);
• 9249T CHOLESTYRAMINE (Questran Lite®); and
• 9250W COLESTIPOL HYDROCHLORIDE (Colestid®).

Used in the treatment of severe dry eyes including Sjogren’s syndrome:

• 9356K CARMELLOSE SODIUM with GLYCERIN (Optive®).

1 November 2008:

Used in the treatment of severe dry eyes including Sjogren’s syndrome:

• 9210R CARBOMER 980 (GelTears®, PAA®, Viscotears Liquid Gel®);
• 9211T, 9212W CARMELLOSE SODIUM (Refresh Tears Plus®, Refresh Liquigel®);
• 9213X, 9214Y HYPROMELLOSE (In a Wink Moisturising®, Genteal®, Methopt®);
• 9215B HYPROMELLOSE with CARBOMER 980 (Genteal gel®, HPMC PAA®);
• 9216C HYPROMELLOSE with DEXTRAN (Poly-Tears®, Tears Naturale®);
• 9219F POLYETHYLENE GLYCOL 400 with PROPYLENE GLYCOL (Systane®);
• 9220G, 9221H, 9222J, 9223K POLYVINYL ALCOHOL (PVA Tears®, Liquifilm Tears®, Vistil®, PVA Forte®, Liquifilm Forte®, Vistil Forte®); and
• 9217D, 9218E PARAFFIN (Poly Visc®, Duratears®, Ircal®, Lacri-Lube®).

Used in the treatment of ulcerative colitis:

• 9208P, 9209Q SULFASALAZINE (Salazopyrin®, Pyralin EN®, Salazopyrin-EN®).

How did the Government decide which medicines would be included?

A set of criteria was developed to determine which medicines would be included in the measure.  The Pharmaceutical Benefits Advisory Committee (PBAC) was asked to consider the criteria and the list of medicines eligible for increased repeat prescriptions. 

The PBAC is an independent committee comprising a range of expertise including health professionals, health economists and a consumer advocate.

In July 2008, the PBAC endorsed the criteria and subsequently approved the list of medicines which will be available for up to 12 months supply.

Is there possibility of new additions to these arrangements?

The Department of Health and Ageing will undertake a review of the revised listings once the initiative has been implemented for 12 months.  It is envisaged that no new medicines will be added to the measure until the review is completed.