Changes to PBS listing of hydromorphone oral solution

Page last updated: 1 August 2022

Changes to the PBS listing of oral solution containing hydromorphone hydrochloride 1 mg per mL, 473 mL (hydromorphone oral solution) are being made to allow pharmacists to dispense volumes smaller than a whole bottle at PBS subsidised prices.

The changes are being implemented following consultation with key stakeholders representing prescribers, pharmacists, pharmacy dispensing software, electronic Schedule 8 drug registers and state and territory health authorities. 

The changes being applied on 1 August 2022 are detailed in the table below and will apply to the two brands of hydromorphone oral solution currently subsidised by the PBS – Hikma and Hydromorphone hydrochloride oral solution, USP (Medsurge) under item codes 12582F, 12559B and 12565H.
 

Amendments to the PBS listing of hydromorphone oral solution

Change	Current	Amendments from 1 August 2022
Legislative Instrument form descriptions	Oral solution containing hydromorphone hydrochloride 1 mg per mL, 473 mL	Oral solution containing hydromorphone hydrochloride 1 mg per mL, 1 mL
Pharmaceutical Item value	1 unit (ie. bottle)	473 units (ie. millilitres)
Pack Qty	1	473
Pricing Qty	1	473
Max Qty Units	1	473

INFORMATION FOR PRESCRIBERS
 

What will happen to prescriptions written prior to 1 August 2022?

Scripts of hydromorphone oral solution written prior to the implementation will continue to have a quantity of 1 (one whole bottle). Repeat prescriptions of hydromorphone oral solution where the original prescription was written prior to the implementation may continue to be dispensed on the PBS.
 

What will happen to prescriptions written after 1 August 2022?

Prescribing software will reflect the PBS Schedule on the date a prescription is written.

Scripts of hydromorphone oral solution written after 1 August 2022 may be written for any quantity between 1 and 473. The quantity must be a whole number (i.e. it cannot be 20.5). The quantity will reflect the millilitres that should be dispensed (i.e. a quantity of 50 will result in 50 mL being dispensed).

Prescribers are requested to clearly state on the prescription the exact volume of hydromorphone oral solution that should be dispensed.
 

Can Authority prescriptions continue to be issued?

Scripts of hydromorphone oral solution written after 1 August 2022 may be written for more than the listed quantity of 473mls and/or repeats as an authority required approval (1 month phone approval or 3 months written). For further information on increased authorities see the Request an authority using Online PBS Authorities in HPOS webpage. Phone applications for increased maximum quantities/repeats may be made by calling 1800 888 333. Written authority applications for increased maximum quantities/repeats can be uploaded online through HPOS form upload or mailed to the following address:

Pharmaceutical Benefits Scheme
Reply Paid 9857
[Your capital city]
 

What is the price payable for PBS dispensing of hydromorphone oral solution?

When dispensed on an eligible PBS prescription, the price payable by patients for the supply of hydromorphone oral solution may be dependent on the volume dispensed. Nonetheless, the maximum charge will not exceed $6.80 for concessional patients and $42.50 for general patients.
 

Do the changes impact existing staged supply arrangements?

The changes to the listings of hydromorphone oral solution detailed above do not impact existing staged supply arrangements that allow prescribers to request that a pharmacist supplies a medicine over a specified period of time in instalments, rather than supplying the full amount prescribed at the outset.
 

INFORMATION FOR PHARMACISTS
 

How should prescriptions written prior to 1 August 2022 be handled?

Services Australia will reimburse pharmacists based on the listing price on the Date of Supply of the product. Scripts of hydromorphone oral solution dispensed prior to 1 August 2022 will not be impacted. Please note that scripts dispensed prior to 1 August 2022 should not be re‑claimed.
 

How should prescriptions written after 1 August 2022 be claimed?

Scripts of hydromorphone oral solution dispensed after 1 August 2022 will change as follows:

• PBS scripts for one bottle of hydromorphone oral solution written prior to 1 August 2022 and dispensed after 1 August 2022 should be claimed with a quantity of 473.
• Scripts for less than one bottle of hydromorphone oral solution written prior to 1 August 2022 and dispensed after 1 August 2022 can be claimed with quantities of up to “473”. The quantity transmitted to Services Australia should match what was written on the prescription and dispensed.
• PBS scripts of hydromorphone oral solution written after 1 August 2022 will include quantities of up to “473”. The quantity transmitted to Services Australia should match what was written on the prescription and dispensed.
   

Will wastage fees be reimbursed?

Pharmacies will be reimbursed applicable wastage fees under the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2020 for PBS supply of quantities of hydromorphone oral solution smaller than 473 mL.
 

Additional factor to consider – Schedule 8 electronic drug registers

Consideration should be given to amend the units entered into Schedule 8 electronic drug registers for hydromorphone oral solution. Please contact the relevant drug register for further information.