New listing on PBS

From 1 June 2021, the Palliative Care Schedule (PCS) will include new and amended listings for opioid medications. 

Following consideration of the Department of Health commissioned review of the PCS, the Pharmaceutical Benefits Advisory Committee has recommended the inclusion of additional formulations of fentanyl, hydromorphone, methadone and morphine on PCS, and the addition of new listings for oxycodone and oxycodone with naloxone modified release products.  

These changes reflect the PBAC’s recommendations and are intended to further reduce barriers to the prescribing and timely supply of opioid analgesic medications for palliative care patients. 

What do these changes involve? 

The current listings under the General Schedule remain unchanged. The new PCS opioid listings will facilitate appropriate access to opioid medications to palliative care patients by reducing the eligibility requirements. Specifically, criteria restricting use for palliative care patients undergoing cancer treatments, and requirements for annual review of opioid use have been removed. Additionally, the new PCS listings for immediate release preparations permit the supply of greater quantities than those available on the General Schedule, where it is clinically indicated.  

There are also changes to the current PCS listings for buprenorphine patches where the listed repeats will be reduced to zero, up to one month supply per prescription can be requested through the Online PBS Authorities System or the telephone and up to three months’ supply can be requested through the Online PBS Authorities system or in writing.  

Authority Required (STREAMLINED): 

New Authority Required (STREAMLINED) listings for immediate release preparations of hydromorphone and morphine will be added to the PCS for the treatment of severe pain. Up to two packs and a repeat will be available for prescribers to prescribe under these listings 

Authority approval for increased quantities and/or repeats can be requested from Services Australia for up to one month supply per prescription through the Online PBS Authorities System or the telephone. Further, up to three months treatment (up to one month quantity and sufficient repeats) will be available through the Online PBS Authorities System or in writing.  

Authority Required (TELEPHONE/ELECTRONIC): 

New Authority Required (TELEPHONE/ELECTRONIC) listings of opioid medications containing fentanyl, hydromorphone, morphine, methadone and oxycodone, for long-term treatment of severe disabling pain will be added to the PCS, to allow up to one month supply  per prescription through the Online PBS Authorities System or the telephone.  

Authority approval for increased quantities and/or repeats can be requested from Services Australia for up to three months’ treatment (up to one month quantity and sufficient repeats) through the Online PBS Authorities System or in writing. 

What does it mean for prescribers? 

You may continue to prescribe PBS subsidised opioid medications where clinically appropriate and where the patient meets the PBS listing requirements. 

Prescribers must continue to ensure that patients meet the relevant PBS listing requirements when prescribing opioids under the Authority Required (STREAMLINED) arrangements and continue to include the correct streamlined code on the prescription (Streamlined codes are provided on the PBS website against the relevant PBS item code). For increased quantities and/or repeats, or for Authority Required (TELEPHONE/ELECTRONIC) PBS listings, prescribers may request authority approval from Services Australia and provide sufficient information to assess patient eligibility.  

You will need to indicate if you are requesting items listed on the PCS when applying for authorities. 

For written authority requests, there will be a new PCS form that will be available to submit with the request. 

What does it mean for Pharmacists?  

Pharmacists will be required to continue to ensure PBS scripts have a valid streamlined authority code or authority approval, where relevant.