Update from Services Australia
Please find below information relating to changes to the Pharmaceutical Benefits Scheme (PBS) listings for opioid medicines. The changes will commence from 1 October 2020. This information relates to the administration of these listings by Services Australia. For further information on broader PBS changes, please visit the PBS website.
Opioids
From 1 October, the restrictions for opioids will be amended following feedback provided by the medical community in regard to the changes made 1 June 2020. Across all PBS listings for opioids, patients must meet at least one of the following clinical criteria depending on the PBS listing (not all options are available for all listings):
- The patient’s pain is attributable to cancer;
- The maximum tolerated doses of non-opioid (or/and other opioid) analgesics do not, or will not provide, adequate pain management;
- The maximum tolerated doses of non-opioid (or/and other opioid) analgesics are contraindicated, or unable to be taken;
- The treatment must be for post-operative pain following a major operative procedure;
- The treatment must be part of pre-operative care;
- The treatment must be used as an analgesic adjunct in general anaesthesia.
Where increased quantities and/or repeats are required:
- Most PBS listings require a review of the patient’s pain management with a second doctor if opioid treatment will exceed or has exceeded 12 months duration. This is an annual requirement.
- A palliative care nurse practitioner is able to perform the pain management review for palliative care patients. As above, this is a requirement for palliative patients who have been receiving or are expected to receive treatment with opioids for more than 12 months, unless their clinical condition is such that a pain management review is not possible.
- Pain management reviews may be conducted by phone or telehealth consultation.
- It is not mandatory to consult a pain specialist as part of the pain management review requirement. Any doctor registered in Australia may conduct this review.
- The date of the review and name of the medical practitioner who conducted it no longer needs to be provided when requesting authority approval. However, prescribers need to ensure they keep this information on the patient’s record for compliance purposes.
- Restrictions are now split into initial and continuing treatment phases to minimise the requirements for prescribers to provide information repetitively. Prescribers will need to indicate if the patient has received initial authority approval for the same drug after 1 June 2020.
- If applying for a continuing authority approval, prescribers will need to confirm if the patient has received a prior authority approval for the same medicine.
How to request an Authority
Applications for authority to prescribe increased quantities and/or repeats for up to 3 months treatment may be made in real time through the Online PBS Authorities system. You will need to use your Provider Digital Access (PRODA) account as the security to access this online service. If you don’t have an account, register now. Once registered, you will need to link your prescriber number in your PRODA account to enable you to access the Online PBS Authorities system.
Alternatively, prescribers can request up to 1 months’ treatment via telephone and up to 3 months’ treatment in writing (via mail or Health Professional Online Services (HPOS) form upload). Services Australia operators are available to assist with this process if needed. Telephone authority requests seeking treatment beyond 1 month will not be approved.
To learn more about these updates, please contact Services Australia directly.
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