Prescribers are encouraged to talk to their patients about the changes. You should advise your patients that their pharmacy can continue to use their existing prescription provided prior to 1 July 2023, and that this script is still valid after 1 July. You should also advise that their OTP medicines will be cheaper as they will only pay PBS rates.
NSW Health suggests you:
There may be additional OTP patients seeking care in GP clinics during this time. For clinical support, contact the DASAS Helpline. The DASAS Helpline is a free 24/7 line staffed by Clinical Nurse Consultants and Addiction Medicine Specialists for health professionals seeking advice about the diagnosis and treatment of patients with alcohol and other drug issues.
From 1 July 2023, like other PBS medicines, new prescriptions that are written by eligible prescribers for OTP medicines will need to meet the PBS requirements to allow for PBS reimbursement. The Commonwealth is putting temporary transition arrangements in place to support patients with existing prescriptions for OTP medicines, as it would be impractical for all continuing OTP patients to obtain new PBS prescriptions on 1 July 2023.
From 1 July 2023, existing paper-based and electronic OTP prescriptions will be able to be dispensed and claimed by PBS approved pharmacies. If you have a review or appointment with your OTP patient prior to 1 July 2023, you are encouraged to write prescriptions that meet PBS requirements. This will support patients to transition from current OTP arrangements to the PBS arrangements from 1 July 2023.
For further information regarding the transition of existing OTP prescriptions and requirements for PBS prescriptions, please see the factsheet for prescribers prepared by the Commonwealth.
From 1 July 2023, eligible prescribers writing new OTP prescriptions will need to meet the PBS requirements if the medicine is to be reimbursed through the PBS.
Requirements for PBS prescriptions are provided by Part 5 of the National Health (Pharmaceutical Benefits) Regulations 2017.
Example handwritten PBS scripts that meet NSW requirements.
Further information on writing a PBS prescription can be found on the factsheet for prescribers prepared by the Commonwealth.
Yes. Applications can be made through Services Australia.
You will have to use PBS and RPBS authority prescriptions. Prescription pads can be ordered through Services Australia.
Most ODT prescriptions will be streamlined. For prescriptions written prior to 1 July 2023, the Authority Approval Number provided in Table 3 of the Commonwealth prescriber factsheet can be used. These numbers will change on July 1.
For prescriptions written from 1 July 2024, the maximum number of repeats for OTP medicines is five– i.e. six months total supply including the original.
Sometimes patients may be on a variable dose of OTP medication. This may occur for example during initiation or when the patient is changing medication. Where necessary, prescribers may prescribe different quantities (up to the maximum quantity) and strengths of OTP medicines to meet the patient's dosing requirements, particularly during initiation. Prescribers are encouraged to prescribe only the quantities and repeats that are suitable for the patient's clinical needs (including during medication initiation) until their next review.
For prescriptions written to facilitate variable or dosing within a range, it is suggested the maximum quantity should be calculated based on the maximum daily dose required.
When writing PBS authority scripts, you should ensure you are meeting the regulatory requirements of both the Commonwealth and NSW. Example handwritten PBS scripts that meet NSW requirements.
Further information on writing increasing or decreasing doses on a PBS prescription can be found on the factsheet for prescribers prepared by the Commonwealth.
For clients receiving a combination of two strengths of sublingual buprenorphine (or any other OTP medicine), the prescriber will have to write separate PBS scripts for each strength. This means there will be a patient co-payment for each strength prescribed.
From 1 July 2023 onward, prescribers will be able to request authority approval for increased quantities of OTP medicines through Services Australia either by calling telephone number 1800 888 333 or applying via PRODA online. The streamlined authority process will not apply in these circumstances.
Further information regarding requesting PBS authorities can be found on the Services Australia website.
NSW Health is seeking regulatory clarification on this matter and will provide an update as soon as possible.
Yes. Please see the Interim Report of the Post-market Review of Opioid Dependence Treatment Program medicines – OOS 2023 for further information. This clinical criteria is already in the PBS restrictions and so prescribers should continue as they have been. There is no functional change.
Those who prescribe for patients dosing at a facility involved in the transitional arrangements to 30 November 2023 are not required to write a PBS prescription during the transition. These NSW services include:
Yes, NSW authority requirements under the Poisons and Therapeutic Goods Act 1966 for prescribing or supplying a drug of addiction to a drug dependent person remain the same. You do not have to write the NSW authority number on the prescription.
The Commonwealth Government will continue to pay for OTP medicines supplied directly to GP clinics, for a transition period until 30 November 2023. This also applies to select Aboriginal Community Controlled Health Services and non-governmental organisations. For more information, please see the factsheet on the transition arrangement prepared by the Commonwealth.
During this transition period, GP clinics should work with a PBS-approved pharmacy to make new dispensing and delivery arrangements following 30 November 2023.
