From the 01 February 2021, the Federal Government have mandated that the active ingredient in medications must be included when writing prescriptions for the PBS and RPBS.
This means that instead of supplying a prescription with a brand name of medication, for example Crestor 10mg, the prescription must now read Rosuvastatin 10mg, reflecting the active ingredient of the medication.
Do all prescriptions need to list the active ingredient?
All PBS and RPBS prescriptions need to include the active ingredient except for a few exceptions:
- Handwritten prescriptions
- Prescriptions for an item that has four or more ingredients (for example Alfare for infants)
- Some non medicinal items on the PBS/RPBS (bandages, tapes, dressings, allergens, diagnostic agents, food supplements and vitamins)
- Any item where the inclusion of active ingredients has been deemed impractical (for example ocular lubricants) or unsafe (for example opthalmologicals) or confusing (for example triple therapies to treat H.pylori (Nexium HP7))
What will the differences be in MediRecords?
Prescriptions will still be completed in the same manner in MediRecords, with just a few changes:
You can still enter the brand name of the medication, like below, where Crestor has been entered as the brand name of the item to be prescribed.
However, as you move through the prescribing process, you'll notice that the description of the item will change to the active ingredient name.
From here, you can continue to prescribe as before. When you reach the final stage of writing the prescription, you will see there is a new checkbox in the menu. This checkbox is included if you would like to also display the brand name on the prescription.
If the Brand Substitution box is checked to restrict the Pharmacy from changing to a generic medication, the original brand name that was searched will be prescribed.
From here you can print your Prescription which will comply with the new prescribing rules.
List of Medicines for Brand Consideration (LMBC)
For some prescription medication, the brands may be an important consideration in determining the correct item to be prescribed. These medications are those that are listed as Medicines for Brand Consideration. So what happens then?
When these medications are prescribed, MediRecords will alert you to the consideration of the brands available by a pop up screen. From this screen, you can choose the most appropriate brand of the drug available. Some of the brands may be different due to a different delivery system, a different absorption rate or incompatible brand substitution.
Scenario
We'd like to prescribe Warfarin to a patient, but we know we either have to write the prescription for Marevan or Coumadin. When we enter the prescription into MediRecords as Coumadin, the system will show the Active Ingredient (Warfarin Sodium). We really need to ensure we give the patient a prescription for 2mg Coumadin, and not 3mg Marevan. So MediRecords will give us the option as shown below.
The full list of LMBC is available on the PBS website and here.
FAQ
- Will e-Prescribing look any different? e-Prescribing will present in exactly the same manner as paper based prescriptions, you will follow the same steps to produce an e-Prescription with the active ingredient.
- Can my patient still choose a brand substitution at the pharmacy? Yes, if you don't mark the prescription as brand substitution not permitted, the patient can still elect for a generic brand of medication.
- Why has this change been introduced? For a number of reasons, including supporting the patients to better understand the active ingredients in their medications, increasing patient safety awareness, decreasing cost of medications that have a brand surcharge on them, improving the financial sustainability of the PBS and to align the Australian prescribing practices with international standards.
- I look after patients in a RACF, does this mean I need to write the active ingredient in their medication charts too? Different facilities adhere to different rules, however, there is no requirement for active ingredients to be listed on the medication charts. There is a requirement that the prescriptions that are sent to the RACF Pharmacy adhere to the new regulations.
- What will happen to my patient's prescription if I don't adhere to the new regulations? The pharmacy will not be able to supply the medication under the PBS or RPBS and the prescription will be a private prescription.
- Can I default all my prescriptions to write with the brand name? No. This is a legislative requirement. If you have any concerns regarding this policy, we suggest you contact the RACGP or your local member of parliament.
For the full list of medications that are exempt, please click on the following link: Australian Commission on Safety and Quality in Health Care Active Ingredient Prescribing - List of Excluded Medicinal Items December 2020.
You can view the legislation around this new regulation here.