Active Ingredient Prescribing

Active Ingredient Prescribing for PBS & RPBS Medications

Since 1 February 2021, it has been a legislative requirement that prescriptions written under the PBS and RPBS include the active ingredient of the medication. This requirement is now a standard part of prescribing practice across Australia and applies to both paper and electronic prescriptions.

In practice, this means prescriptions are issued using the active ingredient name rather than the brand name alone. For example, instead of prescribing Crestor 10 mg, the prescription is written as Rosuvastatin 10 mg, reflecting the medicine’s active ingredient.

Contents

1. Active Ingredient Prescribing for PBS & RPBS Medications

2. Including Active Ingredients

3. Workflow

4. List of Medicines for Brand Consideration (LMBC)

Including Active Ingredients

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))
   

Workflow

Prescribing in MediRecords continues to follow the same workflow, with a few built-in behaviours to support compliance.

You may still search for and select a medication using its brand name.
 

As you progress through the prescribing workflow, the medication description will update to display the active ingredient name. Prescribing then continues as normal.

At the final stage of the prescription, a checkbox is available if you wish to also display the brand name on the prescription. If Brand Substitution is marked as not permitted, the originally selected brand will be prescribed and dispensed accordingly.

Once completed, the prescription can be printed or issued electronically and will comply with active ingredient prescribing requirements.

List of Medicines for Brand Consideration (LMBC)

For some medications, the specific brand is clinically important. These medicines are listed as Medicines for Brand Consideration.

When prescribing one of these items, MediRecords will display a prompt advising that brand selection is required. This allows you to choose the most appropriate brand, taking into account factors such as formulation differences, delivery mechanisms, absorption rates or restrictions on brand substitution.

Scenario

A patient requires Warfarin, but the prescription must be for either Marevan or Coumadin. When Coumadin is entered into MediRecords, the system will display the active ingredient Warfarin Sodium. To ensure the patient receives the correct brand and strength, MediRecords will prompt for brand selection before finalising the prescription.

The full list of Medicines for Brand Consideration is available on the PBS website and here

FAQ

• Will e-Prescribing look any different? No. Electronic prescriptions follow the same requirements and appear in the same format as paper prescriptions, including the active ingredient.
   
• Can my patient still choose a brand substitution at the pharmacy?  Yes. If brand substitution is permitted, the patient may choose a generic alternative at the pharmacy.
   
• Why has this change been introduced?  The requirement supports patient understanding of their medicines, improves medication safety, reduces unnecessary brand costs, supports the sustainability of the PBS and aligns 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?  Medication chart requirements vary by facility. However, prescriptions supplied to the pharmacy must comply with active ingredient prescribing legislation.
   
• What will happen to my patient's prescription if I don't adhere to the new regulations?  The pharmacy will be unable to supply the medication under the PBS or RPBS, and it will be treated as a private prescription.
   
• Can I default all my prescriptions to write with the brand name?  No. Active ingredient prescribing is a legislative requirement. For policy concerns, prescribers should contact the RACGP or their local Member of Parliament.
  
  For the full list of exempt medications, refer to the Australian Commission on Safety and Quality in Health Care Active Ingredient Prescribing exclusions list.

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.

If you need further assistance please contact support on 1300 103 903 or email at support@medirecords.com