Authority requirements for certain prescriptions has emerged as a knowledge gap for many pharmacists. Do you know what type of authorities are required for different prescriptions?
Prescribing and dispensing:
Recently, the Medical Council of NSW undertook interim action to protect public safety by prohibiting seven NSW doctors from prescribing drugs of addiction. The Pharmacy Council also considered interim action against nine pharmacists in relation to the dispensing of these prescriptions.
Central to all cases was inappropriate prescribing and dispensing of opioids or other Schedule 8 Drugs in contravention of the requirements of NSW Poisons and Therapeutic Goods legislation.
There are 2 types of authorities prescribers may need to obtain before prescribing restricted or S8 medications. These are:
- The familiar PBS Authority which prescribers obtain every day by calling 1300 888 333 or sending the script through the mail. This authority ensures the patient will get a PBS subsidy for the medication prescribed.
- The much less commonly required NSW Ministry of Health Authority. This authority is required when prescribing:
- Alprazolam, Flunitrazepam or Schedule 8 opioids for any period of time for someone considered to be drug dependent
- Alprazolam, Flunitrazepam, Buprenorphine (except transdermal), Hydromorphone, methadone or any other injectable, intranasal or spray Schedule 8 opioid for more than two months for someone not considered to be drug dependent.
- Stimulants such as Dexamfetamine, Lisdexamfetmine (Vyvanse) or Methylphenidate (Ritalin, Ritalin LA and Concerta)
A Ministry of Health Authority (as well as other approvals) is also required when someone is enrolled in the NSW Opioid Treatment Program (aka the “Methadone program”).
Many doctors and pharmacists seem to confuse the PBS Authority with the NSW Ministry of Health Authorities. A PBS Authority number means ONLY that the Commonwealth has agreed to subsidise the cost of a medicine. It does not grant approval for the prescriber to prescribe the medicine and therefore does not necessarily mean that it is legal for a prescriber to prescribe it.
The people on the end of the PBS line have no legal authority to allow the prescriber to prescribe stimulants and S8 medications. When the prescriber calls requesting a PBS Authority, the PBS Officers will assume the prescriber has a NSW Ministry of Health Authority to prescribe that medication. They will not conduct a check to ensure that the prescriber has a NSW Ministry of Health Authority. Telling a regulatory body such as the Pharmacy Council, Medical Council or the HCCC that the prescription had a PBS Authority is no defence for a pharmacist should you get into trouble for dispensing these medications in inappropriate circumstances.
For more information about which patients need a Ministry of Health Authority see:
Subscribe to prescribe: stay up to date with the latest news by regularly checking NSW Health’s what’s new page, and have questions around the criteria, call the Deputy Pharmaceutical Officer at Pharmaceutical Services (NSW Ministry of Health) on 02 9391 9944
** This article has been adapted from an article written by the Medical Council of NSW.