This is the text extract for Consultation on a proposal to alter the Close Control rule in the Pharmaceutical Schedule, browse documents here.

6 August 2007 To all interested parties

Consultation on a proposal to alter the Close Control rule in the Pharmaceutical Schedule

PHARMAC is seeking feedback on the following proposal to alter the Close Control rule defined in Section A of the Pharmaceutical Schedule. The proposed amendment is in three parts and will permit: · pharmacists to endorse prescriptions Close Control when PHARMAC has approved and notified pharmacists that they are able to endorse prescriptions for specified pharmaceuticals without prescriber endorsement for a specified time; and · practitioners to prescribe smaller quantities of medicines to be dispensed to patients who are initiated on a new treatment or their dose is changed. The patient must require close monitoring due to recent initiation onto, or dose change for, the medicine. Close Control in this case is applicable to the patient’s first changed prescription only; and · patients in Rest Homes and Residential Disability Care Institutions to have their prescriptions dispensed Close Control in monthly lots. Details of the proposal are as follows (changes in strikethrough and bold): “Close Control” means the dispensing of a Community Pharmaceutical, in accordance with a Prescription, in quantities less than one 90 Day Lot (or, in the case of for oral contraceptives, less than one 180 Day Lot) for a Community Pharmaceutical referred to in Section F Part I, or in quantities less than a Monthly Lot for any other Community Pharmaceutical, where either: as applicable, where a) all of the following conditions are met: i) the Community Pharmaceutical is: A) a tri-cyclic antidepressant,; or B) an antipsychotic,; or C) benzodiazepine,; or D) a Class B Controlled Drug,; or E) any other Community Pharmaceutical that has been prescribed for a patient who: 1A) is not a resident in a Penal Institution, Rest Home or Residential Disability Care Institution; and 2B) either: i) in the opinion of the prescribing Practitioner Doctor, Midwife or Nurse Prescriber is: a. frail; or b. infirm; or c. unable to manage their medication without additional support; or d. intellectually impaired; or and e. requires close monitoring due to recent initiation onto, or dose change for, the medicine (applicable to the patient’s first changed prescription only); and

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f. requires that Community Pharmaceutical to be dispensed in a smaller quantity than that for which it is currently funded, is a resident in a Rest Home or Residential Disability Care Institution; and a. the maximum quantity or period of supply to be dispensed at any one time is not more than 30 days’ supply; and b. the prescriber has written the name of the Rest Home or Residential Disability Care Institution on the prescription; and ii) the prescribing Practitioner Doctor, Midwife or Nurse Prescriber has A) endorsed each Community Pharmaceutical on the Prescription clearly with the words “close control” or “CC”; and B) initialed the endorsement in their the prescribers own handwriting; and C) specified the maximum quantity or period of supply to be dispensed at any one time. or b) all of the following conditions are met: i) where PHARMAC has approved and notified pharmacists to endorse prescriptions for a specified Community Pharmaceutical(s) Close Control without prescriber endorsement for a specified time; and ii) the dispensing pharmacist has: A) clearly endorsed each of the approved Community Pharmaceuticals that appear on the prescription with the words “close control” or “CC”; and B) initialed the endorsement in their own handwriting; and C) specified the maximum quantity or period of supply to be dispensed at any one time, provided this maximum quantity or period is not less than 30 days’ supply. or ii)

PHARMAC welcomes feedback on this proposal. If you wish to make comments regarding this proposal for the PHARMAC Board to consider when making its decision, please forward them to Kaye Wilson at PHARMAC by 5 pm, 21 September 2007. If you have any questions regarding this proposal, please contact me on (04) 9167-563 or kaye.wilson@pharmac.govt.nz. Yours sincerely

Kaye Wilson Schedule Analyst

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