<< Pharmaceutical Schedule

Pharmaceutical Schedule

Glossary of Terms

Definition of terms used in the interactive Schedule. For a fuller explanation of terms, see the Interpretation and Definition section in the Pharmaceutical Schedule

Access Exemption Criteria

The criteria under which patients may receive greater than one month’s supply of a pharmaceutical subsidised in one Lot. The specifics of these criteria are conveyed in Ministry of Health guidelines, which are issued from time to time. The criteria relate to:

1. Limited physical mobility;
2. Distance from a pharmacy;
3. Relocation of residence;
4. Extended travel.

Act

The New Zealand Public Health and Disability Act 2000.

Contractor

A person who is entitled to receive a payment from the Crown or a DHB under a notice issued by the Crown or a DHB under section 88 of the Act or under a contract with the Ministry of Health or a DHB for the supply of Pharmaceuticals.

Controlled Drug

A controlled drug within the meaning of the Misuse of Drugs Act 1975 (other than a controlled drug specified in Part VI of the Third Schedule to that Act).

DHB

An organisation established as a District Health Board by or under section 19 of the Act.

Endorsements

Unless otherwise specified, endorsements should be either handwritten or computer generated by the doctor prescribing the medication. The endorsement can be written as “certified condition”, or state the condition of the patient, where that condition is specified for the pharmaceutical in Section B of the Pharmaceutical Schedule. Where the doctor writes “certified condition” as the endorsement, he/she is making a declaration that the patient meets the criteria as set out in Section B of the Pharmaceutical Schedule.

Funder

The body or bodies responsible for the funding of pharmaceuticals listed on the Schedule (which may be one or more DHBs and/or the Ministry of Health) and their successors.

Hospital Pharmacy

The Pharmaceutical is not eligible for Subsidy unless it is supplied by a hospital or pharmacy contracted to the Funder to dispense as a hospital pharmacy to an Outpatient on the Prescription of a Doctor.

Hospital Pharmacy-Specialist

The Pharmaceutical is not eligible for Subsidy unless it is supplied by a hospital or pharmacy contracted to the Funder to dispense as a hospital pharmacy:

1. to an Outpatient; and
2. on a Prescription signed by a Specialist; or
   if the treatment of an Outpatient with the Pharmaceutical has been recommended by a Specialist, on the Prescription of a Practitioner endorsed with the words “recommended by [name of specialist and year of authorisation]” and signed by the Practitioner.

In Combination

The Pharmaceutical is only subsidised when prescribed in combination with another subsidised pharmaceutical as specified in Section B or C of the Pharmaceutical Schedule.

Lot

A quantity of a Pharmaceutical supplied in one dispensing.

Manufacturer’s Price

The standard price at which a pharmaceutical is supplied to wholesalers (excluding GST), as notified to PHARMAC by the supplier.

Month restriction

No Subsidy is available:

1. unless the Pharmaceutical is dispensed on the Prescription of a Practitioner; and
2. for any quantity of that Pharmaceutical dispensed on the Prescription (whether or not dispensed as a repeat) in excess of a Monthly Lot.

Monthly Lot

The quantity of a Pharmaceutical required for 30 consecutive days’ treatment.

Not In Combination

No Subsidy is available:

1. unless the Pharmaceutical is dispensed on the Prescription of a Practitioner; and
2. for any Prescription containing the Pharmaceutical in combination with other ingredients unless the particular combination of ingredients is separately specified in Section B or C of the Schedule, and then only to the extent specified.

Pharmaceutical Benefits

The right of a person; and any member of that person’s family under 16 years of age, to have made by the Government on his or her behalf, subject to any conditions specified in the Schedule, such payment in respect of any Pharmaceutical supplied to that person or family member under the order of a Practitioner.

Practitioner

A Doctor, a Dentist, a Nurse prescriber, an Optometrist or a Midwife who holds a current annual practicing certificate.

Practitioner’s Supply Order

A written order made by a Practitioner on a form supplied by the Ministry of Health, or approved by HealthPAC, for the supply of Pharmaceuticals to the Practitioner, which the Practitioner requires to ensure medical supplies are available for emergency use, teaching and demonstration purposes, and for provision to certain patient groups where individual prescription is not practicable.

Retail Pharmacy-Specialist Prescription

The Pharmaceutical is only eligible for Subsidy if it is supplied on a Prescription or Practitioner’s Supply Order signed by a Specialist, or, in the case of treatment recommended by a Specialist, a Prescription or Practitioner’s Supply Order and endorsed with the words “recommended by [name of Specialist and year of authorisation]” and signed by the Practitioner.

Special Authority

The Pharmaceutical is only eligible for Subsidy or additional Subsidy for a particular person if an application meeting the criteria specified in the Schedule has been approved, and the valid Special Authority number is present on the prescription.

Subsidy

The maximum amount that the Government will pay contractors for a pharmaceutical dispensed to a person eligible for Pharmaceutical Benefits and is different from the cost to Government of subsidising that pharmaceutical.

Supply Order

A Bulk Supply Order, a Practitioner’s Supply Order or a Wholesale Supply Order.

Wholesale Supply Order

A written order by a Practitioner, on a form supplied by the Ministry of Health for the supply of certain Pharmaceuticals as listed in Section B and Section E Part I of the Schedule.

Page updated on 13 Feb 2008