Hospital medicines list news 4
Prescribing from 1 July 2013 - information for hospitals and health professionals
27 June 2013
DHB hospitals will start prescribing from a nationally consistent pharmaceutical list from 1 July 2013. The Hospital Medicines List (HML) – Part II of Section H of the Pharmaceutical Schedule - has been developed by clinicians and PHARMAC over the past two-and-a half years. It will mean New Zealanders get access to the same hospital medicine, wherever in New Zealand they are being treated.
In this issue:
By now most hospital pharmacies will be receiving copies of the first edition of the HML book, the July Update and information on the Named Patient Pharmaceutical Assessment (NPPA) exceptions process. There are also details on how to contact us for advice or assistance included with each book. All this information is also available on the PHARMAC website.
Recently added to the HML pages are
- Answers to some common questions we’ve had from DHBs. Some of these Q&As are also reproduced below.
- The first HML Update – this should be read in conjunction with the first edition HML (1 July) and includes a summary of pharmaceuticals added to the HML since the final lists were notified in May. This can be found on page 13 of the Update. The first edition and the update are the most up to date list and should be used instead of A-Z list (this may still be helpful to see what pharmaceuticals were considered.)
- An information page and flowchart outlining the NPPA process at either the DHB or PHARMAC for Rapid Assessments (less than five working days) and for standard exception applications. The NPPA Rapid Assessment policy is based on the intention that hospitals with local clinical decision-making groups and processes (such as a Panel/Medicines Committee/Drug and Therapeutics Committee) can continue to make urgent decisions effectively and quickly to meet patient needs – while bearing in mind PHARMAC’s approach to its NPPA decision processes and criteria.
- Also new on the website are new NPPA and Rapid Assessment forms for both the HML and the Pharmaceutical Schedule.
As well as becoming familiar with the HML list itself, we encourage prescribers to be aware of the Rules that guide the way the list will be used. They are available to read on our website.
The HML Rules will allow a hospital to administer, provide or dispense ‘free stock’ (stock provided free of charge by a supplier).
Existing patients (being treated before 1 July) may continue receiving any ‘free stock’ they are being treated with under Rule 13 (Pre-Existing Use). Following sector feedback, we are modifying our notified approach in the 1 July HML Rules regarding free stock for the transition phase, by creating a specific exception to allow for the use of such stock for new patients without requiring a PHARMAC approval process.
Instead, we’ll require DHBs or suppliers of the medicine to notify us of free stock programmes in advance of commencing any patient on the programme. We’ll look at developing a formal process to allow that notification, but in the meantime we are seeking information on the nature and full intended scope of the programme.
We’ve published the amended rule on our website. The August HML update will also reflect this change. While the Schedule Rules establish PHARMAC’s requirements, prescribers also need to comply with any other legal or DHB level requirements.
The new approach is a transitional arrangement while we consider in more detail how best to approach the issue of free stock so as to meet the national consistency goals of the HML. This is in line with the overall HML transition approach to monitor issues as they arise and maintain a flexible approach.
As we get more questions to our 0800 and email advice lines, we’ll start sharing the answers on some topics we think may be common across DHB hospitals.
We will still have stock of some products that are not listed on the HML – can we use them after 1 July?
If that product is clinically appropriate and a prescriber wishes to prescribe it after 1 July, then yes, that stock should be used up. However, PHARMAC would expect the DHB not to purchase more of that item.
What can I do if I want to prescribe something that is NOT on the HML?
- During the transition period, if there is an urgent clinical need, and the pharmaceutical is not listed but available, the clinically appropriate action should be taken to treat your patient. You should let PHARMAC know if you have used a non-HML pharmaceutical so we can monitor what is happening on the ground. However we expect that no more of this item is ordered unless it is for a NPPA patient, or the item becomes listed on the HML. Call us to discuss or send an email to HML@pharmac.govt.nz.
- If you want to request that something is added to the HML in the future you can apply to PHARMAC.
- If you want to request an exception to the list for a particular patient you can apply to PHARMAC for NPPA (Named Patient Pharmaceutical Assessment).
- If you need a Rapid Assessment (that is less than five working days) and your DHB has processes in place, you can request an assessment through your local panel/process. You can also request Rapid Assessment by PHARMAC.
How can I tell if an item has a restriction?
The HML uses an arrow symbol to indicate where a pharmaceutical has a prescriber or indication restriction. A guide to the different symbols used through the list is shown on the inside front cover of the HML.
A reminder of the restriction symbol is also given at the bottom of each left hand side page in Part II.
Got an email query?
There are also links below this to our application processes to have pharmaceuticals added to the HML or to apply for an exception for a named patient through NPPA.
The advantage of accessing us this way is you can see what information is already on our web pages before you get in touch – we may have already answered your question or talked about the issue you’ve raised.
If you have a question, comment or concern please email HML@pharmac.govt.nz, phone 0800 66 00 50 or fax 64 4 974 7819.
Last updated: 2 November 2015