Hospital medicines list news 7
Prescribing from the HML - information for hospitals and health professionals
9 September 2013
DHB hospitals started prescribing from a nationally consistent pharmaceutical list on 1 July 2013. The Hospital Medicines List (HML) – Part II of Section H of the Pharmaceutical Schedule – has been developed by clinicians, pharmacists and PHARMAC. It means New Zealanders get access to the same hospital medicines, wherever in New Zealand they are being treated.
In this issue:
Kia ora and welcome to this month’s HML News. This is a summary of information we’ve sent to DHB pharmacies over the month. We think this may also be of general interest to DHB people and the wider sector. If you have questions about anything, please call our queries line or talk to your local DHB pharmacy staff.
To get general feedback on how the transition is going at each DHB, we’re teleconferencing with each DHB pharmacy and other hospital staff during September/October.
You can find the pdf of the September HML Update on our website. Hard copies should also be available in your hospital. These are usually delivered direct to Pharmacy.
The September Update should be read alongside the 1 July HML first edition and the August HML Update can be discarded. We are planning to print the next full edition in October 2013.
We are continuing the development of the HML database and are working towards having an interactive online HML available in the next couple of months. In the meantime, we have continued to keep the ‘old’ Section H (products that PHARMAC has negotiated contracts for) tool up-to-date online. Once the interactive HML is available, this tool will be removed from our website.
Two months into the HML transition, we are starting to gather data on local decision-making for rapid assessments. Ultimately, the HML Rules mean we need to know within a month of those decisions being made.
We have also received information on free stock programmes set up since 1 July, but also we’ve asked for information on programmes started before the HML start date, where that’s available. Pharmacy is assisting us in gathering this information from DHBs each month.
We’re also interested in understanding when clinically urgent decisions to use non-HML products (where the pharmaceutical is available in the hospital) are being made during the transition. This will help us longer-term to continue to manage and build a Section H that meets clinical needs.
Where pharmacy managers and pharmacists are aware of the need for these decisions, we’ve asked them to let us know through their monthly reports. We know they won’t always know when this happens so we’re also asking clinicians to let us know directly if they can (with a cc. to your Pharmacy Manager if you’re emailing). Either give us a call on our 0800 number or email HML@pharmac.govt.nz. We appreciate any input you’d like to offer.
Some products may be listed on the HML for use in DHB hospitals, but a clinician/s may consider either the presentations that may be prescribed, or any restrictions in place, may not be adequate or clinically appropriate.
To help PHARMAC continue to gather and respond to feedback on the list, clinicians should be aware they can request changes to the details of listings using the Schedule funding application process.
We welcome the on-going professional input from DHB clinicians, pharmacists and health professionals.
DHBs cannot administer privately funded medicines to patients under their Crown Funding Agreement. But the HML Rules mean DHBs can agree to fund a previously privately-funded medicine in certain circumstances.
If a patient comes into hospital already stabilised on a non-HML treatment the DHB may prescribe and fund that medicine for the patient’s stay if:
- the patient is unable to bring their treatment with them, or pharmacy staff consider that what has been brought cannot be used and
- if interrupted or delayed treatment would have ‘significant adverse clinical consequences’ and
- the clinician does not consider it appropriate to switch to a HML treatment.
This allowance is covered in the Exceptions section of the HML Rules – Rule 12. The rule’s intent is to ensure continuation of treatment in a stabilised patient where to interrupt or delay treatment would have significant adverse clinical consequences.
Some DHBs have let us know about restrictions they will apply for some HML medicines. While the HML Rules allow local prescriber-type (but not indication based) restrictions to be made, PHARMAC needs to know what these are.
We may also require an amendment or removal of the restriction if it appears it does not meet the requirements of the HML Rules (7.1) that ‘…the Local Restriction does not unreasonably limit funded access to the Hospital Pharmaceutical…’.
Please email us at HML@pharmac.govt.nz with details of any local restrictions that are being considered and we will review these with the above rule in mind.
If you know someone who you think should be getting this newsletter, please let them know they can subscribe (or unsubscribe) through our website. We’re sending it monthly at the moment.
You can also keep an eye on updates to the HML pages on our website.
Last updated: 3 December 2018