Hospital medicines list news 9
Prescribing from the HML - information for hospitals and health professionals
12 December 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 the last HML News. Now we are almost six months into the HML implementation, we expect this will be the final newsletter you get from us that is solely about the HML.
We will continue to work with DHBs over the next six months, to review and resolve remaining implementation issues. There is more information about what this is likely to involve at the end of this HML News, but we will be continuing the close relationship with Pharmacy Managers.
We’ll stay in touch, but in future you’ll be hearing about updates to the HML, and any changes to the rules or processes, through our regular monthly Pharmaceutical Schedule Update processes.
This includes a monthly preview of the changes that will come into effect the following month. This will be emailed to Pharmacy Managers and published on our website. It will be followed by the online publication of the monthly Update document. That Update will also be posted to DHBs. The next full printed HML book will be sent next March 2014.
There will also continue to be general self-help information in other PHARMAC communication channels like our HML website pages. You could also sign up to receive one of our other newsletters like Device Advice or Inpharmation to keep up-to-date generally with PHARMAC’s work and how it might affect you.
At this stage of the HML’s life, very few items are being removed, unless they are discontinued by the supplier. In general, restrictions are being widened, rather than tightened.
PHARMAC has worked hard to make swift decisions on medicines that have been added to the list since 1 July 2013, particularly where there may have been a mistake or an omission identified. When new medicines are added to the HML, or access is widened, we are now doing this through the PHARMAC application process.
Anyone can apply to have changes (or changes to restrictions) and additions made by using the guidance and application form on the PHARMAC website.
Pharmaceuticals that have quite detailed restrictions around their use now have that restriction information linked to them in the interactive version of the HML. An example of this is infliximab.
You can open the full restriction, or parts of it, as a stand-alone page that you can print or save as a PDF.
There is a short tutorial(external link) on our website showing how this works. You can also access this via the ‘i’ (information) icon at the top of the HML online home page.
The transition period has given DHBs time to adjust to the new environment and provide feedback to help us monitor and be responsive to what is happening on the ground. This has included looking at how both the HML and its rules are applied to actual prescribing situations.
In 2014 it’s likely we will be looking at the HML rules again, to fully consider their operational impacts and whether any adjustments may be required. Part of that work will be looking at the issue of clinical trials and free stock (covered in Rule 14). In the meantime, DHBs need to continue to notify us of any ‘free stock’ programmes implemented locally.
As well as this work around the Rules, you can expect to see some increasing monitoring of restrictions and compliance. We’ll be working with DHBs to help shape how that monitoring will work.
The transition has been happening in the context of prescribers ultimately needing to use the HML for all prescribing activity. When a prescriber makes a decision to use a pharmaceutical in the course of their DHB practice, they are doing so on behalf of the relevant DHB. They must therefore comply with the Pharmaceutical Schedule Rules as set out in Section H of the Schedule, as required by legislation, the Crown Funding Agreement and related policies.
This means that only pharmaceuticals listed in the HML should be used, because the HML is part of the Pharmaceutical Schedule, unless an exception applies under Rules 11-17 as outlined in Part 1 of Section H.
While we expect the need to use a non-HML treatment on the basis of an urgent clinical situation will become less and less, our clinical safety message remains in place – if necessary, take the clinically appropriate action and let PHARMAC know about the situation afterwards.
We’d like to thank all DHBs for their work on implementation over the past six months and wish you a safe and happy Christmas. We will be continuing to provide information and support where it’s needed, as HML processes are fully integrated into business as usual across the sector.
If you have questions about anything HML-related, please continue to call our queries line or talk to your local DHB pharmacy staff. If you want to apply for something to be listed please follow our application process.
Last updated: 18 March 2019