Prescribing medicines restricted in the HML
Some medicines in Section H (HML) have prescriber-type or indication restrictions.
Prescribing a medicine on the HML
This flow chart shows the steps to take if there are restrictions on a medicine.
Flow chart description:
Start: I want to prescribe a pharmaceutical that I know is on the HML.
Option 1: If the pharmaceutical has no restrictions, then you can use it.
Option 2: If the pharmaceutical is restricted to a different prescriber group (from mine),
- use it if there is a DHB protocol to use the pharmaceutical for the indication, or
- use it if a prescriber from the relevant prescribing group agrees with the indication*, or
- prescribe an alternative pharmaceutical if a prescriber from the relevant prescribing group disagrees with the indication but has recommended an alternative pharmaceutical.
Option 3: If the pharmaceutical is restricted to an indication:
- use it if pharmaceutical is for this indication
- apply through NPPA to use the pharmaceutical outside of this indication.
NPPA stands for Named Patient Pharmaceutical Application
*24 hour ‘grace period’ - for emergency situations, you may use the medicine if you cannot discuss with a relevant group prescriber, but you should contact them and discuss within 24 hours.
In addition to this guide you should keep in mind:
- It is possible to prescribe a pharmaceutical that is restricted to a different prescriber group (from your own) if you have a DHB hospital protocol or guideline to support this.
- In an emergency situation, if you are not in the prescriber group for a restricted medicine and are unable to get hold of an appropriate person to discuss using that medicine, you may use it. However you would need to make contact with that person during the following 24 hour period.
- It may be possible to prescribe a pharmaceutical outside an indication restriction via the Named Patient Pharmaceutical Assessment (NPPA) policy – either through the PHARMAC or DHB NPPA processes.
Who to contact
If you have questions about restrictions placed on medicines in the HML, you can:
- email: HML@pharmac.govt.nz
- phone: 0800 66 00 50
- fax: 64 4 974 7819
Last updated: 9 March 2020