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Pharmacist Prescribers Able To Prescribe Special Authority Medicines

A change to prescribing rules will make it easier for New Zealanders to get the medicines they need, according to both the Ministry of Health and PHARMAC.

Some medicines are only funded under certain conditions to ensure access to medicines is available for those who would benefit most from treatment. To receive these medicines, a special authority approval is required.

Until today, only medical practitioners, dieticians, nurse practitioners and optometrists were able to apply for special authority approvals.

However, from 1 October 2020, pharmacist prescribers are now able to apply for special authority to prescribe specific restricted medicines.

Ministry of Health Chief Clinical Advisor Andi Shirtcliffe says in some instances this means patients won’t need to wait for medical practitioners such as GPs or hospital doctors to sign off much-needed prescriptions.

“Pharmacist prescribers have specialised clinical knowledge about medicines, skills and understanding relevant to their area of prescribing practice,” Ms Shirtcliffe says.
“They can provide individualised medicines management services, including prescribing medicines to patients.”

There are currently 36 practising pharmacist prescribers in New Zealand, who usually work in collaborative health team environments with other healthcare professionals such as general practice or hospitals.

Because pharmacist prescribers have not been able to apply for or renew special authorities, either a patient who needed one to get their medication would have to see a doctor separately, or the pharmacist prescriber would need to get a doctor to apply for one on their behalf.

“In some cases, this resulted in slower access to medication and often higher costs for patients, duplication of care and time taken from other work for doctors, and additional effort for pharmacist prescribers in finding an available doctor,” Ms Shirtcliffe says.
The issues were exacerbated in rural locations, where the distances travelled by all three parties made the process more difficult, and now riskier in a COVID-19 environment.
The Ministry of Health and PHARMAC worked together to make the change, actively responding to calls from pharmacists and other specialists.

To allow pharmacist prescribers to apply for a special authority, the Ministry updated the complex IT systems used to process special authorities, and then PHARMAC updated the Pharmaceutical Schedule, effectively changing the rule.

PHARMAC Director of Operations Lisa Williams said the change was something both organisations had been working towards with urgency.

“This is a practical move to clear away red tape which was preventing the most efficient care for New Zealanders,” Ms Williams says.

“The application system and Schedule are now appropriate for the current health environment.”

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