New Dispensing Rules in Community Pharmacy Presentation for Prescribers August 2015

Close Control – Why it Changed The previous term, ‘Close Control’, was used to indicate the need for high frequency dispensing. There had been a significant and unsustainable rise in the use of Close Control. Use of Close Control varied considerably across the country (and could not be explained by population difference) $82M of $320M total dispensing fees (26%) was spent on Close Control in 2009/10. $46M of that $82M (56%) was spent on weekly Close Control. Receiving medicines more frequently didn’t necessarily relate to the level of service needed by any particular patient. Aside from trialing new medicines, weekly close control should have been the exception, rather than the rule, e.g. for people with safety issues.

Specific Changes to Dispensing Frequency The term “Close control” is no longer valid on prescriptions. Close Control for patients who are “frail, infirm or unable to manage medicines” has been removed These patients are now assessed for eligibility for the Community Pharmacy LTC Service. – This service is designed for people who need extra help to manage their medicines. – Patients who were receiving Close Control will most likely have been assessed for (and already be on) the Community Pharmacy LTC Service by now. Once in the Community Pharmacy LTC Service, dispensing frequency is determined by the pharmacist, and you will be informed of any changes and the reason why.

Specific Changes (cont.) Flexible periods of supply for trial periods or safety Safety medicines – Codeine and buprenorphine with naloxone (Suboxone) has been added to the list of safety medicines pharmacists use. – Prescribers no longer need to initial trial periods. – Prescribers can request that pharmacy must dispense at a higher frequency. Where required, the pharmacist will discuss the frequency further with the prescriber. – Pharmacists determine the dispensing frequency of other medicines prescribed.

Other Close Control Changes Trial Period for dose change or new medicine: – The Prescriber doesn’t need to initial trial periods but does need to specify period of supply and write ‘trial’ or ‘trial period’. – MedTech has incorporated this in Version 20

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