Pharmaceutical Benefits Scheme (PBS) Restrictions Wording Tool – Background and Progress Faster PBS updates Streamlined processes Increased transparency.

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Presentation transcript:

Pharmaceutical Benefits Scheme (PBS) Restrictions Wording Tool – Background and Progress Faster PBS updates Streamlined processes Increased transparency Positioned for future change February 2009

Tier 1 Fast track timing issues What is the undertaking to be met? Industry expect Tier 1 drugs (on the fast track process) can be listed 6-8 weeks after PBAC. A ‘minimal change’ approach to business as usual in converting to a Monthly Listing from December will result in Tier 1 drugs being listed about 13 weeks after PBAC. So more significant changes were required. Can this undertaking be met? What are the ‘minimal change to business as usual’ timings for the monthly listing cycle? Week 0Week 1 PBAC Wed – Fri 1st Week of month Secretariat Week 2Week 3Week 4Week 5 Listing Publication Week 6 Week 7Week 8Week 9 Notification Effective Date 1 st Month How can the 8 week undertaking be met? ……… March July November April August December PBAC Secretariat Listing Publication Notification Effective Date 1 st Month March July November April August December Week 17 Pre-listing Finalisation Data removal Cutoff not met – Tier 1 listed in about 13 weeks. X What are our targets? 1.For 2007, Tier 1 drugs should be updated on the PBS by the second monthly effective date following PBAC. 2.On implementation of PharmCIS, Tier 1 drugs should be updated 3 weeks after PBAC. Met the cutoff – Tier 1 listed in about 8 weeks.  Pre-entry of Tier 1 drug data Week 16Week 15Week 14Week 1Week 2Wk 12 DUSC ESC RWG Week 3Week 4Week 5 Week 6 Week 7Week 8

PBS Monthly update timing issues Tier 1: How can we improve the process? PBAC Secretariat Publication Notification Effective Date 1 st Month March July November April August December Week 17 Issues What are our targets? 1.Tier 1 drugs should be updated on the PBS by the first monthly effective date following PBAC. 2.All changes to PBS, once finalised should be ‘published’ in 3-6 weeks. Met the cutoff – changes listed in about 4 weeks.  Week 16Week 15Week 14Week 1Week 2 Wk 12 DUSC ESC RWG Week 3Week 4Week 5 Week 6 Week 7Week 8 Contracting the process to 4 weeks requires improvements in the efficiency of all aspects of the process, including reducing the notification period to about 2 weeks. One month only feasible if there is high quality electronic data transfer (XML) Other monthly processes: How can we improve the process? Notification Effective Date 1 st Month Week 17 Issues Week 16Week 15Week 14Week 1Week 2Wk 12 Week 3Week 4Week 5 Week 6 Week 7Week 8 Publication Changes happening any month could include: Minor submissions Deletions Change of Details RPBS Tier 3 Tier 2 New Brands? Section 100 drugs

How can the Notification Period be just 2 weeks? Medicare and Software Vendors told us that Restrictions/Authorities are the key to reducing the time between the listing of drugs on the PBS and their availability through Doctors’ prescribing software. Proposed solution –Develop a syntax so that restrictions/authorities are produced as an xml update for prescribing software in much the same way virus definitions are made available to virus-detection software. –This meant developing a tool for those writing restrictions to be able to produce them in the required syntax. Where are we now? –Syntax has been drafted. –Data model proposed –Prototype tool has been developed

Process Benefits From RWT Simplified entry of restrictions/authorities as a result of using the tool Data entry possible earlier in the process of defining a listing – maybe even by industry Provides consistency – easier to manage (flow-ons and expertise) Believe that restrictions will be easier to understand and use Reduces (?eliminates) interpretation of restrictions rules by software vendors – increases consistency in application of rules