Medicines with restrictions in the HML

Some medicines in the Hospital Medicines (HML) section of the Schedule have prescriber-type or indication restrictions.

On this page

Any medicine with an HML restriction will have a checklist to help you assess whether your patient meets the restrictions. These are the PDFs with an RS number.

You’ll find a link to the right checklist in the HML medicine listing.

Do not submit completed RS forms to PHARMAC or the Ministry of Health. Check your hospital’s specific requirements.

Prescriber group restriction

Some hospital medicines may only be given by a specialist. This will be specified in the restriction form.

If the medicine is restricted to a different prescriber group from your own, you have two options.

  1. Check if there’s a DHB protocol to use the medicine for the indication.
  2. Use it if a prescriber from the relevant prescribing group agrees with the indication. Document your decision.

In an emergency, you may use the medicine even if you cannot discuss it with a relevant group prescriber, but you should discuss it with them within 24 hours.

If a patient needs on-going treatment, a relevant specialist must authorise any further prescribing.

Indication restriction

Where there is a hospital indication restriction, use the RS form checklist to ensure your patient’s indication qualifies for the medicine. If the patient meets the criteria of the RS form, then the medicine may be given to the patient.

Requesting a waiver for an indication restriction

Sometimes a person’s clinical circumstances may meet the spirit or intent of the conditions within the HML, but not meet the technical requirements. In these cases, you can apply to PHARMAC for a waiver.

To request a waiver, email us the following:

  • The details of the medicine
  • Why you are seeking a waiver
  • Which criteria your patient meets and which criteria they don’t.

Email the application to waivers@pharmac.govt.nz

In an emergency, give the patient the medicine and notify PHARMAC afterwards.

Notification of PHARMAC’s decision

If the waiver request is approved, we’ll write to you with the details of the approval for your patient’s records. Each approval is given on a case-by-case basis and is valid for that specific named patient only.

If the waiver request is declined, we’ll write to you explaining why. We may seek more information if needed.

Note: we don’t generally consider a waiver for a prescriber restriction.

Who to contact

If you have questions about HML medicine restriction waivers: