Proposal to subsidise prescriptions written by all Diabetes Nurse Prescribers

Medicines

Consultation Closed

PHARMAC is seeking feedback on a proposal to allow all Diabetes Nurse Prescribers to have their prescriptions subsidised. Currently PHARMAC subsidises prescriptions written by only 27 named Diabetes Nurse Prescribers who participated in the pilot Diabetes Nurse demonstration sites.

In summary, this proposal would result in all Diabetes Nurse Prescribers having their prescriptions subsidised. This is the result of a nationwide rollout of the Diabetes Nurse Prescribers demonstration sites.

Feedback sought

PHARMAC welcomes feedback on this proposal. To provide feedback, please submit it in writing by 5 pm on Monday, 7 April 2014 to:

Kaye Wilson
Senior Schedule Analyst
PHARMAC
PO Box 10 254
Wellington 6143

Email: kaye.wilson@pharmac.govt.nz
Fax:     04 460 4995

All feedback received before the closing date will be considered by PHARMAC’s Board (or its delegate) prior to making a decision on this proposal.

Feedback we receive is subject to the Official Information Act 1982 (OIA) and we will consider any request to have information withheld in accordance with our obligations under the OIA. Anyone providing feedback, whether on their own account or on behalf of an organisation, and whether in a personal or professional capacity, should be aware that the content of their feedback and their identity may need to be disclosed in response to an OIA request.

We are not able to treat any part of your feedback as confidential unless you specifically request that we do, and then only to the extent permissible under the OIA and other relevant laws and requirements. If you would like us to withhold any commercially sensitive, confidential proprietary, or personal information included in your submission, please clearly state this in your submission and identify the relevant sections of your submission that you would like it withheld. PHARMAC will give due consideration to any such request.

Details of the proposal

  • The definition for Diabetes Nurse Prescriber would be amended in Section A of the Pharmaceutical Schedule from 1 May 2014 as follows (deletions in strikethrough):

“Diabetes Nurse Prescriber”, means a registered nurse who is a Designated Prescriber—Registered Nurses Practising in Diabetes Health as determined by the Nursing Council of New Zealand to practice practising in diabetes health and who has authority to prescribe specified diabetes medicines in accordance with regulations made under the Medicines Act 1981, and who is practicing in an approved DHB demonstration site.

  • The General Rule for Diabetes Nurse Prescribers’ Prescriptions would be amended in Section A of the Pharmaceutical Schedule from 1 May 2014 as follows (deletions in strikethrough):

3.6  Diabetes Nurse Prescribers’ Prescriptions

The following provisions apply to every Prescription written by a Diabetes Nurse Prescriber:

3.6.1 Prescriptions written by a Diabetes Nurse Prescriber for a Community Pharmaceutical will only be subsidised where they are for either:

a)  a Community Pharmaceutical classified as a Prescription Medicine or a Restricted Medicine and which a Diabetes Nurse Prescribers is permitted under regulations to prescribe; or
b)  any other Community Pharmaceutical listed below:
aspirin, blood glucose diagnostic test meter, blood glucose diagnostic test strip, blood ketone diagnostic test meter, glucagon hydrochloride inj 1 mg syringe kit, insulin pen needles, insulin syringes disposable with attached needle, insulin pump accessories, insulin pump infusion set, insulin pump reservoir, ketone blood beta-ketone electrodes test strip, nicotine, sodium nitroprusside test strip,

3.6.2 Any Diabetes Nurse Prescribers’ prescription for a medication requiring a Special Authority will only be subsidised if it is for a repeat prescription (ie after the initial prescription with Special Authority approval was dispensed).

Note: A list of Diabetes Nurse Prescribers will be published periodically in the Update of the Pharmaceutical Schedule for the duration of an initial pilot scheme. After this period there will be no approved DHB demonstration sites and hence no Diabetes Nurse Prescribers.

  • By amending the General Rules of the Pharmaceutical Schedule to remove reference to the approved DHB demonstration sites, any Diabetes Nurse Prescriber registered by the Nursing Council of New Zealand would have their prescriptions subsidised.

Background

In 2011, Health Workforce New Zealand (HWNZ), in collaboration with the Ministry of Health’s Nursing Team, and the New Zealand Society for the Study of Diabetes (NZSSD) established the diabetes nurse specialist prescribing project to demonstrate the effectiveness and safety of diabetes nurse prescribing.

The pilot for Diabetes Nurse Prescribers has concluded. The Minister of Health, along with Health Workforce New Zealand (HWNZ) Committee have directed HWNZ and the Nursing Council of New Zealand to extend the number of Diabetes Nurse Prescribers to at least 100 nurses by the middle of 2014.  There are currently 27 registered Diabetes Nurse Prescribers. 

Currently subsidies for Diabetes Nurse Prescribers are limited to named prescribers for a defined list of pharmaceuticals. The list of subsidised pharmaceuticals includes prescription medicines listed in the legislation (Medicines (Designated Prescriber: Nurse Practitioners) Regulations 2005) and a small number of medical devices and non-prescription items. 

The Nursing Council of New Zealand is supportive of allowing all Diabetes Nurse Prescribers access to subsidised pharmaceuticals. The Council has agreed to maintain the registration and scope for Diabetes Nurse Prescribers.

The list of pharmaceuticals a Diabetes Nurse Prescriber may prescribe and have subsidised is not being reviewed at this stage.

This consultation relates only to the availability of subsidy (which is PHARMAC’s responsibility), not the overall extension of Diabetes Nurse Prescribers which has already been implemented. Please refer to the Nursing Council of New Zealand website for further detail: http://www.nursingcouncil.org.nz/News/Further-extension-of-prescribing-to-registered-nurses-working-in-diabetes-health [link no longer available]