Questions and answers for pharmacists
Here are answers to some of the questions you ask us.
On this page
Is dulaglutide funded for twice a week dosing?
Whether someone needs twice weekly dosing is a clinical decision to be determined by the prescriber. If the prescriber decides that the patient needs twice weekly dosing of dulaglutide, then the medicine would be funded, as long as the patient meets the Special Authority criteria.
However, there is still global supply issue affecting dulaglutide, so we are asking clinicians to be mindful of how and why they are using Trulicity.
What's a "relevant practitioner"?
A range of health care professionals can prescribe funded medicines, including nurses, pharmacists, dietitians, and midwives. Their professional bodies, not Pharmac, set out their ‘scopes of practice’, which determine what professional services and activities they can perform.
Some medicines in the Schedule have a Special Authority approval required for subsidy, with applications allowed by any Relevant Practitioner. This means that any practitioner prescribing within their scope of practice may apply for the Special Authority approval.
Where can I find brand change leaflets?
If there is a pamplet, you will be able to download it from the relevant medicine notice page
More general pamphlets and documents are available on our publications page
When can I claim a brand switch fee?
When there is a brand switch fee claimable, pharmacists can claim 1 fee per patient. The fee can be claimed at the first dispensing of the new brand after sole supply begins, even if the brand was changed earlier.
Pharmacists cannot claim a brand switch fee when the medicine is supplied on a PSO or BSO.
You can find all current medicines where a brand switch fee can be claimed by typing "BSF" in the Schedule search bar, the drop down will show the medicines these apply to.
The fee is applied to support more difficult brand changes. We have criteria to decide whether a brand switch fee is needed. These include:
- that the medicine is used long-term by patients
- there is a large patient group
- there has been no recent brand change.
Bulk Supply Order (BSO)
Who can order medicines on a BSO?
Registered private hospitals can use a BSO for bulk supplies of funded medicines and related products. For example a rest home with a registered hospital wing can use a BSO.
Where facilities that are not registered as hospitals, practitioners should use an individual prescription or practitioners supply order (PSO).
What medicines can be ordered on a BSO?
Any reasonable monthly quantity of any pharmaceutical, provided all requirements in the listing are met.
Products not funded on a BSO:
- are listed as ‘only on a prescription'
- are listed as 'not on a BSO'
- have a Retail Pharmacy Specialist restriction
- require a Special Authority
The only exception to this is ivermectin, which can be obtained on a BSO with a valid Special Authority for one patient.
OP and Wastage – What's the difference?
Original pack (OP) dispensing means dispensing (and claiming for) a whole number of packs, which may be more than the total quantity prescribed. This is generally used for products that cannot be broken down such as tubes of cream and inhalers. Wastage is about dispensing the quantity prescribed but reimbursing for excess product discarded.
Original pack (OP)
When OP is specified, you should dispense the closest pack size to meet the dosage instructions. The subsidy claim is rounded up to the nearest original container size..
Wastage
Wastage can be claimed on some medicines, including liquid antibiotics that are diluted at the time of dispensing and s29 medicines. Wastage does not apply for medicines that are Cost Brand Source (CBS) or OP because the whole pack can be claimed.
Claiming wastage is optional. If you do claim wastage, you must discard the claimed quantity at the time of dispensing.
Te Whatu Ora hospital pharmacists may claim the unused portion of products labelled as PCT or PCT only.
We expect pharmacists to minimise wastage by:
- claiming only when the unused portion is unlikely to be used
- dispensing a smaller quantity if:
- the difference is less than 10%, and
- it won’t have a clinical effect on the treatment
Is it funded: Emtricibine with tenofovir
Read our guide for pharmacists to assess whether a prescription for emtricibine with tenofovir is funded for PrEP.
Is it funded: Blood glucose meters
Are they funded for people on metformin or diet alone?
No, they are not funded. Patients should discuss the need to test with their doctor. If a meter is needed, patients can pay for a meter at their pharmacy or contact the meter supplier, Pharmaco on 0800 458 267 (or 0800 GLUCOSE).
Someone has lost their funded meter
Only one CareSens meter per patient is funded (no repeat prescriptions). If the patient loses the meter or it is damaged, a replacement is not funded. It may be covered by household insurance.
If the meter is faulty, contact the supplier to ask for a replacement.
Is it funded: Insulin pumps and consumables
Consumables – someone is using more packs than usual
People can get funding for only up to 13 packs per year. Each pack should last one month. If the person is likely to use more than this, the prescriber will need to apply for a Special Authority waiver.
About Special Authority waivers
Someone uses a small amount of insulin to prime the needle before each injection. Can I claim for this?
If priming is included in the prescription, you can dispense it. In general, this would not be more than 2 units per dose.
Is it funded: one tube of Ovestin cream per month
At the usual dose, one tube should last 3 months. One per month for hygiene reasons is not funded.
Is it funded: How many inhalers or eyedrops or prescriptions for multiple people
For this information and more, check the Procedures manual on the TAS website.
Why isn't Methylphenidate ER – Teva listed with the other extended release formulations?
Since October 2020, Methylphenidate ER – Teva can be used as a first line treatment for ADHD. We have put it together with the immediate and sustained release formulations, which are also first line. This makes it easier for prescribers to find the correct Special Authority form to apply for funding for these medicines.
Other extended release formulations (Concerta or Ritalin LA) can only be used as a second-line treatment. They require a different Special Authority form, so we’ve kept them separate.
Read the Schedule listings for all methylphenidate products(external link)
Why is my wholesaler charging me more than I'll be reimbursed
We have no control over what your wholesaler charges for an individual item. Contact your wholesaler to discuss.
Note that any additional charges to the patient must be in line with your Community Pharmacy Service Agreement (CPSA).