Is it funded: Emtricitabine with tenofovir disoproxil (PrEP)
A short guide to help pharmacists assess whether a prescription is funded for PrEP.
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Note: This guidance does not cover the funding of emtricitabine with tenofovir disoproxil for PEP (post-exposure prophylaxis). We're currently reviewing this content to cover this scenario
We have used some examples to illustrate the funding rules for this medicine.
Prescribed for treatment of HIV
Rx emtricitabine with tenofovir disoproxil
- Does this person have a Special Authority approval under SA2138? No
- Is this person prescribed another antiretroviral funded with Special Authority approval under SA2139? No
- Is the prescription endorsed with “Certified Condition” or "for treatment of HIV" by the prescriber? Yes
Is this funded? Yes
By endorsing the prescription, the prescriber declared that it’s for a condition that meets the subsidy criteria.
Relevant part of the rule in the Schedule listing:
“Subsidy by endorsement; ... Endorsement for treatment of HIV”
Schedule listing for emtricitabine with tenofovir disoproxil(external link)
Read the general Schedule Rule for subsidy by endorsement (2.3.1)
Co-prescribed with funded antiretrovirals for treatment of HIV
Rx emtricitabine with tenofovir disoproxil
- Does this person have a Special Authority approval under SA2138? No
- Is this person prescribed another antiretroviral funded with Special Authority approval under SA2139? Yes
- Is the prescription endorsed with “Certified Condition” or "for treatment of HIV" by the prescriber? No
Is this funded? Yes
It is co-prescribed with another antiretroviral, which has a Special Authority approval.
A pharmacist should annotate the prescription in this instance. No endorsement is needed from the prescriber.
Relevant part of the rule in the Schedule listing:
"Endorsement for treatment of HIV: [The] prescription is deemed to be endorsed if:
• emtricitabine with tenofovir disoproxil is co-prescribed with another antiretroviral [which is] subsidised under Special Authority SA2139 and
• the prescription is annotated accordingly by the Pharmacist or endorsed by the prescriber."
Schedule listing for emtricitabine with tenofovir disoproxil(external link)
Read the general Schedule Rule for about annotating prescriptions (2.3.2)
Prescribed for pre-exposure prophylaxis (PrEP)
Rx emtricitabine with tenofovir disoproxil
- Does this person have a Special Authority approval under SA2138? Yes
- Is this person prescribed another antiretroviral funded with Special Authority approval under SA2139? No
- Is the prescription endorsed with “Certified Condition” by the prescriber? No
Is this funded? Yes
The SA2138 Special Authority approval means there’s no need for the endorsement.
Relevant part of the rule in the Schedule listing:
"Subsidy by endorsement; can be waived by Special Authority SA1994"
Schedule listing for emtricitabine with tenofovir disoproxil(external link)
Flow chart summary
This flow chart provides a summary of the rules. This is a guide, it does not replace the Schedule. If you have any questions, contact enquiry@pharmac.govt.nz
