Handle request for increased quantity and/or repeats for unrestricted, restricted and Authority benefit 012-63020090

The maximum quantity and number of repeats allowed for PBS items are recommended by the Pharmaceutical Benefits Advisory Committee (PBAC). In the case of Repatriation Pharmaceutical Benefits Scheme (RPBS) items, the recommendations come from the Repatriation Pharmaceutical Reference Committee (RPRC).

Only approved prescribers can prescribe repeats.

Prescriptions and repeats can be for any quantity up to the maximum listed in the Schedule of Pharmaceutical Benefits. It is not necessary to prescribe the maximum quantity if a lesser quantity is sufficient for the patient's needs. The approved prescriber indicates the quantity and number of repeats on the prescription.

If an approved prescriber decides the patient's treatment requires an increase to the maximum quantity or number of repeats, they must complete an Authority prescription form. The provision of increased quantities and repeats on Authority prescriptions is intended to provide approximately 1 month’s therapy, which may be repeated (if clinically appropriate) to provide 6 months' therapy in total. This situation usually arises where higher than normal dosages are required.

Approval for increased quantity and/or repeats can be obtained for:

• unrestricted benefits
• restricted, Authority required and Authority required (streamlined) benefits

Attachment A for Section 85, Section 85A and Section 88 of the National Health Act. See the References page for a link to the Act.

Increase quantity and or repeats for unrestricted benefits

The approved prescriber must go through the authority process to gain approval for increase in the maximum quantity or number of repeats for an item listed as an unrestricted benefit.

Guidelines:

The application for increased quantities and/or repeats can be authorised to provide approximately 1 month's therapy, with repeats for up to 6 months’ treatment in total. The dosage tables can be used to calculate the quantity for approval based on the dose stated by the approved prescriber.

The Service Officer is not required to check whether use of the pharmaceutical benefit is in accordance with the product information.

Increase quantity and/or repeats for Restricted, Authority required and Authority required (streamlined) benefits

The approved prescriber must go through the Authority process to gain approval for increase in the quantity and/or number of repeats for items listed as Restricted, Authority required and Authority required (streamlined) benefits.

Guidelines:

The indication must be consistent with the indication in the Schedule for that item.

If the restriction indicates that increased quantities and/or repeats are not permitted then increase quantity and/or repeats cannot be approved.

The application for the increased quantity and/or repeats can be authorised to provide approximately 1 month's treatment, with repeats for up to 6 months’ treatment in total. The approval amounts will be in line with the dosage tables based on the dose stated by the approved prescriber.

Approved prescribers must follow state or territory law when prescribing drugs listed as narcotic, specified or restricted, and must notify or receive approval from, the appropriate health authority. Approved prescribers are responsible to ensure they meet their responsibility regarding state legislation. See Authority approval processing for Pharmaceutical Benefits Scheme (PBS).

Guidelines:

When a PBS or Repatriation Pharmaceutical Benefits Scheme (RPBS) authority application is for a drug of addiction (other than Dexamphetamine Sulfate), the following guidelines apply:

• Approved prescribers need to ensure they are complying with state and territory requirements

State or territory health authorities may need to be notified about ongoing treatment. The interval of where repeats are called for may need to be stated.

Opioids only (no maximum quantity unless stated by restrictions)

• Prescribers may write prescriptions for the listed quantities of opioids without contacting Services Australia. Where the item is streamlined, these should not be approved over the phone
• Services Australia can only approve increased quantities and/or repeats for a maximum of 1 month treatment over the phone
• Applications to prescribe quantities and/or repeats for up to 3 months treatment can be made via HPOS form upload, post or by prescriber self-serve using the Online PBS Authorities System