As I read it - some medical boffins have a long lunch a few times a year and chew over all the new meds (probably literally in some cases) and decide why, where and how they fit into the Pharmaceutical Benefits Scheme - this includes deciding how many repeats a particular medicine might have.
Then subject to a number of factors, there are other exceptions, conditions and limitations on frequency of supply, amount, authorisation, etc.
Here’s one I’ve been on - it has a default max of 5 repeats, doctor could order less or (from what I saw in the FAQ above) may be able to apply for more under some circumstances …
I take Kalma Tablets (Xanaax) for an anxiety disorder . There are newer medications ans I have tried them , on my doctors advice , and had adverse reactions to them all ./
My usual script was 100 x .5mg tabs with 2 repeats every 3 months or so . Things have changed now . Instead of getting 2 bottles of 50 tabs each I now get 10 bottles with 10 tabs in each . If I want to get them on the PBS I have to go to the chemist every 3 days as they are only allowed to prescribe 10 tabs . Whereas it used to cost me $6.30 a month it now costs me $32.50 a month because I can’t get to the chemist every 3 days and use a private script from my doctor .
Kalma are marked as a controlled drug and are highly addictive . I was told I was on a government register for drug dependent persons because I use them . Verification required on that one but my pharmacist has always been on the ball re; these matters . /
Alpazolam , the active component of Xanax , Kalma and Aplprax , has taken lives with overdoses . Heath Ledger and Whitney Houston being amongst them and countless Australians . Changing the packaging from 50 to 10 per bottle will not stop peoples dependency nee addiction to these tablets . A proactive approach by the Government in regards to weaning people off these tablets to me is much more positive than a knee jerk reaction in restricting access to them .
Ahhh sorry I was trying to point out an extra script a year compared to packaging in 30’s whilst not a huge price difference in concessional script terms allowed that extra income otherwise forfeited and the script if packaged as 30 would be above the concessional pricing ie it would be $6.78. The Chemist is allowed to add a surcharge to a script as well if it is below the co-payment amount. The $5.40 is just the $6.40 concessional amount reduced by the Chemist by the allowed $1.00. This $6.40/5.40 does not generally reflect the true cost of the medication, the remainder being paid by the Government to the Pharmacy. A drug company’s reimbursement is probably much larger and so an extra script is much more profitable for each step in the chain.
This is one of the situations where “Authority” prescriptions can be used. Same as for[quote=“draughtrider, post:21, topic:15112”]
11 repeats for some specialised drugs
[/quote]
Targin or other opiates when a Dr prescribes them for a month’s worth has a requirement for the obtaining of an “Authority”.
… maybe I’m confused, but was this in response to the pack sizing question? Sounded a little like weasel words combined with a duck-shove, but I guess it will be interesting to see what more comes of it.
I’m not ‘necessarily’ a subscriber to the big-pharma conspiracy theories, any more than a conspiracy theory on any big industry player, but I reckon they could elbow in a pack size suggestion here and there … it’s not rocket science … and aren’t they paying for the boozy lunches the medical boffins are having? oops - sorry, I wasn’t going there no conspiracy here, nothing to see, move along …
Yes. Bottom line is what is brought into Australia is listed on the TGA, including pack sizes, so that is what they can sell. Perhaps more to come, or not.
It’s complex, of course, having evolved over decades with many stakeholders.
There ARE restrictions on how many doses can be written on a prescription if some of the medication cost is be paid by taxpayers via Medicare (specifically the PBS section).
For PBS-funded scripts:
The maximum allowed per script is enough for 6 months only. Each script is valid for 12 months from the date of the script, not the date of first dispensing. Even though it can only have 6 months worth of medications on it.
If you take more tablets per day than the box (e.g. 2 per day) then an authority script can often (but not always) be requested to allow dispensing of sufficient for each month.
There are some restrictions on the number of doses and repeats allowed, usually for medications with the potential for dependency, e.g. opiates, benzodiazepines.
For a description of some of the complexities of supply and pricing: https://www.humanservices.gov.au/organisations/health-professionals/enablers/pricing-pharmaceutical-benefits-scheme-medicine#a6
For private scripts (no government/taxpayer funding):
There is no limit to the amount of tablets or repeats but the pharmacy will probably charge the price of the amount dispensed (e.g. if you get 2 x 28 tablets boxes then the cost is double the cost of 1 box of 28).
Each script is valid for 12 months from the date of the script, not the date of first dispensing. Most doctors won’t write a script for more than 12 months supply.
You can negotiate the price with the pharmacist but they are unlikely to accept less than the cost of having the item in stock. The PBS list of A-Z includes the recommended private price, which can be used as a source of information about the real cost of medications.
Non-PBS scripts may be eligible for a partial rebate from private health insurance, depending on your policy.
Not being argumentative, just curious. I have a common script including 11 repeats, 12 months supply at 1/day. It is written as a PBS script. I have been getting the same script for more than a decade.
The PBS website lists the maximum number of repeats allowed for a PBS-funded script.
If more repeats are wanted then obtaining an Authority approval for extra repeats allows for PBS funding. Otherwise a script with more than the approved repeats is a private script, (see the PBS and Dept Health websites).
I couldn’t find any medications on the PBS website with more than 5 repeats but I did not look at all entries.
The TGA finally replied, and as expected it is not their concern, but to their credit they passed it along to an unnamed department where it is their concern. I suppose that might be a ‘win’ of sorts. Maybe?
Thank you for your enquiry of 13 February 2018 to the Therapeutic Goods Administration (TGA). We apologise for the delay in responding.
We appreciate you raising your concerns with the inconsistencies in the quantity of tablets supplied for the medications that you take.
The TGA does not have a fixed position on pack sizes unless there is a clear concern for safety or efficacy of a certain pack size; and potential for patient misadventure.
However, we have referred your correspondence to the relevant regulatory area so that they are aware that this matter can cause frustration for people.
Yours sincerely
Regulatory Assistance Section Regulatory Services and Improvement Branch
My chemist, like many others, arranges for my medicine to arrive in sachets marked by date and time to take the meds. The convenience of this is offset by the fact that the packs are ready two weeks before needed and include a month’s worth of medicine. This means that changes my doctor might make to my medication will not appear in my sachet for 3 to 6 weeks.
I do not know if all companies marketing these sachets work the same way. It is very difficult to find any information on the internet which in turn means it is virtually impossible to compare different systems used by different chemists.
The sachets are mostly directed to seniors needing a lot of medication. There needs to be some system for adding new medications, or deleting old ones, especially since most of us are, indeed, getting old and perhaps forgetful.
An inquiry and comparison by Choice about these companies would be useful.
I moved your post here because related packaging has been discussed, although your point is a newly raised concern.
Not having personally experienced the prepacks (sachets), when a dose or medicine is changed, shouldn’t the chemist deliver the new dose in traditional packaging for the first month if that is what it takes?
There seems something wrong if a chemist sells one an inappropriate ‘packet’ for a month just because of the convenience factor a prepack offers, or refuses to ‘own’ a superseded prepack. If you are also worried about seniors missing their meds because of their own issues, that is another aspect. I was under the impression some (many, most?) chemists made their own prepacks; is that a false assumption?
I was unable to find a reference on this from the Choice web site, so it may not have been covered (or I missed it).
We use the strip packs for our medications. Generally they give you the month’s worth in 2 fortnights of strips and as they are strips they are manufactured elsewhere rather than at the Chemist’s as the Webster packs are.
However if I or my spouse have a change of medication we can take the strips back and the Chemists will take out the obsolete ones and insert the new ones, they then initial the changes and write the new medication on the sealing strip they use to close the packet… Next pack is adjusted so there is the correct medication for the next month and our’s are only available about a week before they are due.
@PhilT the strips have a translucent white front and a clear back that on the front has time, date, for whom, and medication type and dosage. The first and last packet have further details but no medication, the details include Date of Manufacture amongst others. I have attached the final wrap from an old pack that was used in the beginning of September (I keep them as records).
Many chemists will take back already made Webster packs when a prescription or dose changes. They will open the unused Webster packs, recover the medicines and use as much of them to make up the new prescription. Usually chemists can prepare new Webster packs for the new prescription/dose within a day or two which means that one doesn’t have to wait 2-4 weeks until existing made up Webster packs are deleted.
Have a chat to your local pharmacist and see what they can do as they know that a prescription should be filled and taken when issued by a doctor…and not wait 2-4 weeks for the new medications to be taken. This is especially important where efficacy of a medicine is monitored and doses changed when it is identified that a higher or lower dose is needed (e.g. some blood thinning medications).
We have a free Webster pack service for an older family member. We have one month’s supply of medicine preprepared. The front of the pack is transparent to see the tablets, and the back of the pack has in very small print the contents of each of the little receptacles.
Any prescription changes should be done as soon as possible unless advised otherwise by the doctor. Take the preprepared packs you have remaining back to the chemist as soon as you can so they can change the contents to suit your new medications. Our chemist will do this while we do our shopping at the supermarket.
I suspect that there is no one standard way preparing Webster packs (or equivalent). It varies from chemist to chemist, possibly according to which group they are affilated to. Apparently some chemists charge for the service, others don’t.
Perhaps as an ongoing strategy, take your prepackaged tablets with you to the doctor in case there are any medication changes. Then you can go straight to the chemist and have the changed made immediately before returning home.
no conspiracy here, nothing to see, move along …
