Pharmaceutical Benefits Scheme (PBS)

Restrictions Wording Tool – Background and Progress

Faster PBS updates

Streamlined processes

Increased transparency

Positioned for future change

February 2009

Tier 1 Fast track timing issues What is the undertaking to be met?Industry expect Tier 1 drugs (on the fast track process) can be listed 6-8 weeks after PBAC.

A ‘minimal change’ approach to business as usual in converting to a Monthly Listing from December will result in Tier 1 drugs being listed about 13 weeks after PBAC. So more significant changes were required.

Can this undertaking be met?

What are the ‘minimal change to business as usual’ timings for the monthly listing cycle?

Week 0 Week 1

PBACWed – Fri1st Week of month

Secretariat

Week 2 Week 3 Week 4 Week 5

Listing Publication

Week 6 Week 7 Week 8 Week 9

Notification

Effective Date 1st Month

Effective Date 1st Month

Effective Date 1st Month

How can the 8 week undertaking be met?

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6………

MarchJuly

November

AprilAugust

December

PBAC Secretariat Listing Publication Notification

Effective Date 1st Month

Effective Date 1st Month

Effective Date 1st Month

MarchJuly

November

AprilAugust

December

Week 17

Pre-listing FinalisationData removal

Cutoff not met – Tier 1 listed in about 13 weeks.X

What are our targets?1. For 2007, Tier 1 drugs should be

updated on the PBS by the second monthly effective date following PBAC.

2. On implementation of PharmCIS, Tier 1 drugs should be updated 3 weeks after PBAC.

Met the cutoff – Tier 1 listed in about 8 weeks.Pre-entry of Tier

1 drug data

Week 16Week 15Week 14 Week 1 Week 2Wk 12

DUSC ESC RWG

Week 3 Week 4 Week 5 Week 6 Week 7 Week 8

PBS Monthly update timing issues

Tier 1: How can we improve the process?

PBAC Secretariat Publication Notification

Effective Date 1st Month

Effective Date 1st Month

Effective Date 1st Month

MarchJuly

November

AprilAugust

December

Week 17

Issues

What are our targets?1. Tier 1 drugs should be updated on the

PBS by the first monthly effective date following PBAC.

2. All changes to PBS, once finalised should be ‘published’ in 3-6 weeks.

Met the cutoff – changes listed in about 4 weeks.

Week 16Week 15Week 14 Week 1 Week 2Wk 12

DUSC ESC RWG

Week 3 Week 4 Week 5 Week 6 Week 7 Week 8

• Contracting the process to 4 weeks requires improvements in the efficiency of all aspects of the process, including reducing the notification period to about 2 weeks.

• One month only feasible if there is high quality electronic data transfer (XML)

Other monthly processes: How can we improve the process?

Notification

Effective Date 1st Month

Effective Date 1st Month

Effective Date 1st Month

Week 17

Issues Issues

Week 16Week 15Week 14 Week 1 Week 2Wk 12 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8

Publication

Changes happening any month could include:• Minor submissions• Deletions• Change of Details• RPBS

• Tier 3• Tier 2• New Brands?• Section 100 drugs

How can the Notification Period be just 2 weeks?

• Medicare and Software Vendors told us that Restrictions/Authorities are the key to reducing the time between the listing of drugs on the PBS and their availability through Doctors’ prescribing software.

• Proposed solution– Develop a syntax so that restrictions/authorities are produced as an

xml update for prescribing software in much the same way virus definitions are made available to virus-detection software.

– This meant developing a tool for those writing restrictions to be able to produce them in the required syntax.

• Where are we now?– Syntax has been drafted.– Data model proposed– Prototype tool has been developed

Process Benefits From RWT

• Simplified entry of restrictions/authorities as a result of using the tool

• Data entry possible earlier in the process of defining a listing – maybe even by industry

• Provides consistency – easier to manage (flow-ons and expertise)

• Believe that restrictions will be easier to understand and use

• Reduces (?eliminates) interpretation of restrictions rules by software vendors – increases consistency in application of rules