Communications and advocacy update: 20 October
20 October 2022
Here’s an update on a few of the issues AMA Victoria is working on for members, including:
- Public health emergency order (PHEO#22)- Pharmacist emergency supply to patients impacted by floods
- Updated advice: MBS telehealth item numbers
- Update: Evusheld™ criteria and PBS oral antiviral updates
- Opportunity to share feedback with the TAC
- Research study on fitness to drive assessments.
Public health emergency order (PHEO#22) - Pharmacist emergency supply to patients impacted by floods
Public health emergency order (PHEO#22) has been issued by the Secretary of the Victorian Department of Health due to serious risk to public health resulting from floods in Victoria. PHEO#22 authorises a registered pharmacist to supply a Schedule 4 medicine to a patient for continued treatment without a prescription subject to the following conditions:
- there is an immediate need for the medicine and it is impracticable for the patient to obtain a prescription in time to meet that need
- treatment with the medicine has previously been provided for by a prescription issued, or a chart instruction written, for the patient by a prescriber
- the patient, or an agent of the patient, or a person who has the care of the patient, or a person who is assisting in the care of the patient, is aware of the appropriate dose of that medicine for that patient.
The quantity of the medicine supplied must not exceed:
- for a medicine that is on the Pharmaceutical Benefits Scheme, the standard Pharmaceutical Benefits maximum quantity
- for a medicine that is not on the Pharmaceutical Benefits Scheme, the quantity that is contained in the smallest commercially available pack.
A pharmacist is required to make a record that supply was made under PHEO#22.
Medical practitioners and other suitably registered health practitioners may issue verbal instructions to a pharmacist to supply a Schedule 4 or a Schedule 8 medicine if, in the opinion of the practitioner, an emergency exists (Regulation 25 of the Drugs, Poisons and Controlled Substances Regulations 2017). The prescriber who issues verbal instructions must, as soon as practicable, send written confirmation (most commonly in the form of a prescription) to the pharmacist.
Updated advice: MBS telehealth item numbers
Please see below advice from the Victorian Department of Health’s Primary and Community Health Team pertaining to MBS telehealth items numbers:
- Effective from Thursday 13th October 2022 until 31 December 2022, an exemption has been implemented for COVID-19 positive patients from the established relationship requirement for telehealth services provided by General Practitioners (GPs) and Other Medical Practitioners (OMPs). This will enable COVID-19 positive patients to access Medicare rebates for telehealth services with any GP.
- A COVID-19 positive patient is defined under these new arrangements as a person who has received a positive COVID-19 test result within the last 7 days, confirmed by either a laboratory testing (PCR) or a COVID-19 rapid antigen self-test (RAT) which has been approved for supply in Australia by the Therapeutic Goods Administration.
The determination which puts the exemption in place has been registered on the Federal Register of Legislation and is available at: https://www.legislation.gov.au/Details/F2022L01359.
For clarity, the level C telehealth item for assessment and consideration of COVID-19 antivirals is excluded from the 1 in 12 rule. That is, there is no requirement for a pre-existing relationship and this item is unaffected by any change in state and territory Public Health Orders.
In relation to broader telehealth, it is important to note that the established relationship requirement still does not apply to:
- children under the age of 12 months;
- people who are homeless;
- patients receiving an urgent after-hours (unsociable hours) service; or
- patients of medical practitioners at an Aboriginal Medical Service or an Aboriginal Community Controlled Health Service; or
- people isolating because of a COVID-related State or Territory public health order, or in COVID-19 quarantine because of a State or Territory public health order; or
- people living in a flood-affected area, defined as a State or Territory local government area which is currently declared as a natural disaster area due to flood by a State or Territory Government.
Update: Evusheld™ criteria and PBS oral antiviral updates
Please find the latest advice from the Victorian Department of Health’s COVID+ Pathways Program Team:
Evusheld™ update – expanded criteria
A limited supply of tixagevimab and cilgavimab (EvusheldTM) is available in Victoria for use in high-risk people for pre-exposure prophylaxis of COVID-19 until 31 December 2022, for both first and second doses.
As part of this expansion, the Evusheld FAQ, Community Prescriber Guide and Request to Access Forms have been updated. This updated information and these documents can be found here: https://www.health.vic.gov.au/covid-19/vaccines-and-medications-in-patients-with-covid-19
PBS oral antiviral treatment expanded criteria
The PBAC has recommended the following PBS and Prescriber’s Bag updates, expected to come into effect on November 1 2022. These include;
- amending the PBS listings for molnupiravir and nirmatrelvir + ritonavir, so that people identifying as Aboriginal or Torres Strait Islander, and 30 years of age or more, require only one condition (from the current list of conditions) to meet the definition of high risk for the purpose of PBS eligibility.
- that molnupiravir and nirmatrelvir + ritonavir both be added to Prescriber’s Bag supplies (Medical Practitioner and Nurse Practitioner), with the quantity being two bottles of molnupiravir (40 capsules per bottle) and two cartons of nirmatrelvir + ritonavir (30 tablets divided in 5 dailydose blister cards, per carton).
Opportunity to share feedback with the TAC
The TAC has launched an online survey to hear providers’ views on working with them and providing services to TAC clients.
The survey is now open to any TAC provider who has delivered treatment or services to a TAC client in the last 12 months.
It takes about 15 minutes to complete and will help shape future changes to support providers and TAC clients. Please note the survey closes on 31 October 2022.
To get started, access the survey here.
Research study on fitness to drive assessments
A research team at the University of the Sunshine Coast Road Safety Research Collaboration is conducting a research study to explore General Practitioners’ perspectives, opinions and attitudes towards assessing driving capacity in older adults, with a particular emphasis on the assessment of cognitive function and how it relates to driving.
The findings from this study will inform the design of future research projects aiming to improve current fitness to drive assessment procedures as well as identify older adults who are at increased risk for motor vehicle collisions and require further assessment.
Further information can be found here.