pharmaceutical benefits scheme (pbs) restrictions wording tool – background and progress faster...
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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