Active Ingredient Prescribing is coming: here’s what you need to know
Active Ingredient Prescribing was announced by the Federal Government in the 2018-19 budget at the same time as the ePrescribing initiative. While we’ve all heard a lot about ePrescribing and how it works, many of the GPs we’ve spoken to have heard very little, if anything, about Active Ingredient Prescribing.
What is Active Ingredient Prescribing?
Active Ingredient Prescribing became law on 1 November 2019 with a 12-month grace period to ease its introduction. The upheaval due to COVID-19 brought an extension of that grace period, but by 1 February 2021 it will be mandatory to include active ingredients on most PBS and RPBS prescriptions. And that’s not all: the new law mandates that such prescriptions will now list only the active ingredient(s) of each medication unless the prescriber specifies that the brand name should be included as well.
It’s time now to start educating yourself about Active Ingredient Prescribing and talking to your patients about the active ingredients in their medications. The better prepared we all are for Active Ingredient Prescribing, the easier the transition will be.
Why are we changing to Active Ingredient Prescribing?
Active Ingredient Prescribing has been brought in for two main reasons:
- To encourage the uptake of generic and biosimilar medicines to help make the healthcare system more financially viable in the long term.
- To ensure prescribers and patients are more cognisant of active ingredients in their medications, with a view to reducing medication-related harm.
What do prescribers need to do?
Under this new law, the prescribing workflow in MedicalDirector software will remain unchanged unless prescribers want to ensure that brand names continue to be displayed on prescriptions. It may be useful for practitioners to educate themselves on the active ingredients in medications they prescribe. Practitioners will also need to identify situations where it is necessary for the medical treatment of the patient to identify a brand of the medication and ensure this is specified on their prescription. MedicalDirector Clinical and Helix will have a new checkbox to include the brand-name on the prescription; the law prohibits software from pre-ticking this box.
The most important thing for practitioners to do is to educate their patients about the change and talk through any concerns or questions they have, particularly those who are on long-term medication or who are taking multiple medications – or ensure that brand names are included on prescriptions where appropriate.
There is no change to the ‘Brand substitution not permitted’ checkbox. If this is left unticked, existing brand substitution arrangements still apply.
Are there any exceptions to Active Ingredient Prescribing?
Yes. Handwritten prescriptions, medications with four or more active ingredients and certain Pharmaceutical Benefits that have no active ingredients in the conventional sense (e.g. dressings, nutritional products) will be exempt.
Benefits of Active Ingredient Prescribing
By educating patients on the active ingredient in their medication, they will be more informed as to what they are taking and potentially be able to identify if they are doubling up on medications with the same active ingredient.
Another benefit of switching to Active Ingredient Prescribing is that in the event of medication shortages, it is easier for patients to switch to an alternative if they understand what their active ingredient is. This is very timely when we consider that COVID-19 has already led to a number of medication shortages which are likely to be ongoing.
On a wider community level, it’s expected that Active Ingredient Prescribing will encourage competition and lower the price of medications across the board, freeing up funds for the government to invest in new innovations and discoveries and helping the system become more sustainable as a whole.
Are there any disadvantages?
There is the potential for confusion, especially for patients who may only be familiar with the brand name of their medication.
Some patients may feel loyal to their particular brand and be anxious about changing or using an alternative brand. It’s important that patients are made aware they don’t have to change, they can still request their particular brand when they go to their pharmacist or doctor. Likewise, doctors are still able to tick a ‘do not substitute’ box in their software if they wish to prescribe a specific brand of medication.
There are cases when patients may respond differently to a product that’s different to their regular brand. There is a list of products where this phenomenon is recognised; in these cases, the software will prompt the prescriber to consider whether the ‘Print brand on prescription’ checkbox should be ticked.
As always, MedicalDirector is here to support you through the introduction of Active Ingredient Prescribing. We’ll be updating our software to reflect the updated legislation and providing you with resources to help you educate yourself and your patients on the changes. These software upgrades are critically important, from 1 February 2021 a prescription that does not comply with Active Ingredient Prescribing legislation will not be valid for PBS/RPBS subsidy. Helix users will receive the update automatically; MedicalDirector Clinical users must upgrade if they want to prescribe under the PBS/RPBS.