Complex Authority Required Highly Specialised Drugs (CAR HSDs)

Prescribing CAR HSDs

All Commonwealth funded supply of CAR HSDs and PBS trastuzumab requires an authority approval from Medicare Australia prior to dispensing. Failure to gain prior approval will result in non-payment for that item. No retrospective approval will be permitted.

Find out more information on authority approvals for these drugs on our website or call 1800 700 270*

• Specialised drugs (PBS) A-I
• Specialised drugs (PBS) J-Z

When applying to Medicare Australia for authority approval, public hospital prescribers must use a Medicare Australia Authority Prescription form or a form approved by Medicare Australia. If a signatory to the Pharmaceutical Reforms, then a Public Participating Prescription can be used in place of these forms.

Public hospital prescribers must submit the appropriate CAR HSDs and PBS trastuzumab authority application form and supporting information together with a Medicare Australia Authority Prescription form including the following information:

• The prescriber indicates on the Medicare Australia Authority Prescription form whether the approved script is to be returned to the prescriber or the patient.
• The prescriber sends the completed and signed PBS authority application supporting information, Medicare Australia Authority Prescription and patient declaration forms to Medicare Australia by mail.
• When approved, Medicare Australia stamps the form with a HSD approval stamp and returns the prescription to the prescriber or patient by mail (as indicated on the form).
• If the program has allowances for applications to be made by telephone, the prescriber will enter the phone approval number, as provided by the Medicare Australia operator, on the Medicare Australia authority prescription.
• The format for phone approval numbers is: Z XXXXXX—4 digits plus 2 alphas (for example, Z1234XM). This may be preceded by the letters 'HSD'.

Dispensing CAR HSDs

The Medicare Australia authority prescription with approval number or approval stamp, for a CAR item and PBS trastuzumab, can be dispensed either by the public hospital pharmacy, public participating hospital or community pharmacy.

Dispensing repeats from public hospital pharmacy

• Repeats on CAR drugs and PBS trastuzumab can be dispensed up to the maximum number which has been approved by Medicare Australia and shown on the Medicare Australia authority approval.
• Repeats are to be identified on hospital pharmacy records by the Medicare Australia authority prescription number.
• Patient co-payment arrangements will be the same as for other HSDs.

Payment for approved CAR HSDs dispensed by public hospital pharmacies

State and territory claims to Medicare Australia must include the following information.

The Medicare Australia Prescription Authority Number is found printed on the authority prescription or hospital prescription. It is in numeric format only (i.e. there are no letters in the prescription authority number).

.

CAR HSD form prescribing criteria

All CAR HSDs and PBS trastuzumab require prior approval from Medicare Australia before dispensing. CAR HSDs and PBS trastuzumab that are not approved or have not been approved prior to dispensing cannot be claimed.

Refer to relevant pages of the Schedule of Pharmaceutical Benefits at www.pbs.gov.au

Download the application forms for CAR HSDs and PBS trastuzumab:

• Specialised drugs (PBS) A-I
• Specialised drugs (PBS) J-Z

Last updated: 13 August, 2009