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Related post: within the subsidy timeframes, examples include a service user is moving away, is in hospital,
going overseas, or has died.
If requested by the DHB or its agent each pharmacy must prepare and produce a report, either in
hardcopy or by electronic, of all Prescription Items claimed as Uncollected and/or Uncollected
Repeats. This report is to include the following information:
Patient Name and address, unique identifying number of the Prescription Item, deemed date of
dispensing, medicine name (including strength and form), quantity, and claim date.
Pharmacy Raloxifene Cost Procedures Manual | 1 March 2010 18
An annotation is text written by a pharmacist. Any annotation should clearly differentiate the
information added by the pharmacist from that written by the prescriber, preferably using
green ink unless the prescriber has written in green. If possible all annotations should be
adjacent to the prescription Raloxifene Osteoporosis item. .
Prescriptions should be annotated:
a. Where it is required by regulations, or
b. Where it is necessary for clarification, or
c. Where it is required for subsidy, including those outlined in the Pharmaceutical
Schedule e.g. Cost Brand Source, Multiple-Patients.
d. Where there is no Patient category code or status code on the prescription or when it is
known to be erroneous.
Changes made to the category codes by the pharmacist must be initialled and reflected in the
Pharmacists may annotate prescriptions Raloxifene Hydrochloride with clarifications to:
d. Brand (the pharmacist may only annotate a change of brand subject to the substitution
rules contained in the Medicines Regulations)
The reason for any variance between the original prescription and the electronic record
must be annotated on the prescription. Note: �C.B� can be used as an abbreviation for
Subject to the rules of the Pharmaceutical Schedule, where there is a financial
implication for the DHB the pharmacist cannot increase the quantity of a prescription,
without the prescriber signing the alteration
Non-subsidised items should be identified.
Manual Claimants should annotate the brand dispensed on any generic prescription
where more than one brand is subsidised.
An endorsement is text written by a prescriber on a prescription. The Pharmaceutical
Schedule defines the requirements, which may vary from time to time. Where an
endorsement is required on a prescription it must either be:
a. Hand-written, or computer generated on the prescription by the prescriber; or
b. Where it is not hand-written, or computer generated by the prescriber, and where it is
specified in the Pharmaceutical Schedule, be initialled by the prescriber; and
c. Where it has been altered or added to by the pharmacy, be initialled by the prescriber.
4.11 Alteration to Quantity Dispensed
An alteration What Is Raloxifene made by a pharmacist to the unit Raloxifene 60 Mg quantity dispensed is one that does not affect
the end amount of medicine prescribed to the Patient. The Patient will get the same dosage
of medicine in the following example: the prescription reads �500 mg, one tablet per day, 30�
and the pharmacist dispenses �250 mg tablets, two tablets per day, 60.� In this case, the
pharmacist has altered the unit quantity, and subsequent dosage instructions, without
changing the total daily dose or frequency ordered by the prescriber.
Pharmacy Procedures Manual | 1 March 2010 19
Alternatively, a change from tablets to mixtures is deemed appropriate as long as both the
individual dose and total daily dose is not altered. In the above example, if there is no
additional cost to the District Health Board the pharmacist can annotate and sign the changes.
For any alteration made by the pharmacist to the quantity dispensed, if there is a financial implication
or increased cost to the DHB:
The pharmacist must annotate and sign the reason for the change
The change must be authorised and signed by the prescriber.
In cases where PHARMAC has approved and notified in writing such a change in dispensing of a
named pharmaceutical due to an out of stock event or short supply, the pharmacist must annotate
and initial the alteration.
4.12 Cost, Brand, Source (CBS)
Where CBS is indicated against a medicine in the Pharmaceutical Schedule or if the item is
an Exceptional Circumstances medicine not in the Pharmaceutical Schedule (as described in
the Pharmacy Agreement), the medicine is eligible for subsidy on the basis of the
Pharmacists annotation of purchase price, brand and source of supply. The purchase price
should be GST exclusive. The Pharmaceutical Schedule requires that the purchase price,
brand and source of supply be annotated. Alternatively a copy of the invoice for the purchase
of the Pharmaceutical may be attached to the prescription, in the place of an annotation, in
order to be eligible for Subsidy.
The details of the purchase may be subject to audit, and all receipts of purchase must be kept
and available for audit.
4.13 Original Pack Dispensing
If an item has the letters �OP� Raloxifene Buy in the pack size column of the Pharmaceutical Schedule, then
payment is made to the nearest original unit size
The pack size dispensed should be the closest size to meet the dosage instructions, and will be
reimbursed for the total subsidy per OP dispensed.
Example: Collapsible Tube (if defined as �OP� in the Pharmaceutical Schedule): Locoid Lipo
cream Apply bd 15g. Even though the prescription only calls for 15g, the pharmacist can
claim 1OP or 30g. If the Locoid prescription had called for 50g, the pharmacist can claim 2OP
4.14 Oral Antibiotic Liquids
Where a prescriber has written a prescription for a reconstitutable oral liquid antibiotic
indicated in the Pharmaceutical Schedule as an original pack, and the dispensing of which
would require the pharmacist to break into another pack, the pharmacist should reduce the
amount dispensed to the quantity contained in a whole pack provided that the reduction in the
amount dispensed is less than 10% of an original pack and in the reasonable opinion of the
pharmacist will not effect the efficacy of the course of treatment.
Pharmacy Procedures Manual | 1 March 2010 20
5ml tds for 7 days = 105ml
10ml stat, 5ml tds for 7 days = 110ml
Remainder can be claimed if unused
Where a pharmacist dispenses a part pack of a proprietary product, subsidy is based on the
appropriate portion of the pack size listed in the Pharmaceutical Schedule, unless the item
lists �OP� in the pack size column of the Schedule.
At the time of dispensing the pharmacist must keep a record of the Buy Raloxifene quantity discarded. To
ensure wastage is reduced, the pharmacis should reduce the amount dispensed to make it
equal to the quantity contained in a whole pack where:
a) the difference of the amount dispensed and the amount prescribed by the
Practitioner is less than 10% (e.g; if a prescription is for 105mls then a 100ml pack
would be dispensed); and
b) in the reasonable opinion of the pharmacis the difference would not affect the
efficacy Raloxifene Hci of the course of treatment prescribed by the Practitioner.
The Close Control rule is detailed in the Pharmaceutical Schedule. Below is a copy of the rule and a
flow chart explaining how the rule works.
�Close Control� means the dispensing of a Community Pharmaceutical, in accordance with a
Prescription, in quantities less than one 90 Day Lot (or for oral contraceptives, less than one 180 Day
Lot) for a Community Pharmaceutical referred to in Section F Part I, or in quantities less than a
Monthly Lot for any other Community Pharmaceutical, where any of a), b) or c) apply.
a) All of the following conditions are met:
i) the Community Pharmaceutical has been prescribed for a patient who:
1) is not a resident in a Penal Institution, Rest Home or Residential Disability Care
2) either of the following:
i) in the opinion of the prescribing Practitioner is:
c) unable to manage their medication without additional support; or
d) intellectually impaired; or
e) requires close monitoring due to recent initiation onto, or dose
change for, the Community Pharmaceutical (applicable to the
patient�s first changed Prescription only); and
f) requires that Community Pharmaceutical to be dispensed in a
smaller quantity than that for which it is currently funded, or
Pharmacy Procedures Manual | 1 March 2010 21
ii) the Community Pharmaceutical is any of the following:
a) a tri-cyclic antidepressant; or
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