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ODT Community Pharmacy Program information

From 1 July, the way in which ODT medicines are currently listed on the PBS Schedule is changing. The Department of Health and Aged Care and the Pharmacy Programs Administrator (PPA) have now released the Program Rules and updated webpage.

All queries relating to reforms to ODT access or PBS listings should be directed the Department via email at ODT@health.gov.au.

Key points

  • ODT medicines will become part of the Section100 Highly Specialised Drugs (HSD) Program (Community Access) arrangements. This means ODT medicines will be dispensed in the same way as other community access Section 100 HSD Program medicines.
  • Under the Section 100 HSD Program, PBS-eligible patients will pay the PBS co-payment to access their treatment (for up to 28 days' supply per pharmaceutical benefit prescribed) and the amount paid will contribute towards their PBS Safety Net threshold. Additional private dispensing or dosing fees cannot be charged by section 90 community pharmacies where a PBS supply is provided to a patient.
  • There are transitional arrangements for patients with existing prescriptions.  Pharmacists may need to calculate the quantity of medicines and repeats required sufficient for the number of days remaining on existing ODT prescriptions.  Administrative systems do not support electronic prescriptions written prior to 1 July 2023 being used for PBS dispensing during the transition.   Details are provided on this factsheet.
  • To be able to claim the ODT services you are providing to patients, you need to gain informed patient consent. Patient consent you may collect as part of your state/territory requirements is not sufficient for this new ODT program. If you're providing services to a patient that has previously completed a consent form at another pharmacy, you will still need to gain consent from this patient at your pharmacy.
  • You'll need to collect certain patient data in order to claim but will not be able to input this data into the PPA portal until 1 August. You can use the ODT Staged Supply (Oral/Sublingual) and ODT Injection temporary data collection forms to capture this information in lieu of entering the data into the portal.

How to claim

From 1 August 2023, the ODT Community Pharmacy Program will go live in the PPA portal and you will be able to register and claim. Closer to 1 August, a Portal User Guide specific for the ODT Community Pharmacy Program will be published on the program webpage to help you lodge your claims. We understand that software vendors are planning to integrate their software to allow claims.

Please note that temporary data collection forms and/or other data capture spreadsheets cannot be uploaded into the PPA portal but need to be manually entered.

Key resources

Frequently Asked Questions- provided by DASSA

ODT Prescription and Program Requirements

Allocated Stock or ‘Virtual’ Stock Balance

Controlled Drugs Register

Missed Doses

Templates and Resources updated Pharmacy ODT client dosing and attendance record templates.

Page last updated on: 06 July 2023