News in brief: PBS cuts red tape for Authority script approvals; Cardiology among top Medicare referrals: AIHW; Absolute CVD risk scores not used in practice

18 Jul 2022

PBS cuts red tape for Authority script approvals

The PBS approval system is being simplified to allow prescribers to obtain immediate approval for Authority Required (Written) prescriptions online without having to submit paperwork by post to Services Australia for assessment.

Starting from 1 July, prescribers will be to apply digitally for authority approval to prescribe certain PBS listed medicines using Services Australia’s Online PBS Authorities (OPA) System.

Authority requests will be assessed via questions within the OPA system via HPOS in real time, allowing prescribers to obtain immediate authority approval (following confirmation of eligibility), without having to submit physical copies of forms, prescriptions and test results.

“This same channel is already in use for medicines that have Authority Required (telephone) PBS listings and these changes are intended to reduce the administrative burden for prescribers and allow patients to have faster access to their medicines,” the Department of Health said.

However it cautioned that the changes would be phased in gradually as not all PBS medicine listings could be updated at the same time. A list of cancer medicines for which PBS changes has been published by Services Australia.

Prescribers will still be able to submit applications for authority to prescribe via Australia Post or upload documents in HPOS if they choose to do so.

Cardiology among top Medicare referrals: AIHW

Cardiology is among the most widely accessed specialties in terms of the percentage of the population receiving a consultation, new figures from the Australian Institute of Health and Welfare show.

In its Australia’s Health 2022 report the AIHW notes that cardiology accounted for 4.6% of Medicare-subsidised referred medical specialist consultations in a non-hospital setting, putting it in second place after ophthalmology (5.1%) and ahead of general surgery (3.8%).

Cardiology was also among the specialties with the highest number of non-hospital consultations subsidised by Medicare, with 2.2 million compared to to 2.6 million consults for obstetrics and gynaecology, and 1.7 million for general surgery.

The report noted that cardiology was the second highest speciality in terms of spending on non-hospital referred medical specialist consultations, with an overall cost of $207.3 million, coming behind psychiatry ($370 million) and ahead of obstetrics and gynaecology ($175.7 million), paediatric medicine ($160.9 million), ophthalmology ($131.6 million) and gastroenterology ($108.5 million).

Absolute CVD risk scores not used in practice

Despite being recommended in guidelines, absolute cardiovascular risk scores are not being assessed for Australians with hypertension nor are they used to guide antihypertensive treatment, an analysis by NPS MedicineWise has found.

A review of records for more than 250,000 primary care patients with a hypertension diagnosis found that only half  (51.0%) had sufficient data recorded to calculate CVD risk, of whom 29.3% were at high risk clinically and 6.0% were at high risk based on their CVD risk score.

About 60% of patients were receiving antihypertensive therapy, but  prescribing rates were slightly lower in patients at high risk based on their CVD risk score (57.4%) compared with those at low [63.3%) or moderate risk (61.8%)  or those at high risk clinically [64.1%), according to findings published in the Journal of Human Hypertension.

“Guideline adherence is suboptimal, and many patients miss out on treatments that may prevent future CVD events,” the study authors concluded.

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