Prescriptions
Medicine Formularies
|
Medicines
ADF Medicines Formulary
Consultants external to the Australian Defence Organisation providing healthcare services to Australian Defence Force (ADF) Members on referral should be aware that the Defence Health Service has now implemented a formulary of medicines intended to provide for routine medicines requirements in the provision of healthcare support within the Australian "National Support Area (known as "garrison" or "barracks" healthcare). The ADF Formulary had been gradually introduced from September 2009 and is now fully implemented.
Commander Joint Health (who is the Surgeon General of the Australian Defence Force) requests consulting practitioners to constrain routine prescribing to ADF Formulary items where possible and clinically appropriate. This may require some adjustment to individual prescribing habits.
Similar to public hospital formularies, the ADF Formulary provides for a limited range of medicines in any particular therapeutic class. However the ADF Formulary cannot provide for all of the medicine requirements for ADF Members in every circumstance. For that reason the ADF Formulary is not necessarily prescriptive or proscriptive. When non-ADF Formulary medicines are recommended, the reasons for those recommendations should be provided to the ADF Member's referring Defence Health Service (DHS) practitioner (particularly if there are similar ADF Formulary medicines routinely available). The following points should be noted by consultants when prescribing or recommending medicines for ADF Members:
- The core entitlement standard for medicines to be provided at public expense to ADF Members can be summarised as "provision of healthcare parity with the wider Australian community" (which does not necessarily mean identical to the wider community),and "where required to meet and maintain operational readiness". Commander Joint Health is the ultimate arbiter of the standards of entitlement to medicines.
- Defence operates a strictly generic medicines provision system (similar to other public healthcare institutions). Brand substitution will be undertaken at the point of dispensing without reference to prescribers (as with public hospitals "no brand substitution" directions will not apply in Defence healthcare facilities). Dispensing of unit-dose preparations will be adjusted according to Defence stocking policy (for example 2 x 10mg tablets might be dispensed in lieu of 1 x 20mg tablet). Single ingredient products may be substituted for combination products (or vice-versa), provided prescribed dosage is unchanged. However changes to specific prescribed drugs will not be made without reference to consultant prescribers (or, if that is not possible, reference will be made to the ADF Member's referring DHS practitioner).
- ADF Formulary items will normally be readily available from Defence dispensaries (known as Central Dispensing Points - CDPs). If required, provision of non ADF Formulary medicines can be arranged by CDPs, but there may be some delays while undertaking procurement for dispensing. An ongoing requirement for a non ADF Formulary medicine to treat a chronic condition may have an impact on an ADF Member's operational readiness (and, ultimately, employability) because of potential difficulties in supplying such medicines during deployed ADF operations.
- Consultants should carefully consider whether proposed prescribing is for a medicine.For example, recommendations for preparations that are nutritional supplements or preparations that are personal care items that are adjuncts to treatment, while appropriate clinically, will normally be considered by the DHS to be the personal responsibility of ADF Members (in the same way as many other inputs into healthcare such as exercise, rest, lifestyle, diet, hygeine etc are the personal responsibility of ADF Members). In this respect ADF Members should be regarded similarly to other members of the wider community where provision of these types of preparations are normally a personal responsibility.
- Complementary medicines will not normally be provided to ADF Members by Defence.
- If a medicine is recommended for provision by the DHS a written prescription must be raised for dispensing - even for "over the counter" preparations (such as paracetamol). Prescriptions can be raised on PBS (or private) prescription forms and these will normally be dispensed at CDPs. In some circumstances referring DHS practitioners may be required to transcribe medicine recommendations to Defence-specific prescription forms (which are not made available to external practitioners). PBS (and private) prescriptions will not normally be authorised for dispensing at community pharmacies at Defence expense.
Accepting a referral of an ADF Member implies an acknowledgement of these constraints and provisions with respect to prescribing, and with respect to the subsequent dispensing, of medicines. Further information about the operation of the ADF Formulary can be obtained from Defence healthcare facilities.
 ADF Medicines Formulary (1 Nov 2012)
Page Sponsor:
Staff Officer Pharmacy
Joint Health Command
JHCPharmacy@defence.gov.au
02 626 63818
22 November, 2012
|
