ADHD: Pharmac changes funding rules for medication prescriptions

People with ADHD (attention deficit hyperactivity disorder) could save more than $200 a year on prescriptions after Pharmac changes funding rules for dispensing two drugs.

ADHD New Zealand says the change will help reduce the “administrative load” for those struggling with executive function.

A Tauranga woman with ADHD says the change is “good,” but getting a diagnosis in the first place is a “bigger problem.”

Pharmac announced Monday that people taking the ADHD drugs methylphenidate or dexamphetamine will now pay just one prescription for three months instead of every month.

Pharmac’s director of operations said it was “welcome” to make the change and could save about 48,000 New Zealanders receiving funded medicines.

“It may reduce stress in people with ADHD.”

Ashleigh Yates was diagnosed with ADHD two years ago and takes methylphenidate. She said the change was “good,” but she said this was the “bigger problem,” citing the difficulty of getting a diagnosis in the first place.

Yeats last month Bay of Plenty Times She had spent about $2000 on ADHD appointments and medication. Unable to obtain help through the public health system, she sought diagnosis and subsequent treatment through a private psychiatrist.

Yates said it was “great” to only have to get a prescription every three months, saving time and “brain energy.”

As a full-time college student, she got discounted doctor visits. Her funding changes save her $20 every three months, she said.

Rotorua woman Eila Ann Gwilliam was diagnosed with ADHD in July and has been on medication since.

She took dexamphetamine and said the change would save her $10 every three months.

However, she consults a private psychiatrist to find another drug that didn’t cause any side effects.

Gwilliam said it costs $35 to pick up at the pharmacy if a psychiatrist issues a prescription.

Suzanne Cookson, chief executive officer of ADHD New Zealand, said the funding change was “really good news” because it would help reduce the “administrative burden” for those struggling with “executive functions”.

She said a “simple change” could save her more than $200 a year.

Cookson bases this calculation on the costs of doctors at Peninsula Medical Center in Miramar, Wellington.

“I used to pay for a script 12 times. [a year], and now pays for scripts four times a year. “

She said the doctor charged two prescription fees.

Paying the standard rate of $20 every 12 months will cost you $240 per year. $80 four times a year, saving $160.

A $28 contingency fee every 12 months costs $336. Save $112, $224 four times a year.

She said every doctor’s center sets its own rates, so it can be different for everyone.

Cookson said it is working with Pharmac, which is reviewing its rules for applying for special powers. Current regulations require people with ADHD to renew their special authorization every two years to maintain access to medicines.

In a media release, Pharmac announced amendments to its drug schedule, effective June 1, amending ADHD treatment funding rules to allow up to three months of prescriptions for controlled substances when using e-prescription services. I agree with the revision.

Head of Operations Lisa Williams said the regulatory changes recently came into effect. This means that ADHD treatment methylphenidate and dexamphetamine can be prescribed for up to three months if the prescription is electronic.

“The law still requires medicines to be dispensed monthly at most. You only have to make a one-time co-payment for your prescription,” she explained.

This change ensures that the funded supply is consistent with recent changes to electronic prescribing and dispensing of Class B controlled substances.

Paper prescriptions remained limited to a month’s supply.

Regarding the special agency’s application, Williams said Farmac agreed to review renewal eligibility criteria for funded Class B drugs, particularly prescriber restrictions.

Before any changes are made, she said, she plans to obtain clinical advice from an advisory panel of mental health professionals, as well as legal and health-economic information to help assess possible impacts.

“We will also consider and ensure that the changes support broader changes in health service delivery to ensure equitable and safe access to care.”