Since 1 October 2015, NSW residents who are patients of NSW public hospitals or authorised NSW community prescribers are not required to pay the patient co-payments for Section 100 (s100) Highly Specialised Drugs or s100 injectable and infusible chemotherapy medicines in NSW.

Last updated: 04 November 2019
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Section 100 Highly Specialised Drugs

Who is eligible?

NSW residents who are patients of NSW public hospitals or community prescribers authorised in NSW and are prescribed s100 Highly Specialised Drugs under Section 100 of the National Health Act 1953 are eligible.

This includes public non-admitted patients, outpatients or day patients, inpatients on discharge from public hospitals and privately referred, non-admitted patients treated in public NSW hospitals.

The changes apply to prescriptions for s100 Highly Specialised Drugs filled through NSW public hospitals and community pharmacies. The NSW Government pays the co-payment for eligible patients who choose to get their s100 Highly Specialised Drugs dispensed in community pharmacies under the community access arrangements of the Pharmaceutical Benefits Scheme (PBS).

HIV antiretroviral therapy, Hepatitis B medicines and clozapine (maintenance therapy) are listed under the community access arrangements which can be dispensed from community pharmacies. Accredited prescribers in NSW for HIV and Hepatitis B medicines are listed on the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine website. For clozapine, prescribers and patients must meet the PBS eligibility requirements. The prescriber does not need to be physically located in NSW for the patient to be eligible for the co-payment.

A full list of community access s100 Highly Specialised Drugs is listed on the PBS website.

Co-payments for s100 Highly Specialised Drugs for patients who access care in the NSW private sector remain the same. Co-payments paid by the NSW Government count towards the patient safety net.

How are the changes be implemented?

Patients prescribed s100 Highly Specialised Drugs through NSW public hospitals or authorised NSW community prescribers can consent to NSW Health meeting the co-payment on their behalf by signing a  12 Month Patient Consent Form.

The patient consent form is to be presented each time the prescription is filled, including any repeats. By signing the form, the patient agrees to have the co-payment contribution paid by the NSW Government.

Section 100 injectable and infusible chemotherapy medicines

Who is eligible?

NSW residents who are patients of NSW public hospitals and are prescribed s100 injectable and infusible chemotherapy medicines in NSW under Section 100 of the National Health Act 1953 are eligible.

Oral chemotherapy, taken by mouth, which are general items on the Pharmaceutical Benefits Scheme are not affected by this commitment.

This includes public non-admitted patients, outpatients or day patients, inpatients on discharge from public hospitals and privately referred, non-admitted patients treated in public NSW hospitals.

The changes apply to prescriptions filled at NSW public hospital pharmacies and through pharmacies used by NSW public hospital oncology services. Co-payments paid by the NSW Government will count towards the patient safety net.

How are the changes be implemented?

When a patient prescription for s100 injectable and infusible chemotherapy medicines is filled at pharmacies used by NSW public hospital oncology services, a patient consent form is already signed. This consent form includes an agreement for the NSW Government to pay the co-payment on behalf of the patient.

The process for supplying s100 injectable and infusible chemotherapy medicines to public patients in NSW public hospitals will otherwise continue as usual.

Why are co-payments paid by the NSW Government?

In March 2015, the NSW Government made the commitment to pay co-payments for both s100 injectable and infusible chemotherapy medicines and s100 Highly Specialised Drugs to help ease the financial burden for people with cancer and other chronic conditions.

This commitment benefits people living with cancer, as well as those with conditions such as HIV, patients with organ and tissue transplants, schizophrenia, hepatitis, Crohn’s disease, ulcerative colitis, cystic fibrosis, psoriatic and rheumatoid arthritis, and severe allergic asthma and rare diseases, particularly those affecting children, including juvenile idiopathic arthritis.

More information

The Pharmacy Guild of Australia has adapted the 6CPA Registration and Claiming Portal for community pharmacies to seek reimbursement for eligible patients that are not charged a co-payment for their Section 100 Highly Specialised Drugs.
More information and resources, including guides and frequently asked questions can be found on the Pharmacy Guild of Australia (NSW Branch) website.

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Page Updated: Monday 4 November 2019
Contact page owner: Strategic Reform and Planning