New Dispensing Rules in
Community Pharmacy
Presentation for Prescribers
August 2015
Close Control – Why it Changed
• The previous term, ‘Close Control’, was used to indicate the need
for high frequency dispensing. There had been a significant and
unsustainable rise in the use of Close Control.
• Use of Close Control varied considerably across the country (and
could not be explained by population difference)
• $82M of $320M total dispensing fees (26%) was spent on Close
Control in 2009/10.
• $46M of that $82M (56%) was spent on weekly Close Control.
• Receiving medicines more frequently didn’t necessarily relate to
the level of service needed by any particular patient.
• Aside from trialing new medicines, weekly close control should
have been the exception, rather than the rule, e.g. for people
with safety issues.
Specific Changes to Dispensing Frequency
• The term “Close control” is no longer valid on prescriptions.
• Close Control for patients who are “frail, infirm or unable to
manage medicines” has been removed
• These patients are now assessed for eligibility for the Community
Pharmacy LTC Service.
– This service is designed for people who need extra help to
manage their medicines.
– Patients who were receiving Close Control will most likely have
been assessed for (and already be on) the Community
Pharmacy LTC Service by now.
• Once in the Community Pharmacy LTC Service, dispensing
frequency is determined by the pharmacist, and you will be
informed of any changes and the reason why.
Specific Changes (cont.)
Flexible periods of supply for trial periods or safety
Safety medicines
– Codeine and buprenorphine with naloxone (Suboxone) has
been added to the list of safety medicines pharmacists use.
– Prescribers no longer need to initial trial periods.
– Prescribers can request that pharmacy must dispense at a
higher frequency. Where required, the pharmacist will discuss
the frequency further with the prescriber.
– Pharmacists determine the dispensing frequency of other
medicines prescribed.
Other Close Control Changes
Trial Period for dose change or new
medicine:
– The Prescriber doesn’t need to initial trial
periods but does need to specify period of
supply and write ‘trial’ or ‘trial period’.
– MedTech has incorporated this in Version 20
For More Information see the
Community Pharmacy page at
www.centraltas.co.nz