Health
The Pharmaceutical Benefits Scheme (PBS)

Pharmaceutical Benefits Scheme (PBS) is a key component of the Australian health system, as it helps to provide access to necessary medicines at affordable prices. The system was originally a paper based system making it highly inefficient.

PharmCIS was created for the Department of Health, to support the nationwide approval of pricing and listing of medicines, making it a centralised paperless system, which allows a more streamlined, accessible and efficient processing system of pharmaceutical products in Australia.

Developed by ToukanLabs, the system incorporates enhancements including chemotherapy drug measures, price disclosure, price calculator functionality and support changes in policy and legislation. It will allow the government to track savings anticipated from recent policy reforms. As part of these reforms, it is expected to deliver $1.9 billion in health savings for taxpayers over five years through price disclosure and other price reductions.

The system processes and tracks industry submissions for the PBS and supports workflow stages including:

  • Validation of submissions
  • Evaluation of economical, clinical, demographic and financial information
  • Committee collaboration and information distribution
  • Price negotiation
  • Subsidy approvals
  • Publishing and listing a drug on the PBS. This includes output to a standardised data format (PBSXML) for integration across the industry

PharmCIS caters for ongoing changes in policy and legislation. This includes recent chemotherapy drug measures, price disclosure and price calculator functionality.

PharmCIS is also an early adopter of the Australian Medicines Terminology which is a national implementation based on the international SNOMED Clinical Terminology. This is a key step change towards the new eHealth records project.

It contains a comprehensive source of information such as industry standard medicine definitions including detailed composition information, subsidies, restrictions and prescribing rules - a fundamental building block for ePrescribing. Advanced searching and high accessibility to this information is also available.

PharmCIS is designed to:

  • Improve the efficiency of submission processing
  • Consolidate over 40 disparate IT and paper-based systems into one centralised system
  • Improve the consistency and accuracy of price changes in the PBS
  • Improve collaboration between the various ministers, departments and branches, committees, authorities secretariats and industry bodies
  • Improve the management of prescribing restrictions by increasing clarity for clinicians and dispensers and introducing encodings to support ePrescribing solutions
  • Provide a platform to help industry transition to a common standard for pharmaceutical information exchange
  • Facilitate increased government transparency to the industry
  • Support eHealth initiatives including the introduction of the Australian Medicines Terminology - an important step toward the implementation of Electronic Transfer of Prescriptions and eHealth

PharmCIS has the following features:

  • Application entry and validation
  • Web based workflow, evaluation and approval processing
  • Extensive price calculator functionality, improving accuracy and introducing efficiencies to effectively administer subsidies and complex pricing policy such as the Chemotherapy Revised Arrangements and High Cost Drugs
  • Advanced medical product packaging, components, treatment unit modelling and visualisation
  • Extensive data validation incorporating AMT data, medicines composition and lineage, schedules, restrictions, prescribing rules, subsidies and pricing
  • Workflow management, tracking and alerts
  • Incorporation of the World Health Organisation Anatomical Therapeutic Chemical Classification system ensuring alignment with international initiatives such as recommended daily dosage guidelines
  • Integration with NEHTA's Australian Medicines Terminology (AMT) derived from the international SNOMED Clinical Terminology
  • Document generation and reporting capability
  • Extensive auditing - includes timestamp tracking and auditing at each stage
  • Comprehensive search and help facilities - including context sensitive help
  • Support and tracking for committee and authority meetings, industry liaison and outcomes
  • Automatic integration capability with Medicare Australia (DHS) to help support activities such as PBS online claiming
  • Standards based - uses industry standards and interface mechanisms such as XML and web services