Therapeutic Goods (Serious Scarcity and Substitutable Medicine) (Warfarin) Instrument 2023
I, Nicholas Henderson, as delegate of the Minister for Health and Aged Care, make the following instrument.
Dated 16 March 2023
Nicholas Henderson
Acting First Assistant Secretary
Medicines Regulation Division
Health Products Regulation Group
Department of Health and Aged Care
Contents
1 Name
2 Commencement
3 Authority
4 Definitions
5 Declaration of a serious scarcity
6 Substitution of scarce medicine by pharmacists
7 Period instrument in force
8 Repeals
Schedule 1—Scarce medicine, substitutable medicine, dose unit equivalence and specific permitted circumstances
Schedule 2—General permitted circumstances
This instrument is the Therapeutic Goods (Serious Scarcity and Substitutable Medicine) (Warfarin) Instrument 2023.
(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.
Column 1 | Column 2 | Column 3 |
Provisions | Commencement | Date/Details |
1. The whole of this instrument | 17 March 2023. | 17 March 2023 |
Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.
(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.
This instrument is made under section 30EK of the Therapeutic Goods Act 1989.
Note: A number of expressions used in this instrument are defined in subsection 3(1) of the Act, including the following:
(a) medicine;
(b) Register;
(c) registered goods;
(d) registration number.
In this instrument:
Act means the Therapeutic Goods Act 1989.
pharmacist has the same meaning as in subsection 30EK(6) of the Act.
prescriber means the person who:
(a) is authorised under a law of a State or Territory to prescribe medicine; and
(b) prescribed the scarce medicine for the patient.
registered medicine means a medicine that is included in the part of the Register for goods known as registered goods.
scarce medicine has the meaning given by section 5.
substitutable medicine has the meaning given by section 6.
tablet has the same meaning as in the Therapeutic Goods (Standard for Tablets, Capsules and Pills) (TGO 101) Order 2019.
Note: TGO 101 is a legislative instrument published on the Federal Register of Legislation at www.legislation.gov.au.
5 Declaration of a serious scarcity
For paragraph 30EK(1)(a) of the Act, a serious scarcity of the medicine specified in column 2 of each item in the table in Schedule 1 (the scarce medicine) across the whole of Australia is declared.
6 Substitution of scarce medicine by pharmacists
(a) column 5 of that item (the specific permitted circumstances); and
(b) the table in Schedule 2 (the general permitted circumstances).
This instrument remains in force until 7 August 2023.
Unless repealed earlier, this instrument is repealed at the start of 8 August 2023.
Schedule 1—Scarce medicine, substitutable medicine, dose unit equivalence and specific permitted circumstances
Note: See sections 5 and 6.
Scarce medicine, substitutable medicine, dose unit equivalence and specific permitted circumstances | ||||
Column 1 | Column 2 | Column 3 | Column 4 | Column 5 |
Item | Scarce medicine | Substitutable medicine | Dose unit equivalence | Specific permitted circumstances |
1 | COUMADIN warfarin sodium 5 milligram tablet, registration number 42279 | COUMADIN warfarin sodium 1 milligram tablet, registration number 42269 | five tablets of substitutable medicine are equivalent to one tablet of scarce medicine | the pharmacist has: (a) advised the patient, or person acting on behalf of the patient, of the number of dose units of substitutable medicine that must be taken by the patient in substitution for the prescribed dose of scarce medicine, based on the dose unit equivalence specified in column 4; and (b) ensured that the patient, or person acting on behalf of the patient, has access to information to support them in administering the substitutable medicine |
2 | COUMADIN warfarin sodium 5 milligram tablet, registration number 42279 | COUMADIN warfarin sodium 2 milligram tablet, registration number 14937 | two and a half tablets of substitutable medicine are equivalent to one tablet of scarce medicine | the pharmacist has: (a) advised the patient, or person acting on behalf of the patient, of the number of dose units of substitutable medicine that must be taken by the patient in substitution for the prescribed dose of scarce medicine, based on the dose unit equivalence specified in column 4; and (b) where cutting of the tablet is required to obtain the correct dose of substitutable medicine—provided instructions to the patient, or person acting on behalf of the patient, for cutting the tablet; and (c) ensured that the patient, or person acting on behalf of the patient, has access to information to support them in administering the substitutable medicine |
Schedule 2—General permitted circumstances
Note: See section 6.
General permitted circumstances | |
Column 1 | Column 2 |
Item | Circumstances |
1 | the patient, or person acting on behalf of the patient, has evidence of a valid prescription for the scarce medicine, unless otherwise permitted by law |
2 | the pharmacist does not have access to the scarce medicine |
3 | the prescriber has not indicated on the prescription for the scarce medicine that substitution is not permitted |
4 | the pharmacist has exercised professional judgement and determined that the patient is suitable to receive the substitutable medicine |
5 | the amount of substitutable medicine dispensed would result in the patient receiving sufficient medicine to ensure an equivalent dosage regimen and duration to that prescribed in relation to the scarce medicine |
6 | the patient, or person acting on behalf of the patient, has consented to receiving the substitutable medicine |
7 | the pharmacist makes a record of dispensing the substitutable medicine in substitution of the scarce medicine at the time of dispensing |
8 |