Appendix 1: Paying pharmacists’ claims

Pharmaceutical Management Agency: Changes to the frequency of medicine dispensing.

Figure 4 gives an overview of how pharmacists’ claims are paid. Pharmacists make claims to be paid dispensing fees, and to be reimbursed for the cost of medicines dispensed to patients. Pharmacists make claims to HealthPAC, which takes various steps to ensure that claims are valid before paying pharmacists on behalf of district health boards.

The information from pharmacists’ claims has other data added to it and the combined data is collected by NZHIS into a data warehouse called the Pharmaceutical Information Database. Pharmac and others use the Pharmaceutical Information Database to monitor the usage of publicly funded medicines, including the frequency of dispensing.

Figure 4
Overview of how pharmacy claims are paid

Overview of how pharmacy claims are paid.

Source: Adapted from a chart on the Ministry of Health’s website.

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