Q: What are the new restrictions for accessing blood glucose test strips (BGTS)?
Note: These restrictions do not apply to people who use insulin, women with gestational diabetes and people with a rare form of diabetes on the NDSS.
Since 1 July 2016, all registrants with type 2 diabetes not using insulin are eligible for an initial six month supply of subsidised blood glucose test strips. This means that they can purchase blood glucose test strips, as required, over a six month period. This change follows the independent advice of the expert Pharmaceutical Benefits Advisory Committee.
The six month access period commences from the date that blood glucose test strips are first purchased on or after 1 July 2016. The NDSS Connect software will automatically calculate this period. If the registrant accesses BGTS within a month of their approval period expiry date, NDSS Connect will alert you with a message advising you to tell the registrant that their approval period will expire soon. After six months, the NDSS system will prompt that the registrant is no longer eligible to receive subsidised test strips, and these registrants should be directed to speak to their health professional.
Importantly, if a person needs access to subsidised blood glucose test strips for clinical reasons, they will continue to receive access after the required form is completed and signed by an authorised health professional.
Q. What about people with other types of diabetes. Can they still access blood glucose test strips?
Yes. People with type 1 diabetes, type 2 diabetes using insulin, women with gestational diabetes and individuals registered through the NDSS as having ‘other diabetes’ are not subject to these changes. They can continue to access BGTS through the NDSS as required without the need for approval.
Q: Why have the restrictions on blood glucose test strips been introduced?
A review of products used in the management of diabetes found that while ongoing self-monitoring of blood glucose in people with type 2 diabetes not using insulin does produce small changes in the three monthly average blood glucose level (HbA1c), the size of this benefit is often very small and unlikely to be clinically significant. It also found that the person’s quality of life, satisfaction or wellbeing outcomes were not significantly different between
those who self-monitor blood glucose and those who do not.
As a result, the Pharmaceutical Benefits Advisory Committee recommended more targeted access to test strips for people with type 2 diabetes to ensure that patients are using the most appropriate products. The outcomes of the Review are available at http://www.pbs.gov.au/info/reviews/diabetes
Q. How do registrants access more blood glucose test strips after six months?
Registrants who have a clinical need for blood glucose test strips will need a signed form from a medical doctor,
credential led diabetes educator or nurse practitioner for subsidised blood glucose test strips after the initial six months. Ideally this extension to access should be sought before the six month period expires.
Ongoing access is based on the clinical judgement of the health professional as to whether the patient benefits from
additional monitoring, for example:
  • the person is taking a medicine which may adversely affect blood glucose control i.e. sulfonylureas;
  • the person has an illness in addition to diabetes that may adversely affect blood glucose control;
  • the person’s diabetes is inadequately controlled;
  • there is a clinical need for the person to self-monitor their blood glucose level; or
  • there has been a change to the person’s existing diabetes management within the previous three (3) months
There is no limit on the number of six month extensions to access that can be authorised.
Q. Who are the authorised health professionals that can approve extensions to access to blood glucose test strips?
Doctors, nurse practitioners and credential led diabetes educators can approve additional six month extension periods to access subsidised BGTS.
Q. Is there a form a medical doctor or authorised health professional needs to fill out for people to access blood glucose test strips?
Yes. A completed and signed Blood Glucose Test Strip Six Month Approval Form from a doctor or authorised health professional is required for subsidised blood glucose test strips after the initial six months. The form is available from the NDSS website at https://www.ndss.com.au/forms
The initial six month supply of subsidised test strips starts from the first time a registrant buys products on or after 1 July 2016. An access form is not required for the initial supply. For example, if a registrant buys NDSS products in May 2016 and then again in August 2016, the six month supply limit will be from the date of their August supply as this was after July 1.
Q: What do pharmacy staff need to do with the authorisation form?
If a registrant is granted an additional six months access, they will need to bring the completed authorisation form to the NDSS pharmacy. Pharmacy staff will need to check that the form is completed and signed and update the relevant details on NDSS Connect following the prompts. The system will automatically calculate the new six month period based on these details. It is important to note that extended access cannot be provided retrospectively and six month access periods are continuous and cannot be accessed in segments.
There are only four fields in which NDSS Access Point pharmacy staff need to enter data before updating NDSS Connect.
Processing the form is simple:
  1. In NDSS Connect, on the registrant record there is an option for ‘BGTS Approval’.
  2. If you select this option, you can input the reason for the six month extension, the type of health professional who certified the form, their provider/CDE number and the date the form was certified and signed. You can find these details on the form.
  3. After entering this information in NDSS Connect, you can then process an order for BGTS as usual.
  4. More detailed information is available on the NDSS Access Point training portal, at ndssacces spoints.learnupon.com
Q. When can NDSS Access Point pharmacy staff submit the Blood Glucose Test Strip Six Month Approval forms into NDSS Connect?
NDSS Connect will allow the Blood Glucose Test Strip Six Month Approval forms to be processed in-pharmacy from 1 December 2016.
Q. What do I do with the form once I have entered the details?
NDSS Access Points are required to enter the details into NDSS Connect, then keep the Blood Glucose Test Strip Six Month Approval form with your other NDSS forms and post it back to your Agent.
Q. How will NDSS Access Point pharmacy staff know whether the registrant needs a Blood Glucose Test Strip Six Month Approval form?
When you enter the registrant’s number and/or name, and also when you click on the ‘BGTS Approval’ butt
on, NDSS Connect will tell you whether the registrant requires a Blood Glucose Test Strip Six Month Approval form.
More details are available on the NDSS Access Point training portal, at ndssaccesspoints.learnupon.com.
Q. How will I know when a registrant’s approval expiry date is coming up?
If the registrant accesses BGTS within a month of their approval period expiry date, NDSS Connect will alert you with a message advising you to tell the registrant that their approval period will expire soon and they should talk to their health professional about whether they need to continue to self-monitor their blood glucose.
Q. How will I know a registrant’s approval expiry date if it is more than a month away?
You can check at any time by entering the registrant’s NDSS number and going to the NDSS Order Screen. The expiry date is displayed on this screen.
Q. A registrant has brought in a Blood Glucose Test Strip Six Month Approval form which is different to the one on the website. Can I process this form or do they need to get another one?
The form has been redesigned slightly since it was first put on the website. Some non-essential questions have been removed. The older form contains all the information you need to update the registrant’s records.
Q: How is the access period worked out?
The new six month access period starts on the day that the form was signed or the next day following the previous expiry period, whichever is later.
Example A
Mr Smith has an approval form signed 31 March 2017. His current access period will expire 1 July 2017. His new six month approval period will commence from 2 July 2017.
Example B
Ms Jones has an approval signed on 31 March 2017. Her previous access period ended on 1 January 2017. Her new six month approval period will commence from 31 March 2017.
Example C
Mr Shaw is part-way through a six-month access period ending 1 May 2017 and obtains a form for further approval for access, signed on 1 January 2017. Mr Shaw does not use his approval for further access until 1 November 2017. His new approved access period would have already expired on the 31 October 2017 (1 May 2017 + 6 months), hence he will not be able to access BGTS. He would need to visit his doctor to obtain a new authorised approval form if he wishes to obtain access.
Q. Blood glucose test strips were removed from the Pharmaceutical Benefits Scheme on 1 July 2016. What does this mean for people with diabetes?
Subsidised blood glucose test stripsremain available through the NDSS and people with diabetes have continued access through the NDSS.
Aboriginal and Torres Strait Islander people who were eligible for a lower co-payment, or no co-payment, under the Closing the Gap arrangements will continue to receive similar subsidisation under the NDSS.
NDSS products, including blood glucose test strips, continue to be provided to Remote Area Aboriginal Health Services and remote clinics.