This programme provides funding for IV iron infusions for patients who meet the PHARMAC special authority criteria for prescribing subsidised ferric carboxymaltose (Ferinject) in the community.
The infusion is to be provided in the community by the patient’s general practitioner.
Please consider the underlying cause of the iron deficiency anaemia and investigate as per best practice. For guidance on diagnosing and managing iron deficiency anaemia, see Anaemia on full blood count: investigating beyond the pale.
This service is part of the Advanced Primary Options programme.
Your Pinnacle Services Contract applies to this service. By claiming for this service, you have indicated that you have read and agreed to the business rules set out here.
This is NOT a clinical guideline.
Any practice in the Tairāwhiti region can offer and claim for this service.
The service is inclusive of the GP consult, the nurse administration of the infusion, observation time and consumables.
When submitting your referral, please specify which condition the patient requires the medication for.
Submit your referral via Primary Options using the initial condition coding: Iron infusion.
When invoicing for the service please lodge an ‘invoice only’ or the ‘outcome and invoice’ form and select the ‘Iron infusion’ invoice.
Patients domiciled in Te Whatu Ora Tairāwhiti area.
Patients who meet the Special authority criteria for subsidised ferric carboxymaltose (Ferinject).
Please refer to the PHARMAC special authority criteria for Ferinject: (SA1840)
Contraindications to using Ferinject in patients:
NB: allergic reactions are more common in people with a history of inflammatory diseases such as asthma, eczema and rheumatoid arthritis. Close observation is recommended for all patients whether or not they have had an iron infusion in the past.
On completion of the infusion delivery and observation time. The patient should be discharged from the iron infusion service once the patient is considered clinically safe to leave the practice. Observation is recommended for 30 minutes post infusion.
The episode of care ends when the outcome and claim are submitted.
Payment will be made once an outcome has been lodged for the case.
The dosing and frequency of administration varies, in accordance with the indication for use. A second claim may be made if the patient requires a divided dose of iron but please add this to the original case number. Note: Each administration will require a new claim.
Please make your claim via Primary Options, select Iron Infusion and then attach the appropriate invoice(s).
Iron infusion: $150 (GST incl)
Please be aware the claim is all inclusive of the GP consultation, administration of the infusion, observation time and consumables.
Please include the Pharmac SA number with your claim
A second claim may be made if the patient requires a divided dose of iron but please add this to the original case number.
Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of funding.
Please ensure the condition that required the iron infusion is documented.
Please include the Pharmac SA number with your claim
No. A patient co-payment cannot be charged. This service funds the administration of the infusion and there is no cost for the infusion to the patient, provided entry criteria are achieved. The funding for the service includes the co-payment for the initial GP consultation followed by the nurse administration of the infusion.
This service does not include the cost of the medication on special authority, this is the responsibility of the patient to purchase.
The service is funded by Te Whatu Ora.
Primary options team, Pinnacle Midlands Health Network
infoprimaryoptions@pinnacle.health.nz
027 687 7312
A range of guides to assist when using the iron infusion programme.
Quick guides to assist practices with identifying eligibility criteria;invoices that can be claimed; managing claims and providing assistance with understanding remittance reports
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View detailsA range of guides to assist when using the iron infusion programme.