New Zealand's 12-Month Prescription Policy: GP Decision Support Guide

Effective: 1 February 2026

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🔑 KEY FINDING FOR PRESCRIBERS

The legislation grants YOU full clinical discretion. There are NO mandatory patient eligibility criteria in law. The "eligibility frameworks" you'll see are professional guidance to help you make safe decisions—they are NOT legal requirements.

Understanding the Markers in This Document

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1. Background & Policy Overview

What Changed

🔴 LEGAL REQUIREMENT: From 1 February 2026, prescriptions may be written for up to 12 months (increased from 3 months for most medicines, 6 months for oral contraceptives). SOURCE: Medicines (Increasing the Period of Supply) Amendment Regulations 2025 (SL 2025/203)

🔴 LEGAL REQUIREMENT: Dispensing limits remain unchanged - pharmacies can still only dispense a maximum of 3 months' supply per occasion (6 months for oral contraceptives). SOURCE: Medicines Regulations 2025, Regulation 42(3)(d)

🔴 LEGAL REQUIREMENT: Prescriptions must be first presented to a pharmacy within 3 months of the issue date. SOURCE: Medicines Regulations 2025, Regulation 42(3)(c)

Who Decides Clinical Appropriateness

🔴 LEGAL REQUIREMENT: The prescriber has full discretion to determine appropriate prescription duration based on individual patient assessment. SOURCE: Medicines Regulations 2025; Ministry of Health Regulatory Impact Statement (21 November 2024)

🟢 GUIDANCE: Government guidance suggests prescribers would consider 12-month prescriptions for patients with "ongoing, stable health conditions" but does not mandate criteria. SOURCE: Ministry of Health RIS, page 15

Cost Implications

🔴 LEGAL REQUIREMENT: Patients pay one prescription co-payment ($5 for most) when first collecting their medicine. No additional co-payments for subsequent 3-monthly dispensings within that 12-month period. SOURCE: Ministry of Health; Te Whatu Ora guidance

Standard co-payment exemptions apply (under 14, 65+, Community Services Card holders). SOURCE: Ministry of Health

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2. Legal Framework

Prescription Duration

🔴 LEGAL REQUIREMENT:

• Maximum 12 months prescription duration permitted (not mandated)
• Prescriber retains full discretion to issue shorter durations (3, 6, 9 months)
• No minimum duration required

SOURCE: Medicines Regulations 2025, Section 3

Dispensing Limits

🔴 LEGAL REQUIREMENT:

• Maximum 3 months' supply per dispensing (most medicines)
• Maximum 6 months' supply per dispensing (oral contraceptives only)
• Patients collect repeats every 3 months from the same pharmacy

SOURCE: Medicines Regulations 2025, Regulation 42(3)(d); Pharmac Schedule Rule 3.2.3

🟢 GUIDANCE: Same pharmacy requirement appears in operational guidance and patient materials but is not explicitly stated in Schedule Rules (may be system limitation). SOURCE: Healthify patient information; RNZCGP patient materials

Controlled Drugs

🔴 LEGAL REQUIREMENT: Controlled drugs are excluded from 12-month prescriptions and remain subject to existing restrictions:

• Max 1 month: All opioids (e.g. morphine, oxycodone, fentanyl, codeine, tramadol)
• Max 3 months: ADHD stimulants (methylphenidate, dexamfetamine), benzodiazepines, zopiclone, cannabis preparations

SOURCE: Misuse of Drugs Act 1975; Misuse of Drugs Regulations 1977

Special Authority

🔴 LEGAL REQUIREMENT: If a Special Authority expires before the 12-month prescription period ends, the prescriber must renew the Special Authority before further funded repeats can be dispensed. SOURCE: Pharmac Schedule Rule 2.4.3 (amended October 2025)

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3. Eligibility Framework

CRITICAL CLARIFICATION

There are NO mandatory patient eligibility criteria in the Medicines Regulations 2025. The law grants full clinical discretion to prescribers. The criteria below are professional guidance to support safe decision-making.

Patient Stability Criteria

🟢 GUIDANCE: RNZCGP patient materials suggest patients "may be eligible" if their condition and medication dose have been stable for at least 6 months. SOURCE: RNZCGP Patient Poster and FAQs (January 2026)

NOTE: This "6 months stable" criterion does NOT appear in:

• The Medicines Regulations 2025
• RNZCGP Position Statement (November 2025)
• RNZCGP Foundation Standard 9.1
• Pharmac Schedule Rules
• Any government guidance

🔵 PRACTICE DECISION: Individual practices may adopt this as policy or use different timeframes (some early adopters trialing 9-month prescriptions).

Review Requirements

🟡 PROFESSIONAL STANDARD: Practices accredited under RNZCGP Foundation Standard must ensure minimum annual review for patients on 12-month prescriptions. SOURCE: RNZCGP Foundation Standard 9.1 (updated 01/11/25)

🟢 GUIDANCE: RNZCGP Position Statement recommends "continuity of care: consider attendance at reviews and follow-ups—a minimum of annual review is required, or earlier if clinically indicated." SOURCE: RNZCGP Position Statement, November 2025, page 3

🔵 PRACTICE DECISION: Some practices require face-to-face appointments for issuing 12-month prescriptions (e.g., The Doctors Napier). SOURCE: NZ Herald, 1 February 2026

Patient Groups Requiring Careful Consideration

🟢 GUIDANCE: RNZCGP Position Statement identifies patient groups where "12-month prescriptions may not be suitable" (note: not "excluded"):

Age and life stage considerations:

• Infants and children
• Adolescents
• Pregnant patients
• Older adults (65+) who typically require closer monitoring

SOURCE: RNZCGP Position Statement, November 2025, page 3

Complex clinical situations:

• Patients with multiple or unstable conditions
• Polypharmacy patients who may require shorter intervals for timely review
• Patients with poor medication adherence
• Patients requiring caregiver/whānau support for medication management

SOURCE: RNZCGP Position Statement, November 2025, page 3

IMPORTANT: These are considerations for clinical judgment, NOT absolute exclusions. The prescriber determines suitability for each individual patient.

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4. Medication Categories

4.1 Medications NOT Suitable for 12-Month Prescriptions

Controlled Drugs

🔴 LEGAL REQUIREMENT: All controlled drugs under the Misuse of Drugs Act 1975 are excluded from 12-month prescriptions.

Max 1 month: All opioids (morphine, oxycodone, fentanyl, methadone, codeine, tramadol)

Max 3 months: ADHD stimulants (methylphenidate, dexamfetamine), benzodiazepines (e.g. diazepam, lorazepam, clonazepam), zopiclone, cannabis preparations

SOURCE: Misuse of Drugs Act 1975; Misuse of Drugs Regulations 1977

High-Risk Medications Requiring Regular Monitoring

🟢 GUIDANCE: The following medications are identified in consumer information (Healthify) and professional materials as generally unsuitable for 12-month prescriptions due to monitoring requirements. These are NOT legal exclusions but clinical recommendations:

Narrow therapeutic index drugs:

• Warfarin (requires INR monitoring)
• Lithium (requires lithium levels, renal function, thyroid function)
• Digoxin (requires serum levels, renal function, electrolytes)
• Phenytoin (requires serum levels)

Immunosuppressants:

• Methotrexate (requires FBC, LFTs, renal function)
• Azathioprine (requires FBC, LFTs)

Antiarrhythmics:

• Amiodarone (requires TFTs, LFTs, CXR, ECG)

Anticonvulsants with monitoring needs:

• Sodium valproate (requires LFTs, FBC)
• Carbamazepine (requires FBC, LFTs, sodium)

Diuretics requiring electrolyte monitoring:

• Spironolactone (potassium, renal function)

SOURCE: Healthify patient information (reviewed 28 January 2026); RNZCGP guidance materials

🔵 PRACTICE DECISION: Your practice should develop its own list of medications requiring shorter prescription intervals based on monitoring needs and patient risk factors.

4.2 Generally Suitable Medications

🟢 GUIDANCE: The following medication classes are commonly considered suitable for 12-month prescriptions in stable patients. This is NOT an official approved list but represents clinical consensus:

Cardiovascular:

• Statins (atorvastatin, simvastatin, rosuvastatin)
• Calcium channel blockers (amlodipine, felodipine)
• Beta blockers (metoprolol, bisoprolol, atenolol)
• Aspirin (antiplatelet dose)

NOTE on statins: 🟢 GUIDANCE: BPAC guidance suggests routine LFT monitoring is not required for patients stable on statins. SOURCE: BPAC Best Practice Journal

Respiratory:

• Inhaled corticosteroids (ICS): fluticasone, budesonide
• Long-acting beta agonists (LABA): salmeterol, formoterol
• ICS/LABA combinations: fluticasone/salmeterol, budesonide/formoterol
• Long-acting muscarinic antagonists (LAMA): tiotropium

NOTE: Special Authority renewal requirements for LAMA/LABA combinations were removed by Pharmac in December 2025. SOURCE: Pharmac announcement, December 2025

Contraceptives: 🔴 LEGAL REQUIREMENT: Oral contraceptives can be prescribed for 12 months and dispensed in 6-month intervals (increased from previous 6-month prescription limit). SOURCE: Medicines Regulations 2025

Thyroid:

• Levothyroxine (once dose stabilized)

Chronic disease management:

• Metformin (see gray area section for patients with renal impairment)
• Proton pump inhibitors (omeprazole, esomeprazole)

SOURCE: Clinical consensus from early adopter practices; RNZCGP guidance materials

4.3 Gray Area Medications Requiring Individual Assessment

The following medications may be suitable for 12-month prescriptions in selected stable patients but require careful individual assessment:

ACE Inhibitors / ARBs

🟢 GUIDANCE: Consider shorter intervals if:

• eGFR <45 mL/min/1.73m² (increased risk of renal deterioration, hyperkalemia)
• Recent dose titration (<6 months)
• Concurrent use of other nephrotoxic drugs
• Unstable heart failure

If prescribing for 12 months: Ensure patient understands need for monitoring and has access to blood tests as clinically indicated.

SOURCE: Clinical best practice; RNZCGP Position Statement considerations

Metformin

🟢 GUIDANCE: Consider shorter intervals if:

• eGFR <45 mL/min/1.73m² (dose adjustment required)
• eGFR <30 mL/min/1.73m² (contraindicated)
• Recent acute illness or hospitalisation
• Elderly patients at risk of declining renal function

SOURCE: Clinical best practice; Medsafe data sheets

Direct Oral Anticoagulants (DOACs)

🟢 GUIDANCE: Rivaroxaban, apixaban, dabigatran - consider shorter intervals if:

• eGFR <50 mL/min/1.73m² (dose adjustment required; increased monitoring needed)
• Age >75 years (increased bleeding risk)
• High bleeding risk (falls, previous bleeds)
• Concurrent antiplatelet therapy

SOURCE: Clinical best practice; Medsafe data sheets

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5. Monitoring Requirements

All monitoring recommendations below are 🟢 GUIDANCE based on clinical best practice, NOT legal requirements.

General Principles

🟡 PROFESSIONAL STANDARD: RNZCGP Foundation Standard requires "annual reviews are a minimum, but more frequent assessments may be necessary based on patient condition and medication risks." SOURCE: RNZCGP Foundation Standard 9.1

🟢 GUIDANCE: Telehealth/phone reviews may be acceptable for stable patients between in-person reviews, at prescriber discretion. SOURCE: RNZCGP Position Statement

Monitoring by Condition

Hypertension on simple regimen (e.g., amlodipine alone):

• Annual BP check, renal function, electrolytes
• Home BP monitoring encouraged

Diabetes on metformin alone:

• Annual HbA1c, renal function, lipids
• More frequent if eGFR <45

Hyperlipidemia on statin:

• Annual lipid profile
• LFTs not routinely required if stable (BPAC guidance)

Asthma/COPD on maintenance inhalers:

• Annual spirometry if available
• Annual review of inhaler technique and symptom control

Polypharmacy (5+ medications): 🟢 GUIDANCE: Consider 6-monthly reviews rather than annual for medication reconciliation and adverse effect screening. SOURCE: RNZCGP Position Statement

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6. Practical Implementation

6.1 Workflow from Early Adopters

🔵 PRACTICE DECISION: The following workflows are examples from early adopter practices. Your practice should develop its own process.

Pinnacle Practices (Waikato/Gisborne PHO):

• Considering trialing with 9-month prescriptions initially
• Developing in-house policy with clear criteria
• Emphasis on equity lens in decision-making

SOURCE: Pinnacle Practices webinar, October 2025

Some practices requiring:

• Face-to-face appointment for issuing 12-month prescription
• Annual review booked at time of prescription issue
• Patient consent/agreement form

SOURCE: Various practice policies shared via Pinnacle

6.2 RNZCGP Foundation Standard Requirements

🟡 PROFESSIONAL STANDARD: For practices seeking/maintaining RNZCGP accreditation:

Mandatory requirements:

1. Documented repeat prescribing policy that includes clear criteria for when 12-month prescriptions are appropriate and when shorter intervals are clinically indicated

2. Annual audits of repeat prescribing activity

3. Audits must differentiate Māori from non-Māori in results to identify and address inequities

4. If audits show non-compliance, improvement actions and follow-up audits are required

5. Patients requiring further examination or assessment must NOT receive repeat prescriptions without being seen by a doctor or nurse practitioner

SOURCE: RNZCGP Foundation Standard 9.1 (updated 01/11/25)

6.3 Documentation Recommendations

🟢 GUIDANCE: Consider documenting in clinical notes:

• Clinical rationale for 12-month prescription
• Monitoring plan discussed with patient
• Next review date
• Patient agreement to annual review

🔵 PRACTICE DECISION: Some practices using consent forms or patient information leaflets.

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7. Managing Patient Expectations

Common Patient Questions

"Can I get all my medicines for 12 months at once?" 🔴 LEGAL REQUIREMENT: No. Pharmacies can only dispense 3 months at a time (6 months for oral contraceptives). You'll collect repeats every 3 months from the same pharmacy.

"Will I still need to see my doctor?" 🟢 GUIDANCE: Yes. RNZCGP recommends annual review as minimum. Your doctor will decide appropriate review frequency based on your health needs.

"Why can't I get a 12-month prescription?" Explain using appropriate marker:

• 🔴 If controlled drug: "This medication is a controlled drug and legally cannot be prescribed for more than [1 or 3] months"
• 🟢 If requires monitoring: "Your medication requires regular blood tests to ensure it's safe and working properly"
• 🟢 If unstable condition: "Your condition needs closer monitoring to ensure your treatment remains appropriate"

"My friend got a 12-month prescription, why can't I?" 🔴 LEGAL REQUIREMENT: "The law gives me discretion to determine the appropriate prescription length for each patient individually based on their specific health needs."

Setting Expectations

🟢 GUIDANCE: Be clear with patients that a 12-month prescription:

• Does NOT mean no contact with practice for 12 months
• Does NOT mean no monitoring required
• Can be changed/stopped if circumstances change
• Requires them to still attend annual reviews

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8. Professional Concerns

8.1 RNZCGP Position

CRITICAL CONTEXT: RNZCGP opposed the 12-month policy and formally recommended 6 months as safer.

🟢 GUIDANCE: RNZCGP October 2024 submission to Ministry of Health:

"Based on unprecedented member feedback, the College does not support the proposed amendment to increase the period of supply limit from 3 months to 12 months. It will however support an increase to 6 months as a safer and more appropriate option."

SOURCE: RNZCGP Submission, 17 October 2024

Reasons for opposition:

• Primary risk: lack of appropriate follow-up over 12 months
• Equity concerns for Māori and Pacific peoples
• Financial impact on practices (estimated $320,000 loss for practice with 14,500 patients)
• Patient safety concerns for unstable conditions

SOURCE: RNZCGP Submission, October 2024

Despite opposition, RNZCGP issued implementation guidance after government decision to proceed.

8.2 Pharmacy Sector

Pharmacy Guild concerns:

• Financial sustainability due to reduced dispensing fees for repeats
• Operational burden of managing 12-month prescriptions
• Technology gaps

Resolution: Te Whatu Ora agreed (November 2025) to fund pharmacies "as if they were still delivering them under 3-month prescription pricing terms." SOURCE: Pharmacy Guild press release, 13 November 2025

Pharmaceutical Society position:

• Supports 12-month prescriptions with robust implementation
• Recommends prescribers add period of supply notation (2/12, 6/12, etc.) to prescriptions

SOURCE: PSNZ submission, 14 October 2024

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9. Te Tiriti Considerations and Equity

9.1 Equity Concerns

🟢 GUIDANCE: Te Tirātū (Iwi Māori Partnership Board for Tainui waka rohe) raised significant equity concerns:

"Māori already face significant barriers to accessing medicines. Despite higher rates of chronic conditions such as diabetes, cardiovascular disease, and respiratory illness, Māori are overall less likely to access dispensed medicines than non-Māori."

"Māori already experience lower rates of monitoring, fewer proactive clinical reviews, and later diagnosis of chronic and complex conditions. Reducing prescribing touchpoints risks further decreasing opportunities to detect deterioration."

SOURCE: Te Tirātū position statement, 2 February 2026

9.2 Five Safeguards Requested

Te Tirātū called for:

1. Mandatory equity-focused monitoring with prescribing rates disaggregated by ethnicity, rurality, deprivation, disability

2. Transparent reporting of adverse events, hospitalisations, medicine changes, wastage

3. Māori-led evaluation of safety, trust, communication, cultural safety

4. Clear national guidance on who is NOT clinically appropriate

5. Te Tiriti-aligned medicines optimisation strategy

SOURCE: Te Tirātū position statement, 2 February 2026

9.3 Practice-Level Equity Actions

🟡 PROFESSIONAL STANDARD: RNZCGP Foundation Standard requires practices to:

• Include "additional measures to optimise Māori access to repeat prescriptions and collection of medicines" in policy
• Differentiate Māori from non-Māori in repeat prescribing audits

SOURCE: RNZCGP Foundation Standard 9.1

🟢 GUIDANCE: RNZCGP Position Statement recommends:

• Apply equity lens to decision-making
• Ensure culturally safe care continues
• Consider barriers to access when determining prescription duration

SOURCE: RNZCGP Position Statement, November 2025

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10. International Evidence

🔵 CONTEXT: International evidence provides context but does NOT determine NZ legal requirements or professional standards.

Australia PBS (Most Comparable System)

• Prescription validity: 12 months
• Dispensing: 60-day intervals (implemented Sept 2023-Sept 2024)
• Covers 300+ medicines for chronic conditions
• Clinical requirement: condition must be "stable"

SOURCE: Australian Government PBS; University of NSW evaluation

UK Evidence

NIHR Health Technology Assessment (2017):

• 3-month prescriptions associated with better adherence than 28-day prescriptions
• Cost savings: £8.38-£12.06 per prescription per 120 days
• Evidence quality: "very low" (GRADE) - no RCTs, all observational

SOURCE: Miani et al., Health Technology Assessment 2017; DOI: 10.3310/hta21780

Current UK practice:

• 28-day standard but not mandated
• Up to 56-day intervals permitted
• Prescription validity: 6 months

WHO Recommendations

Global Report on Hypertension (2023):

• Recommends 90-180 day dispensing for stable hypertensive patients
• Emphasizes "regular, uninterrupted access to affordable medication"

SOURCE: WHO Global Report on Hypertension 2023

International Comparison (32 Countries)

12-month prescription validity is standard in: Australia, Canada (Ontario), UK, Norway, Sweden, Netherlands, USA (varies)

SOURCE: af Geijerstam et al., Hypertension Research 2024; DOI: 10.1038/s41440-024-01743-2

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11. Quick Reference Checklist

Before Issuing a 12-Month Prescription, Consider:

Legal Requirements (🔴)

• Is the patient on any controlled drugs? (If yes → max 1-3 months)
• Special Authority will remain valid for full 12 months? (If no → shorter duration or plan renewal)
• Patient understands they collect 3-month supplies from same pharmacy?

Professional Standards (🟡) - If Your Practice is RNZCGP Accredited

• Does this meet our practice's documented criteria for 12-month prescriptions?
• Is annual review planned/booked?
• Have we documented clinical rationale?

Clinical Judgment (🟢) - RNZCGP Guidance

• Condition stable ≥6 months? (patient materials suggest this)
• Medication dose stable ≥6 months?
• Patient has good medication adherence?
• Medication does NOT require regular monitoring (bloods, ECG, etc.)?
• Patient NOT in high-consideration group (65+, pregnant, child, polypharmacy, unstable)?

Equity Considerations (🟢)

• Have I considered barriers to access for this patient?
• Will 12-month prescription improve or hinder their medication access?
• Does patient have support for medication management if needed?

Patient Understanding (🟢)

• Patient understands need for ongoing reviews?
• Patient agrees to annual review minimum?
• Patient knows when to seek review earlier?

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Key Takeaway Messages

1. You have full legal discretion - the Medicines Regulations 2025 grant prescribers complete authority to determine appropriate prescription duration. There are no mandatory patient eligibility criteria in law.

2. Eligibility criteria are guidance - the "6 months stable" and other patient suitability factors are recommendations from RNZCGP and consumer information, NOT legal requirements.

3. RNZCGP opposed this policy - they recommended 6 months as safer. Their guidance reflects this caution.

4. Accredited practices have standards to meet - if your practice is RNZCGP-accredited, you must comply with Foundation Standard 9.1 requirements (policy, audits, Māori equity measures).

5. Equity must be central - Māori health advocates warn this policy risks widening inequities without proper safeguards. Monitor your prescribing patterns and outcomes.

6. It's okay to prescribe shorter durations - 6 months, 9 months, or any duration you deem appropriate is completely acceptable and often safer.

7. Document your reasoning - whatever duration you choose, document your clinical rationale.

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Further Resources

Government:

• Ministry of Health: https://www.health.govt.nz/strategies-initiatives/programmes-and-initiatives/primary-and-community-health-care/increasing-prescribing-lengths
• Medicines Regulations 2025: https://www.legislation.govt.nz/regulation/public/2025/0203/
• Pharmac decision: https://www.pharmac.govt.nz/news-and-resources/consultations-and-decisions/2025-10-decision-on-changes-to-support-increased-prescription-lengths

RNZCGP:

• Position Statement: https://www.rnzcgp.org.nz/documents/657/12-month-prescribing-position-statement-NOV-2025.pdf
• Foundation Standard 9.1: https://www.rnzcgp.org.nz/running-a-practice/the-foundation-standard/whakahau-rongoa-medicines-management/91-repeat-prescribing/
• Patient resources: https://www.rnzcgp.org.nz/our-voice/hot-topics/12-month-prescriptions/

Consumer Information:

• Healthify: https://healthify.nz/medicines-a-z/p/12-month-prescriptions

Practice Implementation:

• Pinnacle Practices: https://www.pinnaclepractices.co.nz/resources/12-month-prescribing/

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This guide synthesizes information from multiple authoritative sources with clear attribution of each claim's origin and binding status. It is designed to support clinical decision-making but does not replace individual clinical judgment or your practice's policies.

Document version: 2.0 (Source-Validated Edition)
Last updated: 4 February 2026

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12-Month Prescriptions: Source Authority Quick Guide

Understanding What You MUST Follow vs What You CAN Consider

One-page reference for GPs and Practice Managers

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The Authority Hierarchy

┌─────────────────────────────────────────────────────────────────┐
│  🔴 TIER 1: LEGAL REQUIREMENTS (MUST COMPLY)                    │
│  You have no discretion - these are legally binding             │
└─────────────────────────────────────────────────────────────────┘
        ↓
┌─────────────────────────────────────────────────────────────────┐
│  🟡 TIER 2: PROFESSIONAL STANDARDS (REQUIRED FOR ACCREDITATION) │
│  Mandatory if your practice is RNZCGP-accredited                │
└─────────────────────────────────────────────────────────────────┘
        ↓
┌─────────────────────────────────────────────────────────────────┐
│  🟢 TIER 3: PROFESSIONAL GUIDANCE (RECOMMENDED)                 │
│  Best practice recommendations - you have discretion            │
└─────────────────────────────────────────────────────────────────┘
        ↓
┌─────────────────────────────────────────────────────────────────┐
│  🔵 TIER 4: INDIVIDUAL PRACTICE DECISIONS                       │
│  Your practice determines implementation details                │
└─────────────────────────────────────────────────────────────────┘

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🔴 TIER 1: LEGAL REQUIREMENTS (MUST COMPLY)

Source: Medicines Regulations 2025, Misuse of Drugs Act 1975, Pharmac Schedule Rules

Critical Legal Point:

The law gives YOU full clinical discretion. There are NO mandatory patient eligibility criteria, NO required "stability period", NO excluded patient groups in the Medicines Regulations 2025.

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🟡 TIER 2: PROFESSIONAL STANDARDS (Required for RNZCGP Accreditation)

Source: RNZCGP Foundation Standard 9.1

If your practice is RNZCGP-accredited (or seeking accreditation), you MUST:

What Happens If You Don't Comply?

• You may lose RNZCGP accreditation
• Your practice's Foundation Standard status may be affected
• Audit findings must be discussed at clinical governance meetings

What If Your Practice Isn't RNZCGP-Accredited?

These become strong recommendations (Tier 3) but are not mandatory. However, the Medical Council's Good Prescribing Practice expects documented processes for repeat prescribing.

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🟢 TIER 3: PROFESSIONAL GUIDANCE (Recommended Best Practice)

Sources: RNZCGP Position Statement, Healthify, PSNZ, clinical consensus

These are recommendations to guide your clinical judgment - you have discretion to follow or adapt them.

Patient Eligibility Criteria (🟢 GUIDANCE)

Medication Suitability (🟢 GUIDANCE)

RNZCGP's Position

IMPORTANT CONTEXT: RNZCGP opposed 12-month prescriptions and recommended 6 months as safer (October 2024 submission to Ministry of Health).

Their guidance reflects this caution - you can legitimately prescribe 6-month prescriptions instead of 12-month as a safety measure.

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🔵 TIER 4: INDIVIDUAL PRACTICE DECISIONS

Sources: Early adopter practices, PHO guidance

Your practice determines:

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Common Misconceptions - CORRECTED

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Quick Decision Guide: "What MUST I Do vs What SHOULD I Consider?"

MUST (🔴 Legal or 🟡 Standard for accredited practices):

• ✓ Not prescribe controlled drugs for >1-3 months
• ✓ Ensure Special Authority valid for funded repeats
• ✓ Have documented repeat prescribing policy (if accredited)
• ✓ Conduct annual audits with Māori/non-Māori differentiation (if accredited)
• ✓ Not issue repeats without seeing patients who need examination (if accredited)

SHOULD CONSIDER (🟢 Guidance):

• ✓ Is condition stable? (you define "stable")
• ✓ Does medication require regular monitoring?
• ✓ Is patient in higher-risk group? (age, polypharmacy, etc.)
• ✓ Will patient attend annual review?
• ✓ Equity considerations for this patient

CAN DECIDE (🔵 Practice):

• ✓ Use 6, 9, or 12 months based on your clinical judgment
• ✓ Require face-to-face or allow phone/video
• ✓ Use consent forms or just document in notes
• ✓ Set your own "stability" criteria

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The Bottom Line

1. The law is permissive, not prescriptive: You CAN prescribe 12 months; you're not required to.

2. RNZCGP opposed this policy: They recommended 6 months as safer. Their guidance reflects caution.

3. Accreditation has requirements: If you're RNZCGP-accredited, you must have policy, audits, and equity measures.

4. Clinical judgment is paramount: You determine what's appropriate for each patient.

5. Six months is completely acceptable: Despite the policy being called "12-month prescriptions," prescribing for 6 months aligns with RNZCGP's position and is often safer.

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When in Doubt:

• Legal question? → Check Medicines Regulations 2025
• Accreditation question? → Check RNZCGP Foundation Standard 9.1
• Clinical question? → Use your professional judgment with RNZCGP guidance
• Practice implementation question? → Decide what works for your practice

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Key Resources:

• Medicines Regulations: legislation.govt.nz/regulation/public/2025/0203
• RNZCGP Foundation Standard 9.1: rnzcgp.org.nz/running-a-practice/the-foundation-standard
• RNZCGP Position Statement: rnzcgp.org.nz/documents/657/

Document Version: 1.0 | Date: February 2026