This article is intended for AHPRA-registered prescribers in Australia (medical practitioners, nurse practitioners, and endorsed midwives) who hold, or are eligible to hold, PBS prescribing authority. It concerns the supply and ordering of medicines, not their clinical use. It does not constitute medical, pharmaceutical, or legal advice. The four medicines on the List, with their forms and strengths, are published by caring@home; refer there for the authoritative List and to the Palliative Care Therapeutic Guidelines for clinical prescribing information. For current formulary and eligibility information, refer to the Pharmaceutical Benefits Scheme (PBS).
Palliative Care Australia (PCA) has highlighted a simple but critical point: home-based palliative patients in the terminal phase need timely access to symptom control medicines, both to avoid unnecessary suffering and to avoid unwanted transfers to hospital. Terminal-phase patients are inherently unstable, distressing symptoms can emerge suddenly, and a delay of hours in obtaining the right medicine can be the difference between a managed death at home and an avoidable ambulance call.
To support standardised access, the National Core Community Palliative Care Medicines List identifies four medicines for use with home-based palliative patients in the terminal phase who require urgent symptom relief. The List was developed in 2024 by caring@home, funded by the Australian Government Department of Health and Aged Care and led by the Brisbane South Palliative Care Collaborative, and reviewed by a national working party in 2026. PCA is asking community pharmacies to keep these medicines in stock where possible, so they can be dispensed quickly when a patient needs them.
That reminder is aimed at pharmacies. This article looks at the same problem from the prescriber's side, because there is a second pathway to timely access that sits alongside pharmacy dispensing: holding the relevant forms of these medicines in a PBS Prescriber Bag for immediate administration during a home visit. For the broader overview of how the scheme works, see our complete guide to the PBS Doctor's Bag scheme.
What the List covers
Most common terminal-phase symptoms in uncomplicated palliative care patients can be managed using four medicines, chosen by an expert working party on the basis of clinical evidence, cost (including PBS subsidy), and ease of community use. Rather than reproduce the named formulary here, the four are summarised below by their therapeutic role and the symptoms they target. All four are available on the PBS for palliative care.
| Therapeutic role | Terminal-phase symptoms addressed |
|---|---|
| Benzodiazepine | Seizures, anxiety, dyspnoea or distressing breathlessness, terminal restlessness or agitation |
| Antipsychotic (butyrophenone) | Delirium, nausea or vomiting, terminal restlessness or agitation, refractory distress |
| Antisecretory agent (anticholinergic) | Respiratory tract secretions or noisy breathing (prophylactic) |
| Opioid analgesic | Pain, dyspnoea or distressing breathlessness |
The four medicines are named, with their exact forms and strengths, on the official caring@home National Core Community Palliative Care Medicines List. The development of the List and its mapping to general PBS and Prescriber Bag access are also described in the Royal Australian College of General Practitioners' Australian Journal of General Practice (September 2025). DocPouch does not provide clinical or dosing guidance: our focus is on the supply and ordering pathway described below.
Why timely access matters
Most palliative patients say they would prefer to be cared for, and to die, at home. Achieving that depends on symptoms being controllable at home, at any hour, without delay. When a terminal-phase symptom flares (agitation, noisy respiratory secretions, breathlessness, pain) the medicine needs to be on hand. If it has to be sourced from a pharmacy that does not hold stock, or ordered in from a wholesaler, the patient may suffer in the interim or be transferred to an inpatient facility against their wishes.
This is why PCA's reminder to community pharmacies matters, and it is also why the prescriber-held option matters. The two pathways are complementary, and both reduce the risk of avoidable delay.
Two pathways to timely access
It is worth being precise about the difference between the two access routes, because they are often conflated.
- Community pharmacy dispensing stock. This is what PCA's reminder addresses. A community pharmacy keeps the four medicines in stock so that, when a prescriber writes a PBS prescription for a named patient, the pharmacy can dispense it the same day rather than ordering it in. The medicine is dispensed against a script, to the patient. Pharmacies can also flag this capability by listing a palliative medicine service on Healthdirect.
- PBS Prescriber Bag supply. This is the prescriber-held route. Under Section 93 of the National Health Act 1953, eligible prescribers obtain certain medicines free of charge for immediate or emergency use, supplied without a prescription, to carry and administer themselves. The relevant forms of all four medicines on the List are Prescriber Bag items, which means a GP or nurse practitioner attending a home-based palliative patient can administer them on the spot, without waiting for a pharmacy to dispense.
For a prescriber doing palliative home visits, the Prescriber Bag is the pathway that removes the dispensing step entirely at the point of urgent need. It does not replace patient-specific prescriptions for ongoing supply, but it covers the gap when a symptom emerges suddenly and treatment cannot wait.
The four medicines in the PBS Prescriber Bag
Three of the four medicines appear in the Prescriber Bag formulary in the same injectable form named on the List. The fourth, the benzodiazepine, is where prescribers most often get caught out, so read the supply detail carefully.
| Therapeutic role | In the Prescriber Bag? | Supply detail to know |
|---|---|---|
| Benzodiazepine | Yes, oral liquid form only | The List includes this medicine in two forms (an oral liquid and an injection). Only the oral liquid is a Prescriber Bag item. The injectable form is available on the PBS for palliative care but must be obtained through a patient-specific prescription dispensed at a pharmacy, not through the bag. |
| Antipsychotic (butyrophenone) | Yes, injection | Shares a combined antipsychotic group limit (a maximum of 10 ampoules combined across the group). |
| Antisecretory agent (anticholinergic) | Yes, injection | Maximum of 5 ampoules. |
| Opioid analgesic | Yes, injection | Schedule 8: locked storage required under state and territory law. The group limit caps the total at 5 ampoules across all strengths combined. |
Each item's exact form, strength, item code, and authorised prescriber types are listed on the PBS Prescriber Bag formulary. Two points are easy to miss and worth flagging plainly:
- Form of the benzodiazepine. If you intend to hold the benzodiazepine in your Prescriber Bag, you can obtain the oral liquid, not the injection. The injectable form still has a role in palliative care and is PBS-subsidised, but it must be sourced through a patient-specific prescription dispensed at a pharmacy.
- The opioid is Schedule 8. Opioid ampoules carried in the bag must be stored in a locked receptacle that meets your state or territory's requirements. The exact standard varies by jurisdiction, so confirm with your state health department or drugs and poisons regulator. Our full PBS Prescriber Bag item list and storage checklist sets out the storage conditions and item codes for every item, including the Schedule 8 obligations.
Order Your PBS Prescriber Bag Online →
Which prescribers can hold these in a Prescriber Bag
Each Prescriber Bag item is marked with the prescriber types authorised to order it: MP (medical practitioner), NP (nurse practitioner), and MW (endorsed midwife). For these four palliative terminal-phase medicines, the position is:
- Medical practitioners (MP) and nurse practitioners (NP) can obtain all four items, in their Prescriber Bag forms, through the scheme.
- Endorsed midwives (MW) are not currently authorised for these four items under the Prescriber Bag scheme. They carry MP and NP designations only. An endorsed midwife who attempts to order them on a Prescriber Bag Supply Order Form will have the order rejected at the pharmacy, because the MW designation does not apply to these items.
This matters because endorsed midwives were added as eligible Prescriber Bag prescribers from 1 February 2025, and it is easy to assume the whole formulary opened up. It did not: the MW-eligible items are a defined subset. If you are a nurse practitioner or endorsed midwife, our dedicated guide to the PBS Prescriber Bag for nurse practitioners and endorsed midwives sets out exactly which items each type can and cannot order.
Setting up Prescriber Bag supply for palliative home visits
If you attend home-based palliative patients and want these medicines on hand, the setup is straightforward.
Step 1: Confirm your PBS prescriber number
You need a valid PBS prescriber number issued by Services Australia, specific to your authorisation as a medical practitioner or nurse practitioner. This is separate from your AHPRA registration number.
Step 2: Obtain your Prescriber Bag Supply Order Book
You need a current Prescriber Bag Supply Order Book (the PB052 book), which you apply for through the Health Professional Online Services (HPOS) portal. Our step-by-step HPOS guide walks through the application. Note that each order form in the book is pre-printed with a specific month and year and is valid only in that calendar month, not for a rolling month from the date you sign it.
Step 3: Select your items within the group limits
Identify the items you need against the PBS Prescriber Bag formulary. Watch the group limits: the opioid is capped at 5 ampoules total across all strengths, and the antipsychotic shares a combined 10-ampoule limit across its group. Once you hold the maximum quantity for any item in a group, you cannot order more of any item in that group until your stock falls below the maximum.
Step 4: Place your order
You can order through a local pharmacy or order online. For prescribers covering home visits, rural runs, or community palliative care, online ordering removes the trip to a pharmacy counter and the risk of a pharmacy not stocking the item. Our guide to ordering your PBS Doctor's Bag online covers the full process. Prescribers working in regional and remote areas, where timely palliative access is hardest, may also find our guide for rural and remote practitioners useful.
Frequently Asked Questions
Are the National Core Community Palliative Care Medicines List medicines available on the PBS?
Yes. All four medicines on the List are available on the PBS for palliative care. They can be dispensed against a PBS prescription at a community pharmacy, and the relevant forms are also available to eligible prescribers through the PBS Prescriber Bag scheme. The medicines are named, with their forms, on the official caring@home List for health professionals.
Can a prescriber carry these palliative medicines in a PBS Prescriber Bag?
Yes, for medical practitioners and nurse practitioners. The benzodiazepine (in its oral liquid form), the antipsychotic injection, the antisecretory injection, and the opioid injection are all Prescriber Bag items. This lets the prescriber administer them immediately during a home visit rather than waiting for a pharmacy to dispense.
Is the injectable form of the benzodiazepine a Prescriber Bag item?
No. The Prescriber Bag carries the benzodiazepine as an oral liquid, not as the injection. The injectable form is available on the PBS for palliative care but must be obtained through a patient-specific prescription dispensed at a pharmacy.
What is the difference between a pharmacy stocking these medicines and a prescriber carrying them?
A pharmacy holding stock means it can dispense the medicine quickly against a prescription written for a named patient. A prescriber carrying the medicine in a Prescriber Bag means they hold it themselves and can administer it on the spot, without a prescription and without a pharmacy dispensing step. Both pathways reduce delay; the Prescriber Bag pathway removes the dispensing step entirely at the point of urgent need.
Does the opioid in the Prescriber Bag need special storage?
Yes. The opioid is a Schedule 8 controlled substance. State and territory legislation requires it to be stored in a locked receptacle that meets specific standards. Requirements vary by jurisdiction, so confirm the exact obligations with your state health department or drugs and poisons regulator.
Can endorsed midwives hold these four palliative medicines in their Prescriber Bag?
Not currently. All four items carry MP (medical practitioner) and NP (nurse practitioner) designations only. They are not MW-designated, so an endorsed midwife cannot obtain them through the Prescriber Bag scheme. Endorsed midwives should check the MW column on the formulary and order only MW-eligible items, otherwise the order will be rejected at the pharmacy.
How do I set up Prescriber Bag supply to support palliative home visits?
Confirm your PBS prescriber number, obtain a Prescriber Bag Supply Order Book through HPOS, select the items you need within the group limits, and place your order through a pharmacy or online. Eligible medical practitioners and nurse practitioners can order their Prescriber Bag online through DocPouch.
How DocPouch supports palliative-care prescribers
DocPouch is a pharmacy-led PBS Prescriber Bag supply service operated through Priceline Pharmacy. For prescribers who attend home-based palliative patients, that means:
- The four core terminal-phase items are part of the standard formulary we supply, in the correct Prescriber Bag forms.
- Pharmacy-led verification checks your order against PBS compliance, including the opioid group limit and the antipsychotic group limit, so you do not place an order that will be rejected.
- Schedule 8 handling for the opioid is managed correctly at dispatch, with the storage obligations set out plainly so you can comply at your end.
- Online ordering from any device, which suits prescribers working across multiple sites, in the community, or in rural and remote settings where timely palliative access is hardest.
- Same-day dispatch for orders verified before 4 PM AEST, with nationwide delivery across Australia.
If you do palliative home visits and want the medicines that manage the most common terminal-phase symptoms on hand, setting up your Prescriber Bag supply is the practical step that removes the delay.
Order your PBS Prescriber Bag online with DocPouch →
Disclaimer: This article is provided for informational purposes only and does not constitute medical, pharmaceutical, or legal advice. It concerns the supply and ordering of medicines under the PBS Prescriber Bag Supply scheme, which is governed by the National Health Act 1953 (Cth) and associated regulations. All pharmaceutical products referenced are described by therapeutic category only and are supplied in accordance with the Pharmaceutical Benefits Scheme and applicable Therapeutic Goods Administration (TGA) requirements. No specific therapeutic claims are made, and nothing in this article should be interpreted as a therapeutic claim or as promotion of specific therapeutic goods outside the requirements of the Therapeutic Goods Act 1989 (Cth). Prescribers must ensure they meet all eligibility, scope-of-practice, and compliance obligations under the PBS and applicable state and territory legislation, and must verify the current formulary at www.pbs.gov.au/browse/doctorsbag before ordering. The National Core Community Palliative Care Medicines List is published by caring@home; refer to caringathomeproject.com.au for the authoritative version and the named medicines. DocPouch is operated by Doc Pouch Pty Ltd (ABN 28 695 916 306) through a registered Australian pharmacy.