HL7 FHIR Implementation Guide - New Zealand Formulary/NZULM IG, published by New Zealand Medicines Formulary LP. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7NZ/nzf/ and changes regularly. See the Directory of published versions
Extension: FundingRule
| Official URL: http://hl7.org.nz/fhir/StructureDefinition/nzf-funding-rule | Version: 1.0.0 | |||
| Draft as of 2025-03-19 | Computable Name: FundingRule | |||
Funding restriction information which complements the general funding information provided in the nzf-funding extension. The extension can be added multiple times to a product for each given rule as well as for each PHARMAC schedule. These can be differentiated via the scheduleDate field.
Context of Use
-
Element ID:
Medication
This extension may be used on the following element(s):
Funding information is added to Containered Trade Product Packs where applicable. The funding information is derived from both the PHARMAC schedule.
There are two extensions added that store this information. The first is nzf-funding. This stores the general information around funding for a specific product such as price and subsidy.
The second extension is nzf-funding-rule. This extension once again has a schedule date so vendors can determine which schedule they would like to look at. The purpose of this extension is to provide the PHARMAC funding rules that apply to the given product. Most of the data here comes from the ps_rule table (in the NZMT releases) however a number of attribute rules are also added. These are:
| Name | Condition | Rule Type | Rule value | Rule text |
| Sole subsidy | When a CTPP associated with a ps_brand entry has the sole_supply flag set | SoleSupply | Sole Subsided Supply | |
| Principal Sole Supply | When a CTPP associated with a ps_brand entry has the pss flag set | PrincipalSoleSupply | Principal Sole Supply | |
| Cost Brand Source | When a CTPP associated with ps_pack entry has cost brand source = 1 | CostBrandSource | CBS | |
| Original Pack | When a CTPP associated with ps_pack entry has originalPack = 1 | OriginalPack | Original Pack | |
| Hospital Supply Status | When a CTPP associated with a ps_brand entry has the hss set | HospitalSupplyStatus | Hospital Supply Status | |
| Safety: Uncompounded | ps_formulary.safety = Uncompounded | Safety | Uncompounded | Safety cap required |
| Safety: Compounded | ps_formulary.safety = compounded | Safety | Compounded | Safety cap required for extemporaneously compounded oral liquid preparations |
| Statim | ps_formulary.statim = Must | Statim | Must | Statim: Three months or six months, as applicable, dispensed all-at-once. |
| Statim | ps_formulary.statim = Must | Statim | Must | Statim: Three months or six months, as applicable, dispensed all-at-once. |
Note - If only part of the schedule is released at a given date (i.e. a mid month community release) then the previous complementary release is also provided at that given schedule date. This means that a complete schedule is available for any given schedule date.
Usage info
Usage:
- Use this Extension: Medication resource for NZ Formulary
- Examples for this Extension: Medication/ctpp-with-funding
Formal Views of Extension Content
Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.
This structure is derived from Extension
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Extension |
0..* | Extension | Extension | |
  extension |
3..* | Extension | Extension | |
  Slices for extension |
Content/Rules for all slices | |||
   extension:scheduleDate |
1..1 | Extension | The date this item was placed on the schedule | |
  extension |
0..0 | |||
| url |
1..1 | uri | "scheduleDate" | |
  value[x] |
0..1 | date | Value of extension | |
| extension:type |
1..1 | Extension | Type of funding - hml, community. | |
| extension |
0..0 | |||
| url |
1..1 | uri | "type" | |
 value[x] |
0..1 | CodeableConcept | Value of extension Binding: PHARMAC funding type (required) | |
| extension:ruleType |
1..1 | Extension | The type of PHARMAC rule - primarily sourced from the ps_rule table but can be derived for attribute based rules | |
| extension |
0..0 | |||
| url |
1..1 | uri | "ruleType" | |
| value[x] |
0..1 | CodeableConcept | Value of extension | |
| extension:ruleAttribute |
0..1 | Extension | The attribute from the ps_rule table | |
| extension |
0..0 | |||
| url |
1..1 | uri | "ruleAttribute" | |
| value[x] |
0..1 | string | Value of extension | |
| extension:ruleValue |
0..1 | Extension | The value from the ps_rule table except for attribute based rules | |
| extension |
0..0 | |||
| url |
1..1 | uri | "ruleValue" | |
| value[x] |
0..1 | string | Value of extension | |
| extension:ruleText |
0..1 | Extension | Derived text based on the rule | |
| extension |
0..0 | |||
| url |
1..1 | uri | "ruleText" | |
| value[x] |
0..1 | string | Value of extension | |
| extension:ruleWaiver |
0..1 | Extension | The waiver from the ps_rule table | |
| extension |
0..0 | |||
| url |
1..1 | uri | "ruleWaiver" | |
| value[x] |
0..1 | string | Value of extension | |
 extension:ruleXlinkHref |
0..1 | Extension | The xlinkHref from the ps_rule table | |
 extension |
0..0 | |||
| url |
1..1 | uri | "ruleXlinkHref" | |
| value[x] |
0..1 | string | Value of extension | |
| url |
1..1 | uri | "http://hl7.org.nz/fhir/StructureDefinition/nzf-funding-rule" | |
 value[x] |
0..0 | |||
| Documentation for this format | ||||
Other representations of profile: CSV, Excel, Schematron
Terminology Bindings
| Path | Conformance | ValueSet | URI |
| Extension.extension:type.value[x] | required | PharmacFundingTypeHB (a valid code from Possible values for PHARMAC funding type)https://nzhts.digital.health.nz/fhir/ValueSet/nzf-funding-typefrom this IG |
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children unless an empty Parameters resource : hasValue() or (children().count() > id.count()) or $this is Parameters | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |