HL7 FHIR Implementation Guide - New Zealand Formulary/NZULM IG
1.0.0 - ci-build

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 2024-12-12 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

This extension may be used on the following element(s):

  • Element ID Medication

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:

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Extension

Summary

Complex Extension: 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.

  • scheduleDate: date: The date this item was placed on the schedule
  • type: CodeableConcept: Type of funding - hml, community.
  • ruleType: CodeableConcept: The type of PHARMAC rule - primarily sourced from the ps_rule table but can be derived for attribute based rules
  • ruleAttribute: string: The attribute from the ps_rule table
  • ruleValue: string: The value from the ps_rule table except for attribute based rules
  • ruleText: string: Derived text based on the rule
  • ruleWaiver: string: The waiver from the ps_rule table
  • ruleXlinkHref: string: The xlinkHref from the ps_rule table

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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"

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension Extension
... id 0..1 id Unique id for inter-element referencing
... Slices for extension 3..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:scheduleDate 1..1 Extension The date this item was placed on the schedule
..... id 0..1 id Unique id for inter-element referencing
..... 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.
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: 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.

  • scheduleDate: date: The date this item was placed on the schedule
  • type: CodeableConcept: Type of funding - hml, community.
  • ruleType: CodeableConcept: The type of PHARMAC rule - primarily sourced from the ps_rule table but can be derived for attribute based rules
  • ruleAttribute: string: The attribute from the ps_rule table
  • ruleValue: string: The value from the ps_rule table except for attribute based rules
  • ruleText: string: Derived text based on the rule
  • ruleWaiver: string: The waiver from the ps_rule table
  • ruleXlinkHref: string: The xlinkHref from the ps_rule table

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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"

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension Extension
... id 0..1 id Unique id for inter-element referencing
... Slices for extension 3..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:scheduleDate 1..1 Extension The date this item was placed on the schedule
..... id 0..1 id Unique id for inter-element referencing
..... 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.
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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
..... id 0..1 id Unique id for inter-element referencing
..... 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"

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSetURI
Extension.extension:type.value[x]requiredPharmacFundingTypeHB (a valid code from Possible values for PHARMAC funding type)
https://nzhts.digital.health.nz/fhir/ValueSet/nzf-funding-type
from this IG

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children unless an empty Parameters resource
: hasValue() or (children().count() > id.count()) or $this is Parameters
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()