It’s all coming up Pharmacy Guild as states and territories fall into line with Queensland.
Victoria is set to be the next domino to fall in the pharmacist prescribing trend – if South Australia and the Northern Territory don’t tip first.
Earlier today, Victorian Premier Dan Andrews pledged, if re-elected, to launch a trial of pharmacist-led prescribing for uncomplicated UTIs and common skin conditions, as well as the ability to reissue scripts for the oral contraceptive pill.
Pharmacists would also be authorised to deliver a wider range of travel and public health vaccines.
Mr Andrews, who is up for re-election this weekend, has earmarked $19 million for a year-long pilot.
Unlike the UTI prescribing program in Queensland and the newly-announced NSW trial, pharmacist consults in Victoria would be free for consumers.
Instead, pharmacists would receive a flat $20 per consult from the government, meaning patients would only pay the PBS co-payment for any medicines they are prescribed.
“[It’s] really important to make sure that families can access the care they need close to home, rather than having to fight for an appointment at an all-too-hard-to-find GP clinic, let alone a bulk-billing GP clinic,” Mr Andrews said.
Medical organisations, however, were not impressed.
RACGP Victoria chair Dr Anita Muñoz told The Medical Republic that the college’s opposition to the pilot was rooted in concerns for patient safety, rather than a turf war.
“We continue to have grave concerns about the potential for misdiagnosis, particularly in the UTI space, given that the protocol does not even require the pharmacist to test the patient’s urine,” she said.
There was also the issue of antimicrobial stewardship, she said.
Ironically, this latest flurry of announcements comes during Antimicrobial Awareness Week.
Dr Muñoz urged the government to resist lowering its standards in the name of convenience.
“This is not about GPs wanting to monopolise a particular part of medicine,” she said.
“It really is genuinely about concerns for patient safety and outcomes, and concerns for the future of our antibiotic usage.”
If Labor retains power, it would have to amend the state Drugs, Poisons and Controlled Substances Act 1981, which currently does not allow for a pilot for pharmacists to prescribe Schedule 4 medicines.
It’s unclear whether the pharmacy trial will be a bipartisan pledge; the Victorian Liberal National Party hasn’t announced a similar offering, but also didn’t respond to a TMR request for confirmation either way.
Mr Andrews’ announcement comes as a relative surprise in some corners. When asked by TMR last week whether the Victorian Department of Health was in talks about a potential pharmacist-led prescribing trial, a spokesman suggested it was unlikely, or at least not imminent.
“We always listen to the expert advice and work closely with the entire health sector to ensure Victorians can access the medication they need when they need it,” the spokesman told TMR.
“Any proposed changes to how medications can be prescribed would require thorough consultation with the health sector.”
This is something of a pattern.
Back in September, TMR asked the Northern Territory health department whether there were any plans to mirror the Queensland UTI trial in the NT.
A spokesman said no, that pharmacists were not authorised to prescribe Schedule 4 or Schedule 8 medicines under NT law, and that the legislation would need to be amended before that could happen.
When asked again last week, a department spokesman said there had been no change since our last query.
Yesterday afternoon, however, the NT passed legislation that will allow certain changes to the way medicines are controlled.
Under the new rules, pharmacists will be allowed to continue dispensing to patients without a script in the wake of a natural disaster, and opioid-reversal medicines will be available over the counter. These changes are largely in keeping with the rest of Australia.
However, the act of amending legislation to allow these functions has also opened the door wider for increased pharmacist scope-of-practice trials. NT Chief Minister Natasha Fyles has already hinted at as much.
“The new legislation will enable the CHO to approve protocols for health practitioners, such as pharmacists to administer specific medicines under specific conditions,” Ms Fyles told media.
“New protocols to treat additional conditions will be developed in the future.”
Pharmacy Guild NT branch president Peter Hatswell said the legislation passing was “a great decision” and “goes a step further than moves announced in Queensland and NSW”.
Meanwhile, South Australian Labor backbencher Jayne Stinson announced late last week that she intended to establish a select committee to investigate whether to authorise a pharmacist-led UTI trial in the state.
“Queenslanders now have the right to access this medication from specially-trained pharmacists,” she said.
“Why aren’t SA women granted that relief?”
If Ms Stinson’s motion passes next week, the select committee will report back to parliament sometime next year.
