‘Extremely problematic’: Pharmacy ads raise concern

An official Victorian Government campaign advising people they can resolve certain medical issues without going to their GP has been slammed by the RACGP.
 
Launched this month, the adverts advise patients they can access treatments for shingles, psoriasis and urinary tract infections (UTIs), as well as contraception and travel vaccinations at their chemist without a visit to the GP.
 
The slogans include ‘I need to get this UTI treated’, ‘my psoriasis has flared up, I need treatment fast’, and ‘this looks like shingles, I need to treat it fast’, with the solution to each being ‘get it at the chemist without a visit to the GP’.
 
The campaign promotes the state’s pharmacy prescribing program, which offers free consultations for specific conditions – but RACGP Victoria Chair Dr Anita Muñoz says it sends out a very unhelpful message.

‘To have a subliminal message … saying that schemes that help you avoid seeing the GP are inherently good schemes that are endorsed by the Government is extremely problematic,’ she told newsGP.
 
The ads are included among the Victorian Health Department’s ‘Resources for pharmacists’ for the Community Pharmacist Program, which is being presented to the public as Chemist Care Now.
 
It also includes details on the protocols and online training required for pharmacists to participate in the program, which offers pharmacies a $20 payment for consultations for shingles, plaque psoriasis flare-ups, uncomplicated UTIs and resupply of contraceptive pills.


The messaging of the adverts towards general practice has been strongly criticised.

However, Dr Muñoz warned that the program risks increasing fragmentation of care and could ultimately contribute to a more expensive health system, as well as noting the potential conflict of interest involved in both prescribing and dispensing.
 
‘The issue here is that the narrative associated with pharmacy prescribing overlooks the basic premise that in order to use medicines rationally, safely and effectively, the starting point is having an appropriate diagnosis made,’ she said.
 
‘The use of the protocol is attempting to get around the fact that in order to be a good diagnostician, you actually need years of education and years of training and is trying to protocolise medical conditions so that people without that training can prescribe.
 
‘The best place for a patient with the medical condition is with their GP or their general practice.’
 
The college advocates for increasing the role of pharmacists in multidisciplinary GP-led care teams, an approach supported by Dr Muñoz.
 
‘It is not done overseas in retail shops, and all of these schemes are designed to be carried out in a retail shop environment,’ she said.

‘I don’t believe that is the right place for Victorian patients to be getting what should be confidential care, but also continuity of care, and comprehensive care.’
 
In response, a Victorian Health Department spokesperson said the program is making it faster to treat ‘a range of common conditions’ and has delivered 58,000 services across hundreds of the state’s chemists.
 
‘We know our hard-working GPs provide the comprehensive care that families need, but this can now be complemented by in-pharmacy treatments,’ they told newsGP.
 
‘Patients are advised that while the pharmacist may be able to assist with specific conditions, patients should still see their doctor about their overall health and for any serious health concerns.’
 
The spokesperson said pharmacists are asked to provide information to the patient’s usual doctor after a consultation, and that a national process being led by the Pharmacy Board of Australia would also ‘address the issue of any conflict of interest in pharmacy prescribing’.
 
The Victorian pilot program began in October 2023 after similar programs were launched in Queensland and New South Wales.
 
Initially planned for a year, the program was then extended until 30 June 2025. In May this year, the Victorian Government confirmed the pilot would become permanent.
 
An evaluation shows 87% of patients surveyed would have used a GP if the pilot was not available, and that no serious safety concerns were reported.
 
It also found 13% of patients seeking treatment for a UTI had symptoms that did not resolve. 

When the pilot first began, participating pharmacists were allowed to prescribe for shingles, a flare-up of mild plaque psoriasis, uncomplicated urinary tract infections, as well as resupply of select oral contraceptive pills. That list later expanded to cover allergies, type 2 diabetes, asthma, ear infections, smoking cessation support, and minor wound care.
 
The Victorian Health Department has flagged the potential of further expansion, stating that ‘participating pharmacies will be notified as new services become available and will be given information about training requirements and how to add services’.  
 
For Dr Muñoz, the campaign also raises questions about the direction of funding at a time when clinics such as Melbourne’s cohealth have had to cut back on general practice services due to financial pressures.
 
‘I don’t understand why the State Government says that it doesn’t have any money to support cohealth, but it is able to find $18 million to pay for Victorian patients to be seen for free in pharmacies,’ she said.
 
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