Federal pharmacy trial must look beyond prescription numbers: RACGP

On the same day as another state has further expanded pharmacists’ prescribing scope, the RACGP is urging the Federal Government to assess its national women’s health pharmacy trial on measures beyond prescription numbers.

From January 2027, women with concession cards will be able to access pharmacy prescribed contraceptives and treatment for uncomplicated urinary tract infections.  
 
It is estimated that during the 12-month trial, 250,000 women between the ages of 18–55 years will be able to access these treatments at the concession rate of $7.70.
 
But the RACGP has raised the question of how the success of this trial will be measured, calling for an independent evaluation considering outcomes for the patient and looking beyond the number of prescriptions.
 
It says questions such as was a prescription what was required, and did it help the woman get better, must be asked.

RACGP President Dr Michael Wright acknowledged that whilst improving access and affordability matters, the trial must also answer a simple question: does this model improve care for women? 

‘A prescription is not an outcome,’ he said. 

‘If this trial is going to help shape the future of women’s healthcare, we need to know what happens after the pharmacy visit. 

‘Did the treatment work? Did the woman need more care? Were important health issues picked up? And did the service connect her with the rest of her healthcare, or make that care more fragmented? 

‘The Government has called this a trial. It should give us clear answers to those questions – not simply tell us how many services were delivered or whether people found it convenient.’

The RACGP is calling for the trial to be independently evaluated and for outcomes to be compared with women receiving usual GP care. 
 
It said the pharmacy prescribing trial evaluation should also use existing health data to track what happens after treatment, including follow-up care and hospital presentations, and examine whether the model delivers value for patients and taxpayers. 
 
The call comes on the same day as New South Wales Premier Chris Minns announced that from 1 January next year, the state’s pharmacists will be able to administer all vaccinations in line with the National Immunisation Program.
 
‘I do want to emphasise, particularly for the childhood vaccinations, it’s not going to be a replacement or a substitute for GP appointments,’ he said.
 
‘We need both sectors working together, with pharmacists encouraging their patients to get those critical early checkups.’
 
Minister Minns also announced a pharmacy trial for treating ear infections and wounds, and to help patients manage chronic conditions including high blood pressure and chronic obstructive pulmonary disease.
 
‘Once we’re satisfied that it’s safe and effective, that it’s used by the public and a trusted part of healthcare in our state, we’ll implement it as a permanent change in New South Wales,’ he said.
 
‘We’re not at the point of announcing it yet, but I can also tell you that we are developing pharmacy supply of anti-inflammatory reliever for patients with mild asthma, as well as antiviral treatments in aged care facilities.’
 
It’s a move RACGP NSW&ACT Chair Dr Rebekah Hoffman describes as a ‘reckless gamble’.
 
‘The safeguards into general practice exist for a reason – to catch red flags, prevent misdiagnosis, use antibiotics appropriately and make sure patients get the follow-up care they need,’ she said.
 
‘The NSW Government is expanding pharmacy prescribing into more complex care when the evidence for the existing model remains weak. Health policy should follow the evidence, not the money.
 
‘The evidence is weak, but the political influence behind this policy is enormous and on public display.
 
‘Access matters. But access to care that hasn’t been proven safe and effective is not progress.’
 
Dr Wright added that recent independent reviews reinforce the importance of getting the evaluation right.

The Grattan Institute has called for rigorous national trials before expanding pharmacist prescribing services, while a separate Sax Institute review commissioned by the RACGP found significant gaps in high-quality evidence about the outcomes of many pharmacist prescribing models.  

‘Access should be the start of the conversation, not the end of it,’ Dr Wright said.
 
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