News
Pushback against Premier’s nationwide pharmacy prescribing call
Dominic Perrottet is set to raise the topic at National Cabinet, but the RACGP is urging leaders to prioritise patient safety ahead of pharmacy profits.
Primary care reform is likely to be at the top of the next National Cabinet agenda, with Federal Health and Aged Care Minister Mark Butler set to table the Strengthening Medicare Taskforce report ahead of its release to the public.
But while general practice reform is expected to feature heavily in the report, NSW Premier Dominic Perrottet has flagged his own desire to promote independent pharmacy prescribing at the meeting, as a way of easing the strain on under-pressure state healthcare systems.
Independent pharmacy prescribing has long been opposed by the RACGP due to fears it would endanger patients and compromise care, and President Dr Nicole Higgins responded to the news by warning against replacing GPs with less qualified substitutes.
‘GPs train for well over 10 years in diagnostics, as well as doing ongoing training for the rest of our working life, in order to be able to diagnose patients,’ she said.
‘There is no substitute for GP care. This road leads to bad health outcomes and more pressure on our already overburdened hospitals.
‘Band-aid solutions will not solve Australia’s health crisis. It might be a cheaper option at first, but who wants cheaper if it means a serious illness is missed?’
Premier Perrottet’s call came shortly after the Pharmacy Guild of Australia sent a letter to all state and territory leaders promoting pharmacists’ ability to independently prescribe, claiming it would prevent 6.5 million trips to the doctor annually.
The estimate is reportedly based on a Guild-commissioned Ernst and Young (EY) economic analysis of the supposed financial and time-saving benefits should pharmacist prescribing be adopted nationwide. A Guild spokesperson told newsGP the report’s public release has been blocked by EY due to copyright.
It also came a day after Australian Electoral Commission records revealed that the Guild had given more than $577,000 to political parties in 2021–22, including $50,950 to the NSW Liberal Party.
Late last year the NSW Government announced separate pharmacy prescribing trials to allow pharmacists to independently diagnose and prescribe medications for several conditions, including UTIs, skin ailments and ear infections, but outcomes for these trials are also not yet available as they are either only in their infancy or have not yet started.
However, in expressing her opposition to the move, Dr Higgins cited adverse clinical outcomes stemming from a similar pilot program instituted in Queensland, which were picked up even without appropriate safeguards in place.
‘The pharmacy prescribing trial in Queensland was not a proper research trial. It did not evaluate health outcomes, and it cannot be used as evidence that such trials should be expanded,’ she said.
‘The RACGP and other medical bodies have long been warning about risky moves to allow retail pharmacists to prescribe antibiotics and other medications in Australia.
‘In Queensland, pharmacists prescribed antibiotics to 96.3% of patients with UTI-like symptoms, without taking urine samples to confirm if they actually had the infection. And there were reports of patients being given antibiotics who in fact had other serious health issues, including a woman with a 15-centimetre pelvic mass.’
Instead of pharmacy prescribing, the RACGP has urged the Government to overhaul Australia’s pharmacy ownership and location laws, which it says limit competition and make it harder for people to access discounted pharmacy services.
‘Australia’s pharmacy ownership laws are anti-competitive, and this inflates the cost to consumers, makes it harder for people to access medicines and reduces choice,’ Dr Higgins said.
‘There have been numerous reviews and reports on pharmacy ownership and location rules, and none of the recommendations to break up the monopoly or allow longer dispensing intervals have ever been actioned.
‘Supermarket pharmacies are widespread in most western nations, including the United States, the United Kingdom, and all over Europe. Why not here? It makes no sense, particularly in a country where we have so many rural and remote communities that don’t have a pharmacy nearby.’
The college has also said that patients would benefit ‘significantly’ if they could access a larger supply of medicines in one visit to the pharmacy via longer dispensing intervals and larger medicine pack sizes.
‘The Medicare Taskforce Review is about improving access to care for patients,’ Dr Higgins said.
‘We need to consider everything as part of this, including Australia’s anti-competitive pharmacy rules which have put Australia so far behind other countries when it comes to access to care and convenience for patients.
‘We [also] need serious investment in general practice care and long-term reforms that ensure all Australians have access to high-quality care, no matter their postcode or income.’
Log in below to join the conversation.
Medicare National Cabinet Pharmacy Guild of Australia pharmacy prescribing reform
newsGP weekly poll
How often do you feel pressure from patients to prescribe antibiotics that are not clinically necessary?