Specialist colleges in united front against pharmacy prescribing

Australia’s 15 specialist colleges have come out in opposition to independent pharmacist prescribing, placing further pressure on state and territory governments to pause or scrap various pilot programs initiating the controversial practice.
 
While the RACGP has long voiced its opposition to pharmacist prescribing schemes, many of the other specialist colleges have stayed silent – until now.
 
As reported in Australian Doctor, the Council of Presidents of Medical Colleges (CPMC) has expressed alarm at state government schemes that appear to bypass the Therapeutic Goods Administration’s (TGA) scheduling system by establishing programs that will allow pharmacists to prescribe some Schedule 4 (S4) medicines such as antibiotics and oral contraception.
 
CPMC Chair Adjunct Professor Vijay Roach, a gynaecologist and obstetrician, told the publication that prescription of S4 medications ‘should not be within the purview’ of non-medical practitioners.
 
‘We are concerned that a move to pharmacy prescribing is inconsistent with good practice and the established TGA scheduling system, which protects patients from potential harm,’ he said.
 
‘When it comes to pharmacist prescribing, who is responsible if there are side effects or complications, or if the patient is not responding to treatment?
 
‘What processes are in place? Medical conditions requiring S4 medication require medical input prior to and/or after treatment. The medication may not be the only assessment required.’
 
RACGP President Dr Nicole Higgins told newsGP the CPMC’s public support is a major win for patient safety and represents united opposition to pharmacy prescribing across medicine.
 
‘I spoke to the 14 other presidents at a meeting last month to explain the RACGP’s position on pharmacy prescribing and am thrilled to see that we’re all on the same page,’ she said.
 
‘Medicine can be an inexact science and different specialties often disagree on the best course of treatment for patients. The fact that we are all opposed to this move speaks volumes.
 
‘This isn’t about turf wars or doctors lashing out against pharmacists – it’s about patient safety and ensuring that limited healthcare dollars are being used where they are most needed.’
 
Queensland has already permanently established a pharmacy prescribing scheme for the treatment of apparent uncomplicated UTIs, while it is also ramping up preparations for an expanded pilot program in north Queensland.
 
New South Wales and Victoria have also recently announced their own UTI schemes modelled in-part on the Queensland pilot, while other states and territories are reportedly considering similar moves.
 
However, Dr Higgins says it is not too late for state and territory governments to heed the advice of doctors and pause the various pharmacy prescribing schemes being set up across the country.
 
‘There are better ways for state governments to invest their taxpayers’ hard-earned money than to line the pocket of pharmacy owners for the provision of sub-standard care,’ she said.
 
‘We value pharmacists’ contribution to Australian healthcare and their expertise in relation to medicines, but we can’t allow pharmacy owners to put profits ahead of patients – especially when there’s so much risk involved.
 
‘We need to look at solutions that will improve patient access to specialist general practice care now and into the future. It is the only way to keep people healthy and ease the pressure on our ailing hospital system.’
 
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Council of Presidents of Medical Colleges pharmacy prescribing Schedule 4 medications