‘We can do more’: pharmacists call for expansion of emergency prescription powers 

When bushfires ravaged the country across 2020, the government announced the continued dispensing emergency measure, allowing pharmacists to provide medications without a repeat prescription in emergencies. 

It meant that if a patient was unable to schedule a GP appointment, had been taking the medications within the past three months for a stable condition, and it was necessary and safe to do so, a pharmacist could renew their prescription.

The program was temporary and scaled back at the end of June, though has been replaced with ongoing continued dispensing programs that allow pharmacists to prescribe medicines for the management of chronic health conditions such as asthma, diabetes, high cholesterol and heart disease.

As floods cause mass evacuations across the east coast, Pharmaceutical Society of Australia national president Dr Fei Sim is calling for an extension of the powers to assist those in need and help ease the GP shortfall. 

“The continued dispensing program was so successful and so needed that it continued from the bushfires across the pandemic,” Dr Sim told Crikey, adding pharmacists could now only prescribe around 100 medicines, down from 900 under the emergency program.

“But the consequence [of reducing the eligible medicines] means things like antidepressants, antiarrhythmics for abnormal heart rhythms or epilepsy medicines such as anticoagulants — different medicines that people need to take on an ongoing, routine basis — can’t be dispensed [without a prescription].”

Pharmacists providing these kinds of medications, even for those evacuated from floodwaters, would be breaking the law, Dr Sim said. 

She’s also calling for pharmacists to work more closely with GPs to allow “collaborative prescribing” to allow continued dispensing of particular drugs for people with certain ongoing conditions. 

A trial is currently underway in Queensland to allow pharmacists to diagnose and prescribe drugs for 23 conditions, ranging from type 2 diabetes to heart conditions. The Australian Medical Association is against the trial, arguing it puts the public at risk and pharmacy profits before patients. 

Royal Australian College of General Practitioners president Dr Karen Price has also voiced concerns about the proposed expansions, questioning their efficacy given pharmacies often have the same opening hours as GPs and the ethics of putting pharmacists on the patient frontline.

Australia has been in the grips of a decade-long GP shortage, with a predicted deficit of 11,517 GPs by 2032. Nearly half say it’s financially unsustainable for them to continue working as a GP as practices turn away from bulk billing due to low Medicare rebates. The decrease has been exacerbated by COVID-19, with 73% of GPs reporting they experienced feelings of burnout across the past year. 

It’s not the first time pharmacists have pushed for more prescribing powers: last year Monash University conducted a federally funded trial for pharmacists to offer counselling on birth control options for those seeking emergency contraception and dispensing oral contraceptive pills without a prescription. The trial is still underway.

Pharmacists also aren’t immune from the nationwide workforce shortage, especially in regional areas. But, Dr Sim said, greater collaboration between GPs and community pharmacies could ease the burden for both professions. 

“We need to look outside the box about how can we more effectively and efficiently administer health care to allow health professionals to practice to the top of scope care,” she said. 

“GPs’ skill sets are so much better utilised in more complex conditions.”

The Health Department and Health Minister Mark Butler have been contacted for comment.