Can I prescribe …?
Most doctors know what the rules are for prescribing medicines in Australia. Or do they?
AMA members frequently ask whether they are able to prescribe in certain circumstances. The most common questions are:
- Can I prescribe for myself?
- Can I prescribe for my family?
- Can I prescribe for someone who isn’t directly my patient (a third party)?
- Can I backdate prescriptions?
It is understandable that doctors are uncertain, because there is no simple answer.
Prescribing in Australia is regulated by a range of laws.
For a medicine to be prescribed in Australia, the Therapeutic Goods Administration (TGA) must approve it for sale.
However, each State and Territory has its own laws regulating the prescription of medicines.
These laws determine who can prescribe, which medicines, in what circumstances, in what manner and for what purpose. In addition, specific conditions must be met to prescribe certain classes of medicines, such as some with Schedule 4 and Schedule 8 classifications.
These laws vary in each jurisdiction, so doctors must be careful they understand and comply with the laws in force where they practise.
A further layer of compliance is added for patients to receive a government subsidy under the Pharmaceutical Benefits Scheme (PBS) when they purchase prescribed medicines. Doctors must comply with requirements and restrictions under Commonwealth laws in order to prescribe under the PBS.
Finally, all doctors are bound by the Medical Board of Australia’s code of practice – Good Medical Practice – as a condition of their registration to practise in Australia.
So can doctors self-prescribe, prescribe for family or for a third party?
Here’s what the different laws say:
- Commonwealth, NSW, Queensland, Tasmanian and South Australian laws do not appear to prohibit self-prescribing, prescribing for family or for a third party.
- Doctors practising in Victoria cannot prescribe any S4 or S8 medicines for themselves or for a third party.
- In the Northern Territory, it is slightly more complicated. Doctors cannot self-prescribe S8 medicines or certain restricted S4 medicines, and cannot prescribe for a third party unless the third party is the partner of a patient being treated for Chlamydia who is also likely to have Chlamydia.
- In the ACT, doctors are only prohibited from prescribing for themselves if they are still an intern, or the medicine is a restricted medicine.
- WA law simply prohibits prescribing for the purpose of self-administration.
Good Medical Practice cautions against prescribing for self, family, friends or “those you work with”.
It recommends “seeking independent, objective advice when you need medical care, and being aware of the risks of self-diagnosis and self-treatment”.
It also advises doctors to “avoid providing medical care to anyone with whom you have a close personal relationship … because of the lack of objectivity, possible discontinuity of care, and risks to the doctor and patient”.
No State or Territory law appears to specifically prohibit backdating of prescriptions. Interestingly, neither does Commonwealth law. While the PBS website states that prescriptions must be not backdated, in fact neither the National Health Act nor the National Health (Pharmaceutical Benefits) Regulations provide any power to enforce this.
However, all prescribing-related laws require that the prescriber signs and dates prescriptions. It is likely that the intention, while not enforceable, is that the date is contemporary with the signature.
In summary, it is important that you understand the laws in force in the State or Territory in which you practise. Don’t rely on hearsay (or this article), because laws change or can be misinterpreted without legal expertise.
If in doubt, check with the drugs and poisons unit in your State/Territory. The TGA maintains up-to-date contact details on its website at: www.tga.gov.au/industry/scheduling-st-contacts.htm.
Information about PBS prescribing rules is available at www.pbs.gov.au.
Good Medical Practice is available at: www.medicalboard.gov.au/Codes-Guidelines-Policies.aspx.
The AMA’s website also maintains a summary of prescribing rules information and links to other sources at node/12303 or you can go to the ‘resources’ tab on our homepage and look under ‘FAQs’.