CONTINUED DISPENSING – FACTS FOR AMA MEMBERS
Pharmacists can now dispense oral contraceptives and statins to patients without a prescription in six out of eight jurisdictions in Australia.
Under ‘Continued Dispensing’, a pharmacist can supply a standard pack of an eligible PBS medicine to patients who requests it, without requiring a prescription from a medical practitioner.
The Continued Dispensing initiative was developed jointly by the Commonwealth Government and Pharmacy Guild of Australia under the Community Pharmacy Agreement.
The AMA lobbied hard to oppose legislation allowing Continued Dispensing within the Pharmaceutical Benefits Scheme, including writing to all Federal parliamentarians to explain the risks to patients. Despite these efforts, the legislation was passed last year.
Legislation in the ACT, NSW, Western Australia, Victoria, Tasmania and South Australia has now also been amended to specifically provide for Continued Dispensing, and may be passed in the Northern Territory and Queensland in the next few months.
Eligible medicines under Continued Dispensing are:
· oral hormonal contraceptives for systemic use; and
· lipid modifying agents, specifically the HMG CoA reductase inhibitors (‘statins’), as listed in the Schedule of Pharmaceutical Benefits
It is important that medical practitioners are familiar with the conditions under which pharmacists can dispense.
The practice guidelines issued by the Pharmaceutical Society for Australia state that pharmacists can supply these medicines by Continued Dispensing if they consider:
· there is an immediate need for supply of the medicine to facilitate continuity of therapy, and it is not practicable for the patient to obtain a prescription for the medicine from an authorised prescriber;
· the medicine has been previously prescribed for the patient, their therapy is stable, and there has been prior clinical review by the prescriber that supports continuation of the medicine; and
· there is an ongoing need for supply, and the medicine is safe and appropriate for that patient.
The practice guidelines state that pharmacists will need to balance the risk to patients of delaying review by their medical practitioner with the benefit of continuity of therapy.
In addition, the pharmacist must:
· be able to identify the most recent prescriber of the requested medicine and their practice address;
· not supply the medicine to a patient if the medicine has already been supplied by any pharmacy by Continued Dispensing in the previous 12 months; and
· advise the patient’s medical practitioner within 24 hours that the medicine has been supplied without a prescription.
The AMA recommends you keep a copy of the pharmacist’s notification to you about a Continued Dispensing episode on your patient’s file.
Please refer to the AMA’s fact sheet on Continued Dispensing [continued-dispensing-pharmacists] for more detailed information, including the full list of eligible PBS medicines.
The AMA wants to hear about your experiences with Continued Dispensing. In particular:
· have you been contacted by pharmacists to establish that you have recently reviewed the patient for that medication?
· Is the information provided to you by pharmacists after Continued Dispensing has occurred been useful?
· Has there been an impact on the management of your patient?
Please forward any comments to firstname.lastname@example.org.