A joint letter from the AMA and RACGP has criticised a Pharmacy Board proposed model of greater prescribing rights for pharmacists.
A joint letter to the Pharmacy Board of Australia has been sent from the AMA and RACGP criticising the board’s proposal of broadening pharmacy prescribing.
The model was proposed in response to a health minister request to establish a nationally consistent model for endorsement of pharmacists to prescribe scheduled medicines.
“If the pharmacy owners lobby can’t appreciate the risks of being the prescriber, dispenser, and custodian of drugs of addiction, they can’t appreciate the inherent risks of what they’re lobbying for,” RACGP Victoria Chair Dr Anita Munoz told The Medical Republic.
“It also tells me they are not who you should go to for advice on what’s safe.
“Pharmacists, GPs, and other health practitioners work in teams for a reason – because patient safety must be our top priority, not profits.”
The proposed push from the board would see a widened scope of practice for pharmacists as “endorsed pharmacist prescribers”.
The AMA and RACGP urged for reconsideration of the proposal consultation process.
Conflict of interest was the joint letters primary argument, with how the proposed model could infringe on the separation of prescribing and dispensing.
“It’s unsurprising that business owners want deregulation, up to and including for Schedule 8 drugs,” Dr Munoz told TMR.
“The Guild speaks about this as though they represent pharmacists, but it’s the pharmacy business owners’ lobby – and it’s the prescriber that bears the responsibility and accountability for prescribing decisions.
“If you want to know what pharmacists consider safe, ask a pharmacist, not a spokesperson for the Pharmacy Guild.”
The Pharmacy Guild responded strongly to the criticism from the peaks.
“A recent media release from the doctor lobby groups about pharmacist prescribing, fails to distinguish between allegations and opinions and contains no actual evidence,” a spokesperson for the Guild said.
“These practices are not new, they are well-established and have contributed to patient safety and access for decades.
“Every day, pharmacists across Australia identify and correct thousands of prescribing mistakes made by other prescribers.
“These same skills and knowledge form the basis for pharmacists to undertake additional training to qualify as an autonomous pharmacist prescriber.”
A spokesperson for the Pharmacy Board of Australia and AHPRA told TMR:
“We acknowledge the long-standing concerns from the medical profession around potential fragmentation of care, conflicts of interest and clinical governance.
“These issues will be a key focus of the consultation and the Board’s consideration in preparing a draft registration standard and guidelines for the consideration of Health Ministers.”
In the Guild’s response to the AMA/RACGP letter, similar overseas models were highlighted as a key reasoning for the model’s credibility.
The AMA and RACGP have argued that most of those overseas models are based on collaborative models of care, meaning that pharmacists would need to integrate into broader clinical teams to reduce fragmentation of patient care.
AMA president Dr Danielle McMullen said that the Pharmacy Board showed a complete disregard for any meaningful discourse in the recent national forum.
This came in conjunction with reportedly restricted opportunities for stakeholders to express concerns over pharmacists prescribing Schedule 4 and 8 medicines.
“The board set the forum up in a way that ensured any opposing views — even when grounded in rigorous evidence and supported by data — were discouraged,” Dr McMullen said.
“Australia has traditionally restricted prescribing to medical practitioners, which remains the safest and preferred model.
“If health ministers and the board are intent on changing this, it’s important to recognise that global evidence shows the most effective non-medical prescribing models involve pharmacists working as part of a collaborative clinical team.”
Following on from criticisms earlier in the week, RACGP president Dr Michael Wright has said that patient safety must remain the core pillar of any healthcare reforms.
“Recent discussions around pharmacy prescribing have raised serious concerns,” Dr Wright said.
“We’ve already seen the risks of prioritising profit in the telehealth space, and it is critical that these mistakes are not repeated in the rollout of pharmacy-based prescribing,” Dr Wright said. “Of particular concern is the absence of safeguards around Schedule 8 medications, and the broader risks of fragmented care and patient confusion when multiple providers deliver overlapping services. The future of healthcare is collaborative, and that collaboration must be safe, structured, and centred on patient wellbeing.”
