AMA Victoria says the government should not only reverse the Chemist Care Now expansion but also abolish it completely – effective immediately.
A week after Victoria expanded pharmacist prescribing, AMA Victoria says the model further fragments care and increases risks to patients.
Under the latest Chemist Care Now expansion, launched on 7 October, participating pharmacists can dispense a one-month resupply of menopausal hormone therapy (MHT) and initiate treatment for gastro-oesophageal reflux disease.
AMA Victoria president Dr Simon Judkins acknowledged the convenience for women, particularly in rural and remote regions, of being able to obtain prescription MHT resupplies when away from their regular GP or unable to book in time.
However, he said the government was expanding a fundamentally flawed model that put patients’ healthcare at risk through an “obvious direct conflict of interest”, placing “profits first and patient welfare second”.
“We have now created a situation in Victoria where the same business that decides whether a patient needs a specific medication is the same business that profits from supplying it,” he said.
Women eligible for MHT resupply must be aged 45 to 59, or aged 30 or older with surgical menopause. They must have seen their GP within the past 12 months and have used the same MHT for at least 6 months.
Consultations for eligible patients would be free, and pharmacists would be required to have completed postgraduate training, which, according to the Pharmacy Guild of Australia, would give Victorian women greater access to safe, timely, cost-effective and conveniently located care.
“The addition of MHT, particularly to the list, is to be commended,” said Pharmacy Guild Victoria president George Tambassis.
However, medicines supplied through Chemist Care Now are not PBS-subsidised, a point previously raised by RACGP Victoria chair Dr Anita Muñoz, who warned that it would cost patients more than GP-prescribed medications.
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Before dispensing medication, pharmacists would be required to conduct a thorough consultation in a private room, outline potential risks, and refer cases requiring further care to a medical practitioner.
Dr Judkins remained unconvinced.
“Convenience is very different to good medicine,” he told TMR.
“A one-off [pharmacy] consultation about getting a prescription is not holistic care. It’s convenient care, and it’s retail therapy,” the AMA Victoria president said.
“Reflux care involves assessing symptoms, reviewing treatment, and deciding whether further investigation is needed. The provision of medication is only one part of that care.
“Menopausal hormone therapy likewise requires individual assessment and ongoing medical review. Even a one-month resupply involves a decision about whether treatment remains safe and appropriate,” he said.
Dr Judkins said an independent audit of patient outcomes was necessary and cited the lack of robust evidence supporting the initiative as a point of concern.
“The Government should reverse this expansion, abolish Chemist Care Now and strengthen access to GP-led care,” he said.
Dr Judkins told TMR the federal government’s push to increase bulk billing through the BB PIP was only making it more difficult for GPs to provide quality, continuous care.
RACGP women’s health expert Associate Professor Magdalena Simonis, by contrast, said on Friday that the expansion was a “sensible move” but affirmed the need to maintain GPs’ role as the “overall care custodian”.
A total of 23 common health conditions are expected to be under pharmacists’ full scope of practice in Victoria by mid-next year.
Chemist Care Now has delivered more than 100,000 services across more than 900 pharmacies since October 2023 – 68% of which have been accessed by women, and 26% of participating pharmacies are located in rural and regional areas.
The latest expansion follows the Pharmacy Guild of Australia’s aim for community pharmacists to be the “first port of call” and its goal of having 80% able to prescribe by 2035.
