Approximately 900,000 Australian women will have access to pharmacy treatment for uncomplicated UTIs and for the initiation or re-supply of hormonal contraception.
Health minister Mark Butler announced today that patient eligibility for the incoming national pharmacist-led prescribing trial would be drastically expanded from women with concession cards to all Australian women.
This will take the pool of potential participants from an estimated 250,000 to an estimated 900,000.
The women’s health trial, set to begin in February 2027, will run for 12 months and provide women with greater access to “timely, affordable, and convenient care” for both urinary tract infections and the oral contraceptive pill.
To be clear, the trial will not involve any new regulations or powers on a federal level; what it will do is trial government funding to cover the cost of a pharmacist consultation and to subsidise any resulting prescription up to the regular PBS co-payment.
In all pharmacist-led prescribing trials thus far, either states or patients have covered consultation costs and patients have paid out-of-pocket for private scripts, because pharmacists cannot write PBS-subsidised prescriptions.
Women would not be required to have seen a GP before accessing hormonal contraception if state or territory rules permit it, the government said.
Currently, women in NSW, Queensland, Tasmania, and Victoria can receive a new or different type of contraceptive pill prescription without first seeing their GP.
The government will cover the cost of pharmacy consultations, saving women up to $38 per visit, and that women would not pay more than $25 per script, with concession card holders paying $7.70.
But Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) President Dr Nisha Khot questioned whether that would cover what pharmacists would actually charge.
The distinction between “uncomplicated” UTIs and those requiring referral could mean serious conditions, including cancer, were missed, she said.
“I feel uncomfortable with this decision,” she told The Medical Republic.
Receiving oral contraceptives from pharmacist prescribers also prevented the opportunity to discuss fertility planning, cervical cancer screening, vaccination and pre-pregnancy planning with their GP, Dr Khot said.
Assistant minister for women Rebecca White said the trial would ensure patient safety by first testing how the pharmacy model would operate in practice, including assessment, referral and follow-up, “before any decision about its future is made”.
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RACGP President Dr Michael Wright told TMR it was “really concerning” that the trial had been expanded before it officially began, and pointed to the TGA’s interim ruling against the over-the-counter sale of oral contraceptives.
“We haven’t seen any new evidence nor understand a rationale as to why this trial’s been broadened,” he said.
In a September open letter, the college urged the government to conduct an independent evaluation of the initial proposed trial for concession card holders.
“We are concerned, particularly that women aren’t going to have access to the full range of contraceptive options they deserve,” the RACGP president said.
RACGP President-elect and WA chair Dr Ramya Raman said hormonal contraception carried established risks, including elevated risk of strokes and blood clots, particularly during periods of hormonal change.
“Women’s health is not a pilot project. Australians deserve maximum transparency and independent evaluation. Publish the safety outcomes,” she said.
President of the Rural Doctors Association Australia NSW branch Dr Rachel Christmas said the initiative to reduce the cost of medication nationally was “fantastic”, but access should not come at the cost of quality care.
“[The government is] doing this under the guise of a trial because a trial says we do a select population for a select period of time in select pharmacies,” she said.
The latest expansion, now available to all women, builds on the government’s initial March announcement that an estimated 250,000 concession card holders aged 18 to 55 years could access treatment for uncomplicated UTIs and oral contraceptives at a subsidised rate of $7.70.
“What worries me is that they are diluting a contraceptive conversation,” Dr Christmas said, including STI screening or alternate contraceptive options.
For women in rural and remote communities, whose access to sexual health clinics was already limited, access did not equate to quality and safe care, she told TMR.
Better coordination between general practice and pharmacy was necessary to prevent fragmentation of care, where symptoms treated in isolation could impede comprehensive longitudinal care, Dr Christmas said.
Pharmacy Guild of Australia president Professor Trent Twomey said community pharmacy was the nation’s “most accessible primary healthcare destination, with more than 6,000 community pharmacies open earlier, later and longer than other healthcare providers.”
The Pharmacy Guild said UTIs were Australia’s most common acute, potentially preventable hospitalisation, accounting for more than 90,000 hospitalisations in 2024-25, and that one in four women who needed to see a GP had waited longer than they thought appropriate.
Professor Twomey said the national trial would build on years of specially trained pharmacists delivering these services safely and that patients deserved a “nationally consistent framework” so that all women had access to “high-quality, safe services” irrespective of where they lived.
