The health minister has opened Commonwealth coffers to support pharmacists in their scope of practice quest.
Pharmacist-led prescribing has cleared yet another hurdle on its journey to official, mainstream status in the form of federal funding for a national contraceptive and UTI prescribing trial.
Speaking at the Australasian Pharmacy Professionals (APP) conference at the Gold Coast on Friday, federal health minister Mark Butler confirmed that scripts written by community pharmacists would be subsidised to the same level as those written by PBS-eligible prescribers from January 2027.
While pharmacists in virtually every state and territory now have the ability to write prescriptions for oral contraceptives and antibiotics, patients have traditionally had to pay entirely out of pocket both for the consultation and for any medicines they get dispensed as a result.
Mr Butler’s announcement marks the first time that the federal government has directly funded pharmacist-led prescribing.
The significance was not lost on Pharmacy Guild of Australia president Professor Trent Twomey.
“I’ve been telling you for years, as we go on this scope of practice journey, it is about state and territory enablement and then it is about federal government funding,” he told APP delegates.
“And this is the very first of all of those conditions that full scope of practice pharmacists are trained to do, where funding is unlocked not just to cover the out-of-pocket expenses for the consultation but to ensure that there is no difference in the cost of the medicines whether [patients] go to a PBS prescriber or to a community pharmacy.
“This is the first of 23 conditions that we’re going to have conversations with Mark [Butler] about, but let’s bed this one down first.”
To be clear, this funding has been on the cards for some time; a national pharmacist-led prescribing trial was announced in February 2025 as part of a pre-election pledge.
At the time, around $100 million was put aside for two national pharmacist-led prescribing trials targeting female concession card holders – one for women seeking contraceptives and one for women with “uncomplicated” cystitis.
It was originally slated to begin in early 2026.
Mr Butler said the fact that multiple states and territories had either ongoing trials or had made pharmacist-led prescribing permanent had spurred the federal government to action.
“If women choose to access their contraception via a pharmacy, in line with the rules … within their state or territory, we as a government must support them with cost,” he said, during his APP address.
“I’ve now asked my department to begin the work to implement a trial outside of the PBS that could benefit thousands of concession card-holding women.
“Under that trial, concession cardholders between the ages of 18 and 55 years will be able to access pharmacy-prescribed contraceptives, consistent with state regulations, as well as antibiotics for uncomplicated UTIs the concession rate of $7.70.”
According to Mr Butler, all states and territories, bar New South Wales and the ACT, allow pharmacists to initiate oral contraceptive prescriptions. NSW and the ACT only allow pharmacists to write continuation prescriptions.
If the rules in NSW and ACT remain unchanged, the pharmacists in those two jurisdictions will only be able to write continuation prescriptions, even as part of the national trial.
It is unclear at this stage how pharmacists will be remunerated for the consultation aspect of the trial, but the initial 2025 announcement did make it clear that patients would not pay out-of-pocket for this component.
Neither Mr Butler nor Professor Twomey addressed the recent criticism from medical advocacy bodies regarding pharmacist-led contraceptive prescribing in Victoria.
Nor did they address the 2021 TGA advice on hormonal contraceptives, which specifically concluded that the adverse effects of oral contraceptive substances and the potential for evolving risks over time were significant enough to require management by a medical practitioner.
Speaking at a press conference following Mr Butler’s address, Pharmacy Guild of Australia councillor Cate Whalan said the trial represented a chance to empower vulnerable women.
“This is about giving women choice, and it’s also about empowering women to make decisions not based on financial cost and not based on where they live and who they see,” she said.
“Women can choose whether they see a GP or whether they see their pharmacist. The choice is back in the hands of women.”
AMA president Dr Danielle McMullen begged to differ.
“With the oral contraceptive pill, we think there is a significant difference between continuation of a medical prescription and initiation of the new one, where we amplify the risks of really limiting choice for women,” she told The Medical Republic.
“At that [pharmacist] point of care, there aren’t options like long-acting, reversible contraceptives available.
“They may not have the full suite of medications available on their formulary, and the selection of a contraceptive is a really personal decision that weighs up people’s medical history and personal preferences and a range of other factors.”
The Queensland-based GP said it was “deeply disappointing” to see the 2021 TGA decision on oral contraceptives ignored.
“From a funding perspective, this trial is being done outside of PBS, and so therefore hasn’t been through PBAC committees and otherwise,” Dr McMullen said.
“That’s an issue that we are raising directly with the department and the minister’s office.
“This has been couched as a trial, but we will be keenly pushing for [information on] … the outcomes data.
“What makes this a trial? What are the outcomes that are required, and when will it go to an evidence-based process?”
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RACGP vice president Dr Ramya Raman took aim at the guild’s cosy relationship with lawmakers; just last week, the Australian Financial Review reported that Professor Twomey paid up to $110,000 to attend prime minister Anthony Albanese’s birthday dinner fundraising event.
“Women’s health is not a pilot project,” Dr Raman said.
“Australians deserve to know why their government is overriding the advice of the nation’s independent medicines regulator, advice that exists for one reason – to keep people safe.
“This is not a question of access versus safety. It is about whether expert, evidence-based medical advice is being respected, or whether political pressure and large political donations are being allowed to dictate health policy.
“Donations don’t equal data. When the loudest lobby is also the largest political donor, Australians deserve maximum transparency and independent evaluation. Publish the safety outcomes.”
ACRRM president Dr Rod Martin questioned why the government, which has just put additional funding toward training GPs to insert long-acting reversible contraceptives, would put more money toward shorter-term solutions like oral contraceptives.
“It’s not in the best interest for a pharmacy to have someone have a long-acting contraceptive because they’re not coming back 12 months’ time to have their next pill script,” he told TMR.
“… Does that mean we’re going to see fewer and fewer long acting contraceptives, which are a game changer?”
Mr Butler also gave a short update on the national medicines register during his APP address, acknowledging the danger inherent when a patient is being prescribed medicines by multiple providers.
“… [Twenty-four-year-old] Erin tragically died by overdose in August last year on medications prescribed through multiple digital health platforms by providers who, frankly, didn’t have sufficient regard to this young woman’s medicines history,” he said during his APP address.
“As a first step to strengthen safety in digital medicines and telehealth, we’re going to implement requirements to ensure that all medicines-related information from online prescribers is made available to consumers and their health care providers through My Health Record.
“This is going to include medicines prescribed and dispensed through online platforms, including the clinical context for prescribing to help avoid harm to patients due to medication errors, adverse drug reactions, or, importantly, inappropriate use or prescribing.
“I know a national medicines record matters to pharmacists, who are just so central to medicine safety and continuity of care.
“And it obviously matters to patients, because for the first time their healthcare team will have a complete picture of their medicines.”
