Perrottet pledges pharma prescribing for UTIs, pill

4 minute read

The profit-motivated Pharmacy Guild expects a return on its investments, according to the RACGP president.

If the NSW Liberal-National party is re-elected next month, women in Australia’s most populous state will have access to pharmacist-prescribed antibiotics for UTIs and oral contraceptive pills.

And the state will foot the bill for the appointment, with women needing only to cover the cost of the medicine.

The pre-election pledge adds further detail to the initial announcement of the programs made late last year.

Though they were announced together, the UTI trial will be separate from the OCP pilot.

The UTI trial would allow pharmacists to assess for, prescribe and dispense antibiotics to non-pregnant women presenting with uncomplicated cystitis.

It is understood that NSW will replicate Queensland’s UTI prescribing trial, which was made into a permanent program last year.

All going to plan, the NSW UTI prescribing trial will kick off on April Fools Day, less than a week after the state election.

The OCP pilot is slated to begin on 1 July and would allow pharmacists to continue dispensing the contraceptive pill by “extending” a script issued by a doctor or nurse practitioner any time in the previous two years.

In late 2021, the TGA made an interim recommendation against down-scheduling the OCP and making it available over-the-counter.

A spokesman for NSW Health Minister Brad Hazzard confirmed that the state government had reviewed the TGA decision.

“The NSW government has reviewed the … submissions made in that process, and has considered what pharmacists already provide within their scope of practice,” the spokesman said.

“This is why patients need to have been issued a script for the oral contraceptive pill in the past two years by a medical or nurse practitioner; the oral contraceptive pill needs to be provided for contraception only; the oral contraceptive pill type will be medicines with a lower risk of severe side effects; and the age range is 18-35 years.”

The University of Newcastle will design and implement the pilots and NSW Health will organise additional training for participating pharmacists.

The Pharmaceutical Society of Australia said its NSW vice president Dr Sarah Dineen-Griffin, a lecturer at the University of Newcastle, had been instrumental in getting the UTI trial up and running.

Federal Health Minister Mark Butler welcomed the announcement as an opportunity to ease pressure on GPs in a time of “skyrocketing demand for quality healthcare”.

NSW Minister for Regional Health Bronnie Taylor said that pharmacist-led prescribing was a response to the GP workforce shortage.

“We know that the GP shortages in the bush are blowing out appointment wait times to days and even weeks,” she said.

“This reform will ease the pressure on primary care and ensure women are able to get the help they need, when they need it.”

RACGP president Dr Nicole Higgins questioned whether the trials would really be in the interest of women.

“Women deserve better … our Aboriginal women and our vulnerable and marginalised women need whole-of-person support,” she told The Medical Republic.

“It’s not just about access.”

Dr Higgins, who is also serving as a special advisor to the Women’s Health Taskforce, said there was no such thing as “just a script”.

“[That yearly appointment] is an opportunity to discuss better contraceptive options and also to review what’s changed since that original prescription,” she said.

“It may be that since that time, their risk has changed – they’ve gotten older, or they may have developed other medical problems such as high blood pressure where the contraceptive pill is no longer the best option.”

The Pharmacy Guild has been the driving force behind the push for pharmacist-led prescribing, Dr Higgins said.

“[The Guild] have been lobbying the government hard so they can increase profits,” she said.

“The Pharmacy Guild is the sixth-biggest political donor in Australia and expects a return on investment.”

The AMA has also come out swinging.

“The Premier is ignoring the considered medical advice of the [TGA] to pad pharmacy profits at women’s expense,” said AMA NSW president Dr Michael Bonning.

The government, he said, should instead pursue models that contribute to care in a collaborative way, like integrating pharmacists into GP practices.

So far, NSW Labor’s plan for health doesn’t contain any measures pertaining to primary care.

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