CONTINUED DISPENSING BY PHARMACISTS

7 Aug 2013
‘Continued dispensing’ is a joint Commonwealth Government and Pharmacy Guild of Australia initiative that effectively allows pharmacists to supply a standard pack of an eligible PBS medicine to patients who request it without a prescription from a medical practitioner.

The Federal AMA lobbied hard to oppose legislation to allow ‘continued dispensing’ within the Pharmaceutical Benefits Scheme, including writing to all Federal parliamentarians to explain the risks to patients, however the legislation was passed last year.

Legislation in the Australian Capital Territory, New South Wales, Western Australia, Victoria, South Australia and Tasmania has now also been amended to specifically provide for ‘continued dispensing’ and may be passed in other jurisdictions over the next few months.

The eligible medicines under ‘continued dispensing’ are:

  • oral hormonal contraceptives for systemic use.
  • lipid modifying agents, specifically the HMG CoA reductase inhibitors (‘statins’) as listed in the Schedule of Pharmaceutical Benefits.
(Refer list below.)

The practice guidelines issued by the Pharmaceutical Society for Australia states pharmacists can supply these medicines by continued dispensing if they consider:

  • there is an immediate need for supply of the medicine to facilitate continuity of therapy, and it is not practicable for the patient to obtain a prescription for the medicine from an authorised prescriber;
  • the medicine has been previously prescribed for the patient, their therapy is stable, and there has been prior clinical review by the prescriber that supports continuation of the medicine;
  • there is an ongoing need for supply and the medicine is safe and appropriate for that patient.
The pharmacist must also be able to identify the most recent prescriber of the requested medicine and their practice address.

The practice guidelines also state that pharmacists will need to balance the risk to patients of delaying review by their medical practitioner with the benefit of continuity of therapy.

Pharmacists must advise the patient’s medical practitioner within 24 hours that the medicine has been supplied without a prescription. Information must include

  • patient details
  • date medicine supplied
  • medicine details
  • reason for supply by continued dispensing
  • declaration co-signed by the patient indicating their understanding and consent to the supply.

The AMA recommends you keep a copy of this notification on your patient's file.

Pharmacists must not supply these medicines to a patient if the medicine has already been supplied by any pharmacy by continued dispensing in the previous 12 months.

Continued dispensing is supplementary to existing urgent or emergency supply provisions existing in each State and Territory.

Continued dispensing - eligible PBS medicines

Oral hormonal contraceptives
  • Levonorgestrel
  • Levonorgestrel with Ethinyloestradiol
  • Norethisterone
  • Norethisterone with Ethinyloestradiol
  • Noresthisterone with Mestranol

Lipid modifying agents

  • Atorvastatin
  • Fluvastatin
  • Pravastatin
  • Rosuvastatin
  • Simvastatin
Feedback

The AMA wants to hear about your experiences with continued dispensing.

In particular:

  • Have you been contacted by pharmacists to establish that you have recently reviewed the patient for that medication?
  • Is the information provided to you by pharmacists after continued dispensing has occurred useful?
  • Has there been an impact on the management of your patient?
Please forward any comments to: ama@ama.com.au