In the last few years there has been increasing interest in autonomous non-medical prescribing in Australia, with several pilots allowing non-medical prescribers to autonomously prescribe Schedule 4 (prescription only) medicines that are traditionally only allowed to be prescribed by medical practitioners. For example, the North Queensland Community Pharmacy Scope of Practice Pilot allows community pharmacists to undertake medication management, autonomously prescribe and dispense medicines for a range of acute conditions, and prescribe as part of chronic disease management. Another example is the Queensland Urinary Tract Infection Pharmacy Pilot, which allows pharmacists to autonomously prescribe and dispense antibiotics for the treatment of uncomplicated urinary tract infections in non-pregnant women aged 18 to 65. This pilot has now been permanently extended, with other states looking to also implement similar programs.
The facts
Pharmacy prescribing trials are not backed by evidence, and bypass the critical checks and balances that are intended to protect you.
Fact 1
Non-medical prescribing is when healthcare professionals who are not medical practitioners ― such as nurses, pharmacists, and physiotherapists ― are authorised to prescribe prescription only medicines to patients.
Fact 2
There are several types of non-medical prescribing which fall into two categories:
- Collaborative non-medical prescribing: where non-medical prescribers are authorised to prescribe as part of a collaborative or multidisciplinary team, often with medical practitioner oversight
- Autonomous non-medical prescribing: where non-medical prescribers are authorised to prescribe outside of a collaborative team, without medical practitioner oversight
Fact 3
The pharmacy prescribing trials sidestep Australia’s national governance frameworks and independent and expert advise, including:
Fact 4
Autonomous prescribing models create a potential financial conflict of interest, as the same healthcare professional can be responsible for both the prescribing and dispensing of a medicine, which contradicts The Pharmacy Guild of Australia’s recommendation regarding separation of prescribing and dispensing:
“The separation of prescribing and dispensing of medicines provides a safety mechanism as it ensures independent review of a prescription occurs prior to the commencement of treatment.”
This point was also raised by participants at the Pharmacist Prescribing Forum in 2018.
Fact 5
Analysis of comparable international non-medical prescribing models reveals that Australia is one of the only countries with autonomous pharmacy prescribing (see map below).
Autonomous pharmacy prescribing around the globe
Comparable countries analysed
circleAutonomous pharmacy prescribing
Non-medical prescribing models in countries with similar health systems to Australia were analysed (including United States of America, United Kingdom, Canada and other European countries (including Ireland, Netherlands, Denmark, Estonia, Finland, Norway, Poland, Spain, Sweden).
Read more about AMA's other research
AMA 10 Minimum Standards for Prescribing
AMA Position Statement on Medicines
Ethical Guidelines on Ownership of Pharmacy and Dispensing By Doctors 2019
AMA’s Plan to Modernise Medicare
AMA’s Plan to improve access to GPs
Why Medicare indexation matters
AMA Position Statement on the Medical Home 2021
Delivering better care for patients: the AMA 10-year framework for primary care reform
AMA Pre-Budget Submission 2022-23
AMA’s Vision for Australia’s Health