All states and territories should follow ‘as a matter of urgency’

Emergency order enables Victorian pharmacists to supply S4s using digital images of scripts alone, reducing burden of having to organise or receive paper scripts

The Victorian Department of Health and Human Services has made an emergency order that aligns with Federal special arrangements allowing GPs to send digital images of scripts directly to a pharmacy, if the patient is at risk of the COVID-19 virus.

Schedule 8 and 4D medicines are excluded from the arrangement and, under the Federal rules, prescribers are only allowed to send the digital image of the script to the pharmacist or pharmacy of the patient’s choice.

However the Victorian emergency order goes one step further, removing the requirement for GPs to then provide the original paper script to the pharmacy.

Previously the Federal Government advised prescribers to send the pharmacy the paper script as soon as possible, where possible, as e-prescribing has not yet been rolled out or legislated at a state and territory level.

This meant some GPs were “expecting the pharmacies to manage coming to pick up the scripts or supply funds themselves to have the scripts posted,” PSA national president Chris Freeman told AJP, leaving pharmacies with “significantly larger amount of work” to do than before.

It also posed an issue for pharmacies’ cash flow, particularly if medications had to be dispensed as script owing.

The Victorian emergency order temporarily removes the necessity for the GP to pass along the paper script to the pharmacist, based on the following requirements that the pharmacist must:

  • be provided with a digital image of the original prescription transmitted directly from the practitioner or an employee acting in accordance with the instruction of the practitioner (but not via the patient or any other intermediary),
  • record that the sale or supply was made under this public health emergency order,
  • retain a copy of the digital image upon which the supply is made for two years, and
  • produce a copy of the digital image at the request of an authorised officer.

Meanwhile, a practitioner who transmits a digital image of an original prescription must:

  • record that a digital image of the original prescription was transmitted under this order;
  • retain the original prescription for two years, and
  • produce the original prescription at the request of an authorised officer.

This emergency order is in effect in Victoria from 7 April 2020 until midnight 6 October 2020 unless earlier revoked.

As of Thursday 9 April, Victoria is the first and only jurisdiction where supply under the special PBS arrangement can be lawfully made at present.

“Victoria has shown terrific leadership in this case and we understand that there are now some other jurisdictions considering doing the same,” said A/Prof Freeman.

He said PSA has asked all other states and territories to follow suit “as a matter of urgency”.

“Many pharmacists all around Australia are being left in a quandary and are stuck in the middle between the federal legislative instrument and the state and territory regulations. This is causing profession-wide confusion and frustration,” he told AJP.

“Pharmacists, currently on the front-line of this COVID-19 pandemic are wanting to do all they can to help their patients at this critical time, and we should not have such a big disconnect between the federal and state governments that stands in the way of pharmacists ensuring continuity of medicine supply.”

Victorian branch president of the Pharmacy Guild, Anthony Tassone, said the emergency order is “a very sensible move during these unprecedented times to help reduce some of the administrative burden of prescribers and pharmacists delivering care for their patients”.

“Whilst it does not cover S8 medicines or drugs of dependence which will still require the original prescription to be sent to pharmacy following telehealth, it will cover the vast majority of medicines prescribed during telehealth consultations,” he told AJP.

“Other states and territories simply must follow as soon as possible for the sake of the great challenges faced by prescribers and pharmacists alike in delivering care to patients who have received a telehealth consultation.”

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