Can I dispense this?

The Pharmacy Council of NSW has identified a “knowledge gap” for many pharmacists around authority requirements for certain scripts

In a piece adapted from an article written by the Medical Council of NSW, the state’s Pharmacy Council says that it recently considered interim action against nine pharmacists regarding the dispensing of drugs of addiction.

The Medical Council of NSW actually did undertake interim action to protect the public, prohibiting seven doctors from prescribing these medicines.

“Central to all cases was inappropriate prescribing and dispensing of opioids or other Schedule 8 Drugs in contravention of the requirements of NSW Poisons and Therapeutic Goods legislation,” warns the Pharmacy Council of NSW.

It outlines the two types of authorities prescribers may need to get before they can prescribe restricted or S8 medicines:

The first is “the familiar PBS Authority which prescribers obtain every day by calling 1300 888 333 or sending the script through the mail.  This authority ensures the patient will get a PBS subsidy for the medication prescribed”.

But there is also the “much less commonly required” NSW Ministry of Health Authority.

This is necessary when Alprazolam, Flunitrazepam or S8 opioids are prescribed for any period of time for someone considered to be drug dependent; or when Alprazolam, Flunitrazepam, Buprenorphine (except transdermal), Hydromorphone, methadone or any other injectable, intranasal or spray S8 opioid is prescribed for more than two months for someone not considered to be drug dependent.

This Authority is also required for stimulants such as Dexamfetamine, Lisdexamfetmine (Vyvanse) or Methylphenidate (Ritalin, Ritalin LA and Concerta).

“A Ministry of Health Authority (as well as other approvals) is also required when someone is enrolled in the NSW Opioid Treatment Program (aka the ‘Methadone program’),” the Council warns.

It says that “many” pharmacists and doctors seem to get the PBS Authority confused with the NSW Ministry of Health Authorities.

“A PBS Authority number means ONLY that the Commonwealth has agreed to subsidise the cost of a medicine,” it warns.

“It does not grant approval for the prescriber to prescribe the medicine and therefore does not necessarily mean that it is legal for a prescriber to prescribe it.

“The people on the end of the PBS line have no legal authority to allow the prescriber to prescribe stimulants and S8 medications.”

Instead, when a prescriber contacts this line to request a PBS Authority, the PBS Officers assume the prescriber already has a NSW Ministry of Health Authority to prescribe that medication, and will not conduct a check to ensure that the prescriber has a NSW Ministry of Health Authority.

“Telling a regulatory body such as the Pharmacy Council, Medical Council or the HCCC that the prescription had a PBS Authority is no defence for a pharmacist should you get into trouble for dispensing these medications in inappropriate circumstances.”

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