Doctors have criticised Queensland’s move towards downscheduling the Pill and UTI medicines as “a cynical attempt to buy the female vote”
Queensland Premier Annastacia Palaszczuk and Health Minister Steven Miles have announced that Ms Palaszczuk will write to Prime Minister Scott Morrison, to ask the Federal Government to support the downschedule of the oral contraceptive pill.
This is aimed at allowing women can access it more regularly from pharmacies without having to renew their initial prescription, they said.
In the meantime, Queensland will make changes to the provisions for interim supply, they said.
“It will mean when a woman can’t get her usual repeat pill prescription, pharmacists will be allowed to provide one full pack of her usual pill,” the Premier said.
“Most women who take the pill have done so since they were teenagers and are used to managing their reproductive health.
“But there are situations where a woman can’t get an appointment with their doctor or can’t make one. The changes we’re making by the end of the year will make women’s lives easier.
“It will also mean we’re freeing up GP waiting rooms, so women are not necessarily burdened with the extra cost or time to just fill a script.”
She also called for a downschedule, to allow pharmacists to supply the pill more regularly, “where it is safe to do so”.
“These changes are about improving reproductive healthcare for women in Queensland and in particular, regional Queensland where sometimes it’s easier to access a pharmacy than a doctor.”
Minister for Health and Ambulance Services Steven Miles noted that the current provisions only include oral contraceptives listed on the PBS, excluding around half of Queensland women who take the pill regularly.
“It will provide more options for women if their pill prescription has expired or run out of repeats and are unable to get to a doctor,” he said of the new move.
“A pharmacist will be able to supply a full standard pack, which usually lasts between one and four months depending on the product, once within a 12-month period.”
The proposed changes are expected to be in effect by late 2020, pending changes to the new Medicines and Poisons (Medicines) Regulation under the Medicines and Poisons Act 2019.
All women will still need to consult with a GP when they are considering contraceptive methods for the first time to determine the best options for them.
The Premier said her government was also working on improving access to medicines for the management of urinary tract infections through pharmacies.
“I know many women affected by UTIs and time is critical in treating these infections,” the Premier said.
“All women can get UTIs and, if not treated in time, women can end up in hospital.
“If we can ease women’s discomfort and prevent them from possibly ending up in hospital by making these common medicines readily available for them without a prescription at the pharmacy then that’s a win in my books.”
But Dilip Dhupelia, Australian Medical Association Queensland branch president, said that the state Government was “playing politics with women’s health in a blatant bid to win votes at this year’s State election,” and urged it to stop.
He said the rule changes were a “cynical attempt to buy the female vote”.
“Women can already get a month’s supply of the oral contraceptive pill without a prescription,” Dr Dhupelia said. “Under the new changes, most women will now be forced to buy four months of the pill because that is how many oral contraceptives are packaged at pharmacies.
“These changes are more about bowing to pressure for profits from the pharmacy sector than improving women’s health care.”
Dr Dhupelia also said it was irresponsible of the State Government to allow pharmacies to provide antibiotics given concerns over antimicrobial resistance, which he said was one of the greatest public health threats of our time.
“This move works against all the national strategies that have been put in place in recent years to help control the growing threat of antibiotic-resistant superbugs,” he said.
“More than 700,000 people die every year around the world because of infections that are resistant to antibiotics. We need people taking less antibiotics, not more.
“No other state or territory has taken this action,” Dr Dhupelia said. “It’s hard to view the Premier’s announcement – made on International Women’s Day – as anything but a blatant grab for votes at the expense of women’s health.
“GPs are right to be concerned. We must never place politics ahead of public health.”
However the Pharmacy Guild welcomed the move to write to the PM about downscheduling, though this was not without its own issues.
Pharmacy Guild of Australia Queensland Branch President, Professor Trent Twomey called for a “comprehensive solution which goes beyond existing arrangements and simple supply”.
“While downscheduling sounds great, the PBS subsidy for S4 medicines associated with the oral contraceptive and other contraception medications needs to be maintained.
“Our advocacy efforts have brought us to this point but there is more work to be done if Queensland women are going to have the same access and ease of service as women in the UK, New Zealand and parts of Canada.
“We’ll continue to work with the Queensland Government to deliver for all women in Queensland.
“The better solution involves minor changes to the current Drug Therapy Protocols, and I would urge the Government to move now, as downscheduling could take years,” he said.
Trent Twomey added that news regarding a trial to allow trained community pharmacists to provide treatment for urinary tract infections will commence over the coming weeks was welcomed.
“In 2018 there were over 20,000 potentially preventable hospitalisations in Queensland due to urinary tract infections and kidney infections,” he said.
“Additionally, around one in two women will experience a urinary tract infection in their lifetime and nearly one in three women will have a urinary tract infection needing treatment before the age of 24. If left untreated, a urinary tract infection can become a kidney infection, so it’s important to seek treatment as early as possible.
“This trial will help to support Queensland women by providing convenient, appropriate, safe and effective treatment for uncomplicated urinary tract infections,” he said.
“Community pharmacists are highly trained health professionals, who complete five years of higher education as well as continuing professional education. This trial will require appropriately qualified pharmacists to complete additional training to ensure safe and accurate screening, diagnosis and treatment, which may include antibiotics.
“Furthermore, community pharmacists are conveniently located with extended opening hours and no appointments necessary. This means that a women experiencing a urinary tract infection can be seen and treated immediately, to avoid further complications.
“I applaud the Queensland Government for supporting this trial, and women’s health, by enabling trained pharmacists to provide immediate treatment for uncomplicated urinary tract infections, in line with other OECD countries, including New Zealand and the UK,” Professor Twomey said.
Queensland Health has engaged a consortium led by the Queensland University of Technology to manage the development and implementation of a state-wide trial of the management of UTIs by pharmacists.
The consortium is made up of Queensland and international universities and industry organisations.
The state-wide trial is expected to commence by mid-2020.
QUT pharmacy Professor Lisa Nissen is leading the Urinary Tract Infection Pharmacy Pilot – Queensland with a team of researchers and Queensland Health.
“Our aim is for community pharmacists to provide optimal care to women presenting with symptoms of an uncomplicated UTI who meet strict inclusion criteria,” Professor Nissen said.
“UTIs are a common condition seen by GPs – about 250,000 Australians develop a UTI each year and women are more susceptible with one in three women and one in 20 men developing a UTI in their lifetime.
“This pilot study follows several models of care for UTI that have been developed in Canada, the UK and New Zealand to allow pharmacists to supply antibiotics to patients with uncomplicated urinary tract infections.”
Professor Nissen said UTIs could develop quickly and were acutely painful and people wanted access to rapid relief of symptoms.
“International models of care have shown that community pharmacies can provide timely and effective treatment for a range of minor health conditions including uncomplicated UTIs,” she said.
“Pharmacists are highly trained and using them to improve access to care will reduce unnecessary visits to emergency departments and other health providers.”
The pilot is being conducted by Professor Nissen with researchers from the Pharmacy Guild of Australia (QLD), the Pharmaceutical Society of Australia (QLD), James Cook University, Griffith University, the University of Queensland and international partners from the University of Alberta and the University of Otago and the University of Auckland.
Professor Nissen and QUT researchers coordinated the successful Queensland Pharmacist Immunisation Pilot which has led to the availability of vaccinations through pharmacies across the country.