Pharmacists should critically examine all electronic scripts for forgery or fraud to ensure lawful supply, particularly for S4s and S8s, says Authority
Victoria has enabled the national electronic prescribing framework implemented by the Commonwealth, explains the Victorian Pharmacy Authority (VPA) in a recent communique. To receive and dispense e-scripts, pharmacists are required to use conformant software.
Australia’s first paperless electronic prescription was prescribed and dispensed in Victoria in May this year, and given the COVID-19 crisis that unfolded in Melbourne, capability expanded to greater Melbourne in August.
The VPA has highlighted that pharmacists are not expected to contact prescribers to verify the authenticity of an e-prescription, provided the e-script complies with criteria specified by the Secretary.
“However, pharmacists should still critically examine electronic prescriptions they are presented to ensure that supply of a S4 or a S8 poison does not occur upon a prescription that a pharmacist has reason to believe has been forged or is fraudulent in any way (e.g. based on prescribed quantity, strength, duration etc.) and contact the prescriber where appropriate,” it says.
“This is because a person other than the prescriber may have accessed the prescribing software to create a fraudulent electronic prescription.”
While the vast majority of prescriptions do not require an intervention, pharmacists must remain vigilant and assess each prescription (critically) before determining whether it is to be dispensed,
The Victorian Department of Health & Human Services (DHHS) warned not to assume that a prescription is genuine, adding that pharmacists have been prosecuted for failing to make the appropriate checks.
“Too many pharmacists have dispensed forged or fraudulently altered prescriptions (sometimes on multiple occasions) in circumstances where, had they fulfilled their legislative responsibilities; examined the prescription critically; and/or examined the MPR website list of stolen prescriptions; the fraudulent prescriptions would have been identified,” says DHHS.
Pharmacists must notify the police and Medicines and Poisons Regulation (MPR) when they suspect or have reason to believe that a person has obtained or attempted to obtain Schedule 4 and Schedule 8 poisons by means of a false pretence.
According to the DHHS, the regulations require pharmacists to contact purported prescribers to inform them that patients have obtained the same or a similar drug of dependence (S4 or S8) from another prescriber during the preceding eight weeks; and to authenticate prescriptions for S8 poisons.
In addition to complying with legislative requirements, pharmacists might need to contact prescribers to check or confirm details or directions on prescriptions; advise prescribers of contraindications and possible adverse reactions; discuss the appropriateness of a particular course of treatment; and question the prescribed dosage or rate of administration.
“While the vast majority of prescriptions do not require an intervention, pharmacists must remain vigilant and assess each prescription (critically) before determining whether it is to be dispensed,” says the DHHS.
“The knowledge and experience of a pharmacist might be the only barrier to undesirable outcomes (inadvertent or intentional) and dispensary assistants cannot be expected to identify issues that pharmacists are trained to identify.”
Pharmacists are also reminded that the mandatory requirement to check SafeScript applies to electronic prescriptions, reminds the VPA.
MPR has resources available for pharmacists on dispensing electronic prescriptions in Victoria: