Stop gatekeeping S3s: Nankivell

Belinda Nankivell

Pharmacy tends to “gatekeep” S3 medicines and needs to move on from this behaviour in order to make the best use of this underutilised category.

So says Belinda Nankivell, practice pharmacist and QCPP state manager at the Pharmacy Guild’s NSW Branch, who told pharmacy assistants over the weekend that “we need to forge a pathway forward now from protecting these medicines.”

Addressing the Pharmacy Assistants’ Conference at SeaWorld, Nankivell said that pseudoephedrine and codeine have modelled how pharmacists and pharmacy assistants approach Pharmacist Only Medicines.

She said that pharmacy has done a great job handling them via Project Stop and MedsASSIST, but that pharmacists and assistants need to remember that many requests are from people who genuinely have congestion or pain, and that these products treat them effectively.

Other S3s don’t have the misuse and diversion complications of codeine and pseudoephedrine, but many customers feel interrogated when they ask for them, she said.

Nankivell said that it’s well accepted that symptom requests and direct product requests tend to be handled differently; when patients request an S3 by name, pharmacists and pharmacy assistants become “more defensive,” she told the conference.

“We seem to already jump into a gatekeeping mode as soon as they ask for the products,” she said.

“We need to acknowledge that we really are the key barrier to the growth of this category. Our approach really does need to evolve.

“What percentage of the time does your pharmacist reject an S3 sale? It’s a really small percentage of the time that we find it’s inappropriate, so why make it difficult for all our customers?”

She said that MedsASSIST is a great tool for flagging inappropriate use of codeine, and thanked pharmacy assistants for using the program, but urged them not to “tarnish the whole category of customers”.

She shared the experience of a family member who had, while on holiday, presented to a pharmacy to ask for pseudoephedrine to treat her cold symptoms, but who was faced with a pharmacist who called out, “are you a druggie?” from the dispensary.

Nankivell also said that it would be good to see certain prescription-only medicines, such as some contraceptive pills and asthma preventers, downscheduled to S3.

“There’s a whole scope of treatment that would be so exciting,” she said.

She encouraged pharmacy assistants to make a plan to overcome barriers to S3 sales in their pharmacies, and identify the opportunity inherent in the category.

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