The Australian Medical Association has condemned a call by the Pharmacy Guild of Australia for a list of 20 drugs to be established which pharmacists could continue to dispense without a current prescription.

The 20 drugs, which are used to treat a number of chronic conditions, make up 45 million prescriptions a year and account for 25% of all claimed Pharmaceutical Benefits Scheme (PBS) items, said the Guild’s national president, Kos Sclavos.

“For these medicines, once a doctor has initiated therapy, it is our view that a pharmacist should be able to continue that therapy for up to 12 months,” said Mr Sclavos. “Currently, when patients run out of prescriptions, a pharmacist must direct them back to the doctor to get a new prescription, and when that happens there is another swipe of the Medicare card.”

“Some would view this proposal as pharmacist prescribing, but we see it as Medication Continuance,” he added, pointing out that the patient would continue to see their doctor as regularly as the physician required and the doctor would remain the key coordinator of care.

However, AMA president Dr Rosanna Capolingua says the proposal could put patients’ safety and clinical outcome at risk.

The 20 drugs on the Pharmacy Guild’s list are "serious medications, important to the patient's clinical condition," and the AMA “is extremely concerned for patients if they are given access to these medications without seeing a doctor. If a prescription-only medicine is issued without a current prescription, this would amount to pharmacists prescribing and this is something they are not trained to do,” she said.

The AMA supports the current rules allowing pharmacists to supply an existing customer in an emergency situation on verbal authority from the doctor, who must then follow up with a written script within one week, said Dr Capolingua. "That's convenient for patients. There's no need to extend that arrangement through any widespread mechanism that puts patients at risk and gives pharmacists unilateral prescribing rights as well as their existing dispensing function,” she added.

Moreover, “any prescribing by the people who make a living from selling medications would present a clear conflict of interest," she said.

The Guild has proposed two further changes, the first being that pharmacists should be able to continue all medicines supply for six months for the 380,000 Australians living in nursing homes or high care residential facilities where pharmacists pack their medications into Dose Administration Aids, whether or not there are repeat prescriptions on the items.

For these patients, pharmacists “are forever chasing up prescriptions and it is an administrative nightmare for doctors,” said Mr Sclavos.

And second, it proposes a new scheduling sub-category, Pharmacist Only Medicines Notifiable, to which certain products – such as the contraceptive pill, low-dose statins and minor ailment treatments - should be moved from the Prescription Only category.

The relevant government agencies could be notified of sales of these products to monitor misuse, with protocols set for each medicine (such as intervals in which patients can access medicines), and perhaps, initial prescribing by doctors for some of the products, it suggests.

These three proposals “would not see one extra cent in remuneration for pharmacists,” and would translate into 4.4 fewer Medicare visits, adding the equivalent of 450 full-time general practitioner (GP) place to the system, said Mr. Sclavos.