The Royal Australian College of General Practitioners (RACGP) has reiterated warnings that making COVID-19 antiviral treatments available from community pharmacies over-the-counter would be a recipe for disaster.
It comes following the Pharmacy Guild citing national GP shortages as a reason for the federal and state and territory governments to make the treatments available from community pharmacies nation-wide without a prescription.
RACGP President Adj. Professor Karen Price said the Pharmacy Guild’s claims are unfounded and misleading.
“Clear messaging is needed for patients. The Pharmacy Guild, which is the body representing pharmacy business owners, needs to stop muddying the message on access for patients,” she said.
“Patients need to understand the urgency of contacting their GP when they test positive for COVID-19 and not be distracted by the Pharmacy Guild’s efforts to push their own agenda. We are in the midst of a pandemic and timely access requires people to be well informed and clear on what they need to do. Providing misleading information like old Healthengine data is unhelpful to patients and shouldn’t be relied on for this discussion concerning COVID-19 antiviral treatments. This is not a time to create a false narrative around accessibility to advance the Pharmacy Guild’s commercial interests.
“Ask any GP and they will tell you the same thing – as soon as a high-risk patient calls and lets the practice know they are COVID-19-positive, a GP will speak to them that day. If appropriate, the GP will make a complex decision on the right COVID-19 oral antiviral and provide all follow-up care. We have telehealth infrastructure in place to make sure patients can access these medicines while isolating, including patient rebates for longer telephone consultations. We are also calling for these antivirals to be added to the doctor’s bag in the event access to a pharmacy is problematic in emergency situations or for rural and remote locations. This means the medication can be dispensed directly from the GP.”
The RACGP President stressed that prescribing these treatments is not a straightforward task.
“The COVID-19 oral antiviral treatments are not without risk. Specialist GPs are medically trained and understand the urgency of getting the medicines out to patients early to ensure effective treatment,” she said.
“Patients needing these treatments will require a medical review of liver and renal function as well as a follow-up to check for side effects and adverse reactions. A sexual history may also need to be taken to ensure medication safety. These treatments are not suitable for everyone and the patients who are eligible often have complex chronic conditions that need to be taken into consideration before making the decision to prescribe.
"GPs are the most appropriate health professional to safely prescribe these treatments in the community because we know our patients and their health history including existing health conditions, what medications they are on and other factors which may impact their eligibility.
“Comparisons to other countries such as New Zealand do not take into account the significant differences in our respective health settings. There are disparities in models of care, variations in the required levels of pharmacy training, and differing safety classifications of medicines. The Pharmacy Guild knows this, and I believe drawing theses comparisons is inappropriate and risks public safety for a business gain.
“Over-the-counter pharmacy consultations and prescribing by pharmacists is not the answer to getting these treatments in the hands of those who need them. We need pharmacists to concentrate on their own job of stocking and dispensing safely and let the GPs get on with doctoring, because lives can be saved. Pharmacies already have an important role to play so that’s where their focus should be right now.
“At the end of the day, pharmacists do not have the appropriate skillset to interpret a life history, including a sexual history, or the diagnostics of liver and kidney function. Nor can they order urgent tests if needed. Prescribing these medications is not simply taking them from a box on a shelf and handing them to a patient. This should be a job for GPs, it’s as simple as that.”