A federal government-supported trial that will provide extra support from January 2027 for concession card holders to access the contraceptive pill and treatment for a urinary tract infection through pharmacy prescribing does not promote the highest quality healthcare and must be robustly evaluated.
Australian Medical Association President Dr Danielle McMullen said pharmacy prescribing was already fracturing care and putting patients at risk.
“When it comes to high-quality care, women deserve a doctor and the most appropriate place to have a conversation about contraception or to seek treatment for a UTI remains a general practice, with highly skilled GPs,” Dr McMullen said.
“General practitioners have the right kind of training and can talk to patients about the safest and most effective contraceptive options as well as make sure a suspected UTI is properly evaluated and there isn’t evidence of a more serious health condition,” she said.
“We’ve seen these ad hoc decisions being made by state governments across the country with very little evidence that speaks to the effectiveness of the programs. The federal government needs to take a different approach.
“What we need is robust evaluation to ensure this program and others like it are safe, cost effective and don’t fragment care. We also need the right kind of reporting mechanisms for adverse events — not just from the pharmacists but from specialists and GPs who treat patients who have had adverse events from treatment within pharmacies.
“The AMA understands the government's desire to support disadvantaged patients. However, GPs already have a strong record of treating concession card holders with no out-of-pocket costs, so these services are already very accessible from a GP.
“The discussion to commence a contraceptive is a complex one, with a range of options needing to be discussed so women can make the choice that is right for them and their individual health factors. Women deserve a consultation with a doctor who can explain all the available options.”
Dr McMullen said the government's own medicines regulator, the Therapeutics Goods Administration, had made it clear that there are risks attached to the contraceptive pill and that these risks require management by a medical practitioner.
“While state and territory governments seem intent on ignoring the TGA, we think the federal government needs to uphold its own department’s decisions.
“The federal government also has other important bodies that make decisions about the funding of medicines and health services — the Pharmaceutical Benefits Advisory Committee and the Medical Services Advisory Committee. These medical, evidenced-based bodies play a critical role in ensuring access to cost effective and safe health services for the community and must be part of decision making.
“The AMA will be seeking assurances from Minister for Health Mark Butler that these bodies will not be bypassed and will play their normal role in assessing whether it is appropriate for the Commonwealth to fund these services beyond the trial.”
