PharmaAdvice: Acquiring prescription drugs for use in your practice

Most dentists know that the recommended timing of a preprocedural dose of medication, such as antibiotic prophylaxis or a sedative for anxiolysis, is one hour before the procedure. However, the issue of where the patient should take that dose of medication is not so clear. Increasingly, it is being recognised that pre procedural medication should be administered at the dental practice, because administration at home, in the car or on the bus coming to the appointment has been associated with falls, accidents and adverse reactions with the dentist often being held responsible.

Administration of pre-procedural medication at the dental practice ensures that the patient is supervised once the medication starts working. Any untoward effects may be observed and appropriately managed and documented. The next question is, how is the medication acquired? You can either write a prescription in the

individual patients name for the small quantity needed or administer the dose required from stock kept at your practice. It is up to you which of these you choose and how you want to manage drug storage and record-keeping. But let’s look closer at drug acquisition.

DRUG ACQUISITION

It has come to my attention that some dentists in Australia obtain stock of prescription drugs for their practice by writing a fake prescription and having it dispensed at a pharmacy. These prescriptions are ‘fake’ in that they are allegedly written in the name of the dentist, a staff member or, at worst, a non-existent patient. It is illegal to write a prescription where the named patient is not the sole person for whom the medicine is intended. In addition, if the cost of a prescription was claimed on the PBS under a false name this commits the offense of PBS fraud.

Even though it appears the use of fake prescriptions has largely gone unnoticed, it is worth knowing that a medical GP in NSW was recently reprimanded and suspended by AHPRA for creating false documents and using names of staff members to obtain stock for his practice.

In case you’re wondering, it is not illegal to write on the prescription “For clinic use only” or “for practice stock” in the patient name section, because this converts the prescription into a purchase order, which is the legally appropriate document to provide to a pharmacy for purchasing stock. At least then you aren’t telling any lies.

However, it is a waste of prescription stationery when you can use practice letterhead instead.

WHAT IS THE APPROPRIATE METHOD FOR OBTAINING STOCK OF PRESCRIPTION DRUGS?

In all states and territories of Australia dentists are legally permitted to acquire medicines for use in their practice from a wholesaler or a pharmacy (this includes online services). The tricky thing is that the method by which stock is legally acquired from these vendors varies from state to state. Basically, two states require a “purchase order”, three require a ‘written order’, one simply stipulates an “order” and one does not stipulate anything.

For the full story, state and territory regulations for obtaining prescriptuion drugs stock, go to News Bulletin Online (May 2019 issue)

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