The following arrangements apply for supply of prescription medicines from a community pharmacy in emergencies.
A temporary special authority has been issued by the NSW Chief Health Officer until 31 March 2020 for supply of most Schedule 4 prescription medicines from a community pharmacy in emergencies in a bushfire affected area in NSW.
The usual arrangements for 3 day emergency supply and Continued Dispensing of Pharmaceutical Benefit Scheme (PBS)-listed oral contraceptives and cholesterol lowering medicines remain in place in all areas of NSW.
Special authority for pharmacists
A patient can receive a supply of Schedule 4 medication without a prescription, where the pharmacist is satisfied there is immediate need. The medicine must have been previously prescribed, be for continuation of current essential treatment and it is impracticable to obtain a prescription.
The quantity to be supplied is no more than:
The pharmacist must record: (a) name and address of the patient; (b) name, strength and quantity of the medicine; (c) directions for use of the substance as determined by the pharmacist; (d) name and address of the authorised practitioner who last prescribed that substance; (e) date of supply; (f) a unique reference number; and (g) name of the pharmacist by whom the substance was supplied. The medicine must be labelled as for a dispensed medicine.
Schedule 4 Appendix D and Schedule 8 substances may NOT be supplied under the special authority.
A pharmacist may dispense S4D and S8 medicine using telephone or email orders in an emergency. The pharmacist can confirm the patient’s current medication details with the prescriber, or a prescriber may direct a pharmacist to supply a medicine to a patient in an emergency situation, by providing a telephone order, email or facsimile. The prescriber must forward a paper prescription to the pharmacy as soon as practicable and within 24 hours, endorsed as such.
Pharmacists must take special care to verify a telephone order for a Schedule 4 Appendix D or Schedule 8 medicine is genuine, e.g. by calling back the prescriber using an independent source of telephone number. If the pharmacist is unable to verify the prescriber’s identity, but has no other reason for suspecting the order is not genuine, then no more than two days’ supply should be made until the written signed hardcopy prescription is received.
The Commonwealth has announced temporary expansion of PBS subsidy to cover most PBS medicines. However any supply of Schedule 4 Appendix D and Schedule 8 medicines without written prescription must comply with NSW law. The NSW temporary special authority does NOT apply to Schedule 4 Appendix D and Schedule 8 medicines.
A patient can receive a three (3) day supply of Schedule 4 medication without a prescription, where the pharmacist is satisfied there is immediate need. The medicine must have been previously prescribed, be for continuation of current essential treatment and it is impracticable to obtain a prescription. In the case of a pre-packed liquid preparation, cream or ointment, pressurised aerosol container or an anovulant, the smallest standard pack may be supplied. Schedule 4 Appendix D and Schedule 8 substances may NOT be supplied under these Emergency Supply arrangements.
The pharmacist must record: (a) name and address of the patient; (b) name, strength and quantity of the medicine; (c) directions for use of the substance as determined by the pharmacist; (d) name and address of the authorised practitioner who last prescribed that substance; (e) date of supply; (f) a unique reference number; and (g) name of the pharmacist by whom the substance was supplied. The medicine must be labelled as for a dispensed medicine and include on the label "EMERGENCY SUPPLY".
The pharmacist can confirm the patient’s current medication details with the prescriber, or a prescriber may direct a pharmacist to supply a medicine to a patient in an emergency situation, by providing a telephone order, email or facsimile. The prescriber must forward a paper prescription to the pharmacy as soon as practicable and within 24 hours, endorsed as such. If not received within 7 days the pharmacist must report this to the Pharmaceutical Regulatory Unit on telephone 02 9391 9944.
For patients requiring urgent supply of oral contraceptives or statins, pharmacists may dispense a single PBS quantity under Continued Dispensing arrangements.
If a patient treated with methadone or buprenorphine under the Opioid Treatment Program is unable to access their designated pharmacy, contact the Pharmaceutical Regulatory Unit on 9391 9944 for advice.
If your pharmacy has lost or damaged prescriptions, dispensing records or drug registers due to bushfires you should complete a Statutory Declaration and notify the Pharmaceutical Regulatory Unit on 02 9391 9944.
Pharmacists seeking to temporarily relocate their pharmacy due to damage from bushfire should contact the Pharmacy Council of NSW on telephone 1300 197177. Pharmacists must continue to comply with regulations with regards to storage of medicines.
Regulations in NSW require the pharmacist personally hand a Schedule 3 substance to the person who is being supplied with it from a community pharmacy (when supplied without prescription). This safeguard ensures a pharmacist can assess therapeutic need and appropriateness of the medicine and reinforces for consumers the importance of professional advice when using Schedule 3 medicines.
A pharmacist can exercise professional judgment about supply to carers or other persons presenting on behalf of a patient. The pharmacist can directly supervise a pharmacy assistant to assist them.
The Poisons and Therapeutic Goods Regulation 2008 (clause 18) specifies that to supply a Schedule 3 substance the pharmacist must ‘personally hand’ the substance to the person, and give the person an opportunity to seek advice on use of the substance.