Non-prescription sleep aids
References
Maughan K, Jackson J. Ankle sprain in adults: Management. Massachusetts: UpToDate 2022.
Chen ET, Borg-Stein J, McInnis KC. Ankle Sprains: Evaluation, Rehabilitation, and...
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[post_content] => After months of anticipation, the Unleashing the potential of our health workforce – Scope of practice review was released yesterday (5 November) – with many of the key recommendations echoing the long-held concerns of the PSA and pharmacists across Australia.
Australian Pharmacist has rounded up some of the key takeouts from the report.
Pharmacists are leaving the profession at an alarming rate
Pharmacy has a high attrition rate compared with other healthcare professions. Among 19 healthcare professions, pharmacy had the fifth highest exit rate of 8.7% in 2023 – almost double that of medical professionals (4.7%).
The professions with the highest exit rates are those that face significant barriers to working to their full scope of practice, the review found.
While there are several factors that impact exit rates, allowing pharmacists to work to their full scope of practice is a crucial factor for strengthening the profession’s retention rate – improving recognition for professional skills, capability and contribution to enhance continuity of care.
‘This report really makes clear that there are all sorts of artificial, inefficient restrictions on what nurses, pharmacists, GPs, and other health professionals are allowed to do that bears no relationship to their training,’ said federal Minister for Health and Aged Care Mark Butler.
Inconsistencies in vaccine schedules for pharmacists are ‘needless’
Pharmacist vaccinators are trained in accordance with the National Immunisation Education Framework, ensuring high standards in vaccine administration and competence.
But the report found that the difference in state and territory laws dictating which vaccines can be administered by pharmacists has led to disparities in access – not only causing confusion among patients but leading to significant inefficiencies.
Legislative differences between states and territories also means that a vaccine subsidised in one region might not be covered in another.
Harmonising these regulations by reviewing Drugs and Poisons Acts would promote equitable vaccine access nationwide, allowing pharmacists’ to provide consistent healthcare services regardless of location.
Aligning funding arrangements for vaccination is also crucial, the review found. While the National Immunisation Program Vaccinations in Pharmacy (NIPVIP) provides government funding for certain vaccines, access to others depends on a mix of user-pay systems and varying jurisdictional funding – creating inconsistencies in affordability and accessibility across states and territories.
Standardising funding mechanisms would ensure subsidies are uniformly applied – making vaccinations more affordable and accessible to all Australians.
It will take some time to implement change, but there are some steps governments and regulators can take now
While some of the recommendations in the review, such as harmonising vaccination legislation, can be achieved in a timely fashion, others are sweeping reforms that will take many years, such as restructuring healthcare education – which currently impacts students and qualified pharmacists’ ability to work to their full scope.
The review recommended the Commonwealth establish a primary care workforce development program to support the development and retention of a skilled, stable, and collaborative primary care workforce through enhanced curriculum, training, placement, and career development opportunities for students, supervisors, mentors, and health professionals.
The current funding model must be overhauled
The current fee-for-service arrangement in primary care incentivises high-turnover care – with payments to providers based on the number and type of care episodes delivered.
This model limits the ability of health professionals to work to their full scope and reduces multidisciplinary collaboration – with some healthcare professionals funded for certain services while others are not, including lack of funding for pharmacists to participate in multidisciplinary case conferences.
To address this, the review recommends introducing a blended payment model to complement the fee-for-service system. This model would enable access to multidisciplinary healthcare delivered by professionals working to their full scope of practice in primary care.
An independent mechanism would be established to advise on pricing and payment levels for the blended payment, ensuring adjustments based on the risk profile of patient populations.
But it’s unlikely to be a quick fix. The review suggests the model would need to be implemented progressively over a 7-year period, beginning with priority areas such as rural and remote regions, Aboriginal Community Controlled Health Organisations, and underserviced regional and outer metropolitan areas.
Pharmacist prescribing programs should be nationally consistent
Implementing pharmacists prescribing rights has been an unnecessarily complex and prolonged process, with ad-hoc investigations, one-off reviews, and small-scale pilots.
Adopting an activity-based approach would streamline regulation for community pharmacists in prescribing medications and promote consistency across jurisdictions.
Introducing a dedicated mechanism to assess health workforce models would also fill a crucial gap, facilitating the systematic adoption of multidisciplinary primary care models that include pharmacists much like the successful models implemented in the United Kingdom.
Improved use of technology should form the backbone of scope of practice changes
A key theme in the review was the need for better use of technology across the board to expand scopes of practice and efficiencies, improving quality of care.
Potential areas for reform identified by the review include establishing access to real‑time patient information, introducing platforms for secure messaging and digital referrals and mandating participation in a multidisciplinary care team for primary care providers.
‘[We need to] improve the digital capability of a system that still uses far too many fax machines and too much paper,’ said Minister Butler.
The government will respond, in time
The government is yet to respond to the key recommendations in the report, with Minister Butler confirming he will not ‘respond to each of the ideas’.
‘We want to consider them, but a lot of them do have a lot of common sense,’ he said.
Other key stakeholders will also need to be consulted.
‘Many of the recommendations will require collaboration between the Commonwealth and state and territory governments, as well as consultation with peak professional organisations, AHPRA, patient groups, and the sector more broadly. I look forward to these discussions,’ Minister Butler added.
But PSA has called for the government to accept all 18 recommendations and put forward a plan of action now.
This review confirms PSA’s view that inconsistent regulations, unnecessary restrictions on practice, and siloed workforces are having a negative impact on patient access to quality health care, said PSA National President Associate Professor Fei Sim.
‘This report recognises the core role of pharmacies and pharmacists as primary healthcare providers and recommends a multidisciplinary approach to patient care,’ she said.
‘There is a clear alignment between Cormack’s recommendations and the actions in PSA’s vision for the pharmacy profession, Pharmacists in 2030. Both present a clear vision for the future that requires collaboration for a health system that works for patients.’
What the health sector is saying
The Australian Medical Association has said that the government ‘must resist’ changes to scope of practice, maintaining its position for even more investment into general practice.
Meanwhile, the Royal Australian College of GPs said the recommendations, if implemented, would ‘raid Medicare’, setting up for a ‘two-tiered health system where those who can afford to see a GP will, and those who can’t, don’t.’
But the Australian Nursing and Midwifery Federation said the review allows highly-trained health professionals to best utilise their skills, education and experience, allowing for the delivery of integrated, quality healthcare services across the community.
Support also came from the National Rural Health Alliance, who welcomed the recommendations that seek to address some of the ‘inequalities faced by rural Australians when it comes to accessing healthcare.’
Outside of the health sector, the Business Council of Australia also welcomed the report, citing improving ‘productivity, patient experience and workforce satisfaction’ as necessary to a sustainable health system.
[post_title] => Key recommendations to strengthen pharmacists’ role in healthcare
[post_excerpt] => The scope of practice review recommends sweeping legislative change and solutions to funding challenges to improve healthcare services.
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[post_content] => Patients with treatment-resistant schizophrenia or who are affected by significant adverse effects from antipsychotics may soon have a treatment which works on an entirely different mechanism of action.
Schizophrenia affects between 150,000 and 200,000 Australians (one in 100), with over a third (34%) of patients experiencing treatment-resistant schizophrenia (TRS).
Patients treated with antipsychotics are often beset by adverse effects, varying from minor tolerability issues such as mild sedation and dry mouth to disfiguring changes including severe weight gain and tardive dyskinesia. Those with TRS prescribed clozapine can also face the rare but life-threatening risk of developing myocarditis or agranulocytosis.
But the first new antipsychotic to be released on the market in decades could help to change this, potentially having life-changing impacts on patients with schizophrenia.
Cobenfy, which targets the cholinergic neurotransmitter system, was recently approved by the United States Food and Drug Administration.
Australian Pharmacist sat down with Arthur Christopoulos FAA FAHMS FPS, Dean of the Faculty of Pharmacy and Pharmaceutical Sciences at Monash University, to discuss how the medicine works, whether it will appear on the Australian market and what else is the pipeline that could transform our approach to mental ill health.
Watch the video below to find out more.
https://www.youtube.com/watch?v=qX2z3SgLHa0
[post_title] => Could this medicine revolutionise schizophrenia treatment?
[post_excerpt] => Working on a new mechanism of action, this treatment could change the lives of patients with schizophrenia. But not all patients can take it.
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[post_content] => The PSA is saddened to learn of the passing of life member William (Bill) Arnold MPS, who died peacefully in his sleep on Saturday (26 October 2024).
Bill was an active community pharmacist and long-standing pharmacy owner in the ACT, who’s profound contribution to the profession and the Australian public spanned many roles and many decades.
Bill was a career-long member of the PSA, regularly attending events and lectures and volunteering his time and expertise for the benefit of the profession. Bill served on Special Interest Groups and was appointed as the pharmacy representative on a diverse range of boards and bodies including the ACT Alcohol, Tobacco and Other Drugs Taskforce Working Group, the ACT Opiate Treatment Advisory Committee and the ACT Vulnerable Families Project.
In 2013, Bill celebrated 50 years of continuous PSA membership and was made a Life Member in recognition of his service to the profession and to PSA.
Bill was the first Chairman of the ACT Division of the Pharmaceutical Society of New South Wales in 1971. He made a significant contribution to the profession as a member of the ACT Pharmacy Board from 1998-2015. He was an active contributor to the International Pharmaceutical Federation (FIP) and an inaugural member of the Pharmacy Guild of Australia’s ACT Branch Committee, who later recognised him as a life member. Bill was also one of the leaders behind Auspharmlist, one of the first online forums for pharmacists to collaborate and mentor each in the virtual world.
Outside of pharmacy, Bill had a love of the Australian bush, was a soccer tragic and undertook extensive chaplaincy work in prisons.
Upon awarding Mr Arnold the honour of life membership, then ACT Branch President Greg Kyle, recognised Bill as a stalwart of PSA for many years, describing his as ‘a very active member [whose] ongoing commitment to the profession and the community is an example that many other pharmacists look up to.’
‘He never shirks from volunteering to offer his expertise and his work has seen him appointed as the pharmacy representative on a diverse range of boards and bodies which have included the ACT Alcohol, Tobacco and Other Drugs Taskforce Working Group, the ACT Opiate Treatment Advisory Committee and the ACT Vulnerable Families Project,’ Associate Professor Kyle said.
On receiving this honour, Bill reflected:
‘I seem to remember going from the Pharmacy Board Office in Sydney after collecting that bit of paper straight round to the PSA NSW Office to join. I have always enjoyed the community pharmacy environment and being able to help people, and this continues to be a great satisfaction for me. We have an expression in Hebrew; "Tikun Olam" which is translated in different ways. Essentially the concept is that each one of us should try to make the only world we have a better place.’
‘My father's version was that if you are part of anything you should be an active participant, and leave it better than when you started. I hope I have made a contribution to the profession.’
His funeral will be held tomorrow (31 October 2024) in Canberra.
Vale Bill Arnold MPS.
[post_title] => Vale William (Bill) Arnold (1940–2024)
[post_excerpt] => The PSA is saddened to learn of the passing of life member William (Bill) Arnold MPS, who died peacefully in his sleep on 26 October 2024.
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[post_content] => Australia coped better than many countries during COVID-19, avoiding severe health system collapse, mass casualties, and deeper economic downturns.
But the government’s COVID-19 Response Inquiry Report found significant collateral damage that could have been avoided – and that pharmacists were not activated in the vaccine roll-out soon enough.
Pharmacists should have been involved in the vaccine rollout much sooner
A delayed vaccine rollout was costly for Australia – leaving people vulnerable to severe illness and death, with a $31 billion economic loss also incurred – as we transitioned to ‘living with COVID-19’.
The Inquiry found that the COVID-19 vaccine rollout was way too slow to activate pharmacists and other vaccinators.
While the vaccine rollout commenced in Australia in February 2021, community pharmacists were not included until August that year. This contrasts with international responses, including the United States – where pharmacists began vaccinating patients in December 2020.
But pharmacists are clearly a vaccinator of choice, delivering around 40% of weekly vaccinations since the start of the rollout.
Vaccination scope harmonisation needs to happen, NOW
The scope of practice changes that occurred during the pandemic revealed inconsistencies in vaccination legislation across Australia. While pharmacists can administer COVID-19 vaccines throughout Australia, legislation around other vaccines, such as herpes zoster (Shingrix), differs per state and territory.
The inquiry panel agreed that a nationally consistent approach is required, and Scope of Practice Review recommendations harmonising existing legislation around what services pharmacists provide should be prioritised.
Prescribing restrictions on ivermectin: wrong approach
Unapproved COVID-19 treatments such as ivermectin and hydroxychloroquine were in high demand during the height of the pandemic, with pharmacists concerned this would lead to supply shortages for those prescribed the medicines for approved indications.
But the government's approach of implementing prescribing restrictions fueled mistrust, particularly given ivermectin is a safe drug when used correctly.
Instead of restricting off-label use of the drug for COVID-19, which had no proven clinical benefit, alternative measures to better manage demand should have been used to safeguard supply for the small number of Australians prescribed the medicine for legitimate users.
Equity fail: Antivirals mainly went to the wealthy
Access to COVID-19 antivirals is not equitable, even for those more at risk of severe complications. First Nations people, who have nearly 70% higher risk of dying from COVID-19 are 25% less likely to receive antivirals. Australians based in rural areas are also 37% less likely to obtain these treatments compared to those in cities.
There’s even a pronounced disparity in cities, with individuals over 70 in Sydney’s affluent Eastern suburbs almost twice as likely to access antivirals compared to those in the Western suburbs.
Better measures to provide access to people in priority populations are required.
Vaccination rates need an urgent boost
The lack of real time evidence based policy and the lack of transparency has driven a large decline in trust, said Minister for Health and Aged Care Mark Butler in a press conference held on Tuesday (30 October).
‘The erosion of trust is not only constraining our ability to respond to a pandemic when it next occurs, but we know it's already bled into the performance of our vaccination programs, including our childhood vaccination program.’
But according to social scientist and public health expert Professor Julie Leask: ‘It’s a slight decline in public trust. It’s not collapsing. It hasn’t taken a nosedive. There is an issue, but the sky is not falling. To claim it is worse risks people responding to that perception negatively.’
But to rebuild what is lost, a key action is the development of a national strategy to instil community confidence in vaccines and improve vaccination rates by target dates is an urgent priority, particularly among priority cohorts.
There should be an emphasis on lifting early childhood vaccination rates for other communicable diseases to pre-pandemic levels.
Australians won’t accept the same restrictions next time
When the next pandemic inevitably hits, the inquiry found that Australians are unlikely to accept the same measures. So a different pandemic response will be required, based on the Australia we are today – not the pre-pandemic version.
‘Right now, we are arguably worse placed as a country to deal with a pandemic than we were in early 2020 for a range of reasons,’ said Minister Butler.
This includes a fractured and fragmented healthcare system and an exhausted healthcare workforce.
[So we need] to build … a high-level playbook for the next pandemic because we know there will be a next pandemic.’
One example of this is vaccine mandates. The report found the application of vaccine mandates to the general population during COVID-19 reduced public trust. Any future implementation of vaccine mandates must be carefully considered, weighing their potential to undermine public trust and increase hesitancy against the need to protect public health. And thresholds to remove those mandates must be defined when they are instituted.
The new CDC could re-engage Australians with vaccination, but pharmacists need to be engaged
Yesterday the Australian Government immediately implemented the recommendation to establish an Australian Centre for Disease Control (CDC) committing $217.5 million to shift from an interim to ongoing arrangements. The intent is for a more coordinated, transparent approach to decision making for both pandemics and chronic health conditions.
The independent CDC is expected to launch on 1 January 2026, pending passage of legislation through federal parliament.
Welcoming the Federal Government’s commitment to establish a CDC as part of our national response to preventable disease, PSA National President Associate Professor Fei Sim FPS said, pharmacists can and should be better utilised as trusted healthcare professionals.
‘We have long known that the skills and expertise of Australia’s pharmacists are not fully utilised in reducing the burden of preventable diseases,’ she said.
‘While pharmacists are delivering more vaccinations than ever before, there is still a long way to go to make vaccination standards consistent across the country, recognising that a pharmacist immuniser in one state is just as qualified as a pharmacist immuniser in another state, and should be able to provide the same vaccinations to the same subsect of patients.’
PSA continues to fight for all pharmacists across the country to be able to deliver all vaccines to patients of all ages, under a nationally consistent vaccination schedule.
[post_title] => What went right (and wrong) with Australia's COVID-19 response?
[post_excerpt] => COVID-19 enquiry criticises delays involving pharmacists in rollout, calling for urgent harmonisation of vaccine scope.
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[title_attribute] => What went right (and wrong) with Australia’s COVID-19 response?
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[post_content] => At the end of this month, new pack sizes will start to arrive in pharmacies – ahead of the impending scheduling change of paracetamol.
From 1 February 2025, pack sizes of paracetamol will change, with larger quantities (50 plus in most jurisdictions) shifting to Schedule 3 following the final decision on paracetamol access controls made by the Therapeutic Goods Administration (TGA) on 3 May 2023.
Why are the changes occurring?
In short, the TGA changes aim to reduce the volume of paracetamol which is kept in people’s homes.
Paracetamol is frequently involved in self-poisoning cases worldwide. Due to concerns around rising cases of paracetamol poisoning in Australia, the TGA commissioned an independent review into the risks of intentional self-poisoning with paracetamol.
The harm caused by paracetamol is commonly perceived as low, given its safety at therapeutic doses, widespread use and broad availability, said Peter Guthrey MPS, PSA Senior Pharmacist – strategic policy.
‘However, paracetamol is still overrepresented in poisoning events – both intentional and unintentional,’ he said.
Around 225 Australians are hospitalised with liver injury and 50 Australians die from paracetamol overdose every year – with intentional overdose highest in female adolescents and young adults.
Given paracetamol is a commonly used medicine in Australia, with people likely having multiple packs at home, along with several different medicines containing paracetamol – reducing access through smaller pack sizes was a key focus of action, said Kay Sorimachi MPS, PSA Manager Policy and Regulatory Affairs.
‘The access route is multifactorial, but the TGA’s report focused on the fact that it's not that people go out and say, “I'm going to buy 100 tablets and take all of them,” but really it's what they had access to at the time,’ she said.
What’s occurring internationally?
The availability and regulation of paracetamol varies significantly across countries, but those with stricter regulations generally report lower incidences of severe poisoning.
In many European countries, including France, Germany, and Italy, paracetamol is not available in supermarkets and is only available in pharmacies, with much tighter pack size limits than Australia. For example, France limits pharmacy sales to 8 g per pack, while Germany only allows up to 10 g.
Modified-release (MR) paracetamol is generally unavailable in most European nations, contrasting with its availability in countries such as Australia and New Zealand.
In countries such as the USA and Canada, there are fewer restrictions on paracetamol sales, with larger pack sizes available outside pharmacies. However, similar to Australia, the USA has reported rising cases of paracetamol-related poisonings – particularly among adolescents.
Will the changes work?
If the findings following the UK’s legislation on paracetamol pack sizes is anything to go by, size matters. Since the legislation was implemented, there was an average reduction of 17 deaths (43%) in England and Wales from paracetamol poisoning per quarter.
Change 1: Pack sizes will shrink
The TGA’s final decision involves reducing pack sizes; key changes include:
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[post_content] => After months of anticipation, the Unleashing the potential of our health workforce – Scope of practice review was released yesterday (5 November) – with many of the key recommendations echoing the long-held concerns of the PSA and pharmacists across Australia.
Australian Pharmacist has rounded up some of the key takeouts from the report.
Pharmacists are leaving the profession at an alarming rate
Pharmacy has a high attrition rate compared with other healthcare professions. Among 19 healthcare professions, pharmacy had the fifth highest exit rate of 8.7% in 2023 – almost double that of medical professionals (4.7%).
The professions with the highest exit rates are those that face significant barriers to working to their full scope of practice, the review found.
While there are several factors that impact exit rates, allowing pharmacists to work to their full scope of practice is a crucial factor for strengthening the profession’s retention rate – improving recognition for professional skills, capability and contribution to enhance continuity of care.
‘This report really makes clear that there are all sorts of artificial, inefficient restrictions on what nurses, pharmacists, GPs, and other health professionals are allowed to do that bears no relationship to their training,’ said federal Minister for Health and Aged Care Mark Butler.
Inconsistencies in vaccine schedules for pharmacists are ‘needless’
Pharmacist vaccinators are trained in accordance with the National Immunisation Education Framework, ensuring high standards in vaccine administration and competence.
But the report found that the difference in state and territory laws dictating which vaccines can be administered by pharmacists has led to disparities in access – not only causing confusion among patients but leading to significant inefficiencies.
Legislative differences between states and territories also means that a vaccine subsidised in one region might not be covered in another.
Harmonising these regulations by reviewing Drugs and Poisons Acts would promote equitable vaccine access nationwide, allowing pharmacists’ to provide consistent healthcare services regardless of location.
Aligning funding arrangements for vaccination is also crucial, the review found. While the National Immunisation Program Vaccinations in Pharmacy (NIPVIP) provides government funding for certain vaccines, access to others depends on a mix of user-pay systems and varying jurisdictional funding – creating inconsistencies in affordability and accessibility across states and territories.
Standardising funding mechanisms would ensure subsidies are uniformly applied – making vaccinations more affordable and accessible to all Australians.
It will take some time to implement change, but there are some steps governments and regulators can take now
While some of the recommendations in the review, such as harmonising vaccination legislation, can be achieved in a timely fashion, others are sweeping reforms that will take many years, such as restructuring healthcare education – which currently impacts students and qualified pharmacists’ ability to work to their full scope.
The review recommended the Commonwealth establish a primary care workforce development program to support the development and retention of a skilled, stable, and collaborative primary care workforce through enhanced curriculum, training, placement, and career development opportunities for students, supervisors, mentors, and health professionals.
The current funding model must be overhauled
The current fee-for-service arrangement in primary care incentivises high-turnover care – with payments to providers based on the number and type of care episodes delivered.
This model limits the ability of health professionals to work to their full scope and reduces multidisciplinary collaboration – with some healthcare professionals funded for certain services while others are not, including lack of funding for pharmacists to participate in multidisciplinary case conferences.
To address this, the review recommends introducing a blended payment model to complement the fee-for-service system. This model would enable access to multidisciplinary healthcare delivered by professionals working to their full scope of practice in primary care.
An independent mechanism would be established to advise on pricing and payment levels for the blended payment, ensuring adjustments based on the risk profile of patient populations.
But it’s unlikely to be a quick fix. The review suggests the model would need to be implemented progressively over a 7-year period, beginning with priority areas such as rural and remote regions, Aboriginal Community Controlled Health Organisations, and underserviced regional and outer metropolitan areas.
Pharmacist prescribing programs should be nationally consistent
Implementing pharmacists prescribing rights has been an unnecessarily complex and prolonged process, with ad-hoc investigations, one-off reviews, and small-scale pilots.
Adopting an activity-based approach would streamline regulation for community pharmacists in prescribing medications and promote consistency across jurisdictions.
Introducing a dedicated mechanism to assess health workforce models would also fill a crucial gap, facilitating the systematic adoption of multidisciplinary primary care models that include pharmacists much like the successful models implemented in the United Kingdom.
Improved use of technology should form the backbone of scope of practice changes
A key theme in the review was the need for better use of technology across the board to expand scopes of practice and efficiencies, improving quality of care.
Potential areas for reform identified by the review include establishing access to real‑time patient information, introducing platforms for secure messaging and digital referrals and mandating participation in a multidisciplinary care team for primary care providers.
‘[We need to] improve the digital capability of a system that still uses far too many fax machines and too much paper,’ said Minister Butler.
The government will respond, in time
The government is yet to respond to the key recommendations in the report, with Minister Butler confirming he will not ‘respond to each of the ideas’.
‘We want to consider them, but a lot of them do have a lot of common sense,’ he said.
Other key stakeholders will also need to be consulted.
‘Many of the recommendations will require collaboration between the Commonwealth and state and territory governments, as well as consultation with peak professional organisations, AHPRA, patient groups, and the sector more broadly. I look forward to these discussions,’ Minister Butler added.
But PSA has called for the government to accept all 18 recommendations and put forward a plan of action now.
This review confirms PSA’s view that inconsistent regulations, unnecessary restrictions on practice, and siloed workforces are having a negative impact on patient access to quality health care, said PSA National President Associate Professor Fei Sim.
‘This report recognises the core role of pharmacies and pharmacists as primary healthcare providers and recommends a multidisciplinary approach to patient care,’ she said.
‘There is a clear alignment between Cormack’s recommendations and the actions in PSA’s vision for the pharmacy profession, Pharmacists in 2030. Both present a clear vision for the future that requires collaboration for a health system that works for patients.’
What the health sector is saying
The Australian Medical Association has said that the government ‘must resist’ changes to scope of practice, maintaining its position for even more investment into general practice.
Meanwhile, the Royal Australian College of GPs said the recommendations, if implemented, would ‘raid Medicare’, setting up for a ‘two-tiered health system where those who can afford to see a GP will, and those who can’t, don’t.’
But the Australian Nursing and Midwifery Federation said the review allows highly-trained health professionals to best utilise their skills, education and experience, allowing for the delivery of integrated, quality healthcare services across the community.
Support also came from the National Rural Health Alliance, who welcomed the recommendations that seek to address some of the ‘inequalities faced by rural Australians when it comes to accessing healthcare.’
Outside of the health sector, the Business Council of Australia also welcomed the report, citing improving ‘productivity, patient experience and workforce satisfaction’ as necessary to a sustainable health system.
[post_title] => Key recommendations to strengthen pharmacists’ role in healthcare
[post_excerpt] => The scope of practice review recommends sweeping legislative change and solutions to funding challenges to improve healthcare services.
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[post_content] => Patients with treatment-resistant schizophrenia or who are affected by significant adverse effects from antipsychotics may soon have a treatment which works on an entirely different mechanism of action.
Schizophrenia affects between 150,000 and 200,000 Australians (one in 100), with over a third (34%) of patients experiencing treatment-resistant schizophrenia (TRS).
Patients treated with antipsychotics are often beset by adverse effects, varying from minor tolerability issues such as mild sedation and dry mouth to disfiguring changes including severe weight gain and tardive dyskinesia. Those with TRS prescribed clozapine can also face the rare but life-threatening risk of developing myocarditis or agranulocytosis.
But the first new antipsychotic to be released on the market in decades could help to change this, potentially having life-changing impacts on patients with schizophrenia.
Cobenfy, which targets the cholinergic neurotransmitter system, was recently approved by the United States Food and Drug Administration.
Australian Pharmacist sat down with Arthur Christopoulos FAA FAHMS FPS, Dean of the Faculty of Pharmacy and Pharmaceutical Sciences at Monash University, to discuss how the medicine works, whether it will appear on the Australian market and what else is the pipeline that could transform our approach to mental ill health.
Watch the video below to find out more.
https://www.youtube.com/watch?v=qX2z3SgLHa0
[post_title] => Could this medicine revolutionise schizophrenia treatment?
[post_excerpt] => Working on a new mechanism of action, this treatment could change the lives of patients with schizophrenia. But not all patients can take it.
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[post_content] => The PSA is saddened to learn of the passing of life member William (Bill) Arnold MPS, who died peacefully in his sleep on Saturday (26 October 2024).
Bill was an active community pharmacist and long-standing pharmacy owner in the ACT, who’s profound contribution to the profession and the Australian public spanned many roles and many decades.
Bill was a career-long member of the PSA, regularly attending events and lectures and volunteering his time and expertise for the benefit of the profession. Bill served on Special Interest Groups and was appointed as the pharmacy representative on a diverse range of boards and bodies including the ACT Alcohol, Tobacco and Other Drugs Taskforce Working Group, the ACT Opiate Treatment Advisory Committee and the ACT Vulnerable Families Project.
In 2013, Bill celebrated 50 years of continuous PSA membership and was made a Life Member in recognition of his service to the profession and to PSA.
Bill was the first Chairman of the ACT Division of the Pharmaceutical Society of New South Wales in 1971. He made a significant contribution to the profession as a member of the ACT Pharmacy Board from 1998-2015. He was an active contributor to the International Pharmaceutical Federation (FIP) and an inaugural member of the Pharmacy Guild of Australia’s ACT Branch Committee, who later recognised him as a life member. Bill was also one of the leaders behind Auspharmlist, one of the first online forums for pharmacists to collaborate and mentor each in the virtual world.
Outside of pharmacy, Bill had a love of the Australian bush, was a soccer tragic and undertook extensive chaplaincy work in prisons.
Upon awarding Mr Arnold the honour of life membership, then ACT Branch President Greg Kyle, recognised Bill as a stalwart of PSA for many years, describing his as ‘a very active member [whose] ongoing commitment to the profession and the community is an example that many other pharmacists look up to.’
‘He never shirks from volunteering to offer his expertise and his work has seen him appointed as the pharmacy representative on a diverse range of boards and bodies which have included the ACT Alcohol, Tobacco and Other Drugs Taskforce Working Group, the ACT Opiate Treatment Advisory Committee and the ACT Vulnerable Families Project,’ Associate Professor Kyle said.
On receiving this honour, Bill reflected:
‘I seem to remember going from the Pharmacy Board Office in Sydney after collecting that bit of paper straight round to the PSA NSW Office to join. I have always enjoyed the community pharmacy environment and being able to help people, and this continues to be a great satisfaction for me. We have an expression in Hebrew; "Tikun Olam" which is translated in different ways. Essentially the concept is that each one of us should try to make the only world we have a better place.’
‘My father's version was that if you are part of anything you should be an active participant, and leave it better than when you started. I hope I have made a contribution to the profession.’
His funeral will be held tomorrow (31 October 2024) in Canberra.
Vale Bill Arnold MPS.
[post_title] => Vale William (Bill) Arnold (1940–2024)
[post_excerpt] => The PSA is saddened to learn of the passing of life member William (Bill) Arnold MPS, who died peacefully in his sleep on 26 October 2024.
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[post_content] => Australia coped better than many countries during COVID-19, avoiding severe health system collapse, mass casualties, and deeper economic downturns.
But the government’s COVID-19 Response Inquiry Report found significant collateral damage that could have been avoided – and that pharmacists were not activated in the vaccine roll-out soon enough.
Pharmacists should have been involved in the vaccine rollout much sooner
A delayed vaccine rollout was costly for Australia – leaving people vulnerable to severe illness and death, with a $31 billion economic loss also incurred – as we transitioned to ‘living with COVID-19’.
The Inquiry found that the COVID-19 vaccine rollout was way too slow to activate pharmacists and other vaccinators.
While the vaccine rollout commenced in Australia in February 2021, community pharmacists were not included until August that year. This contrasts with international responses, including the United States – where pharmacists began vaccinating patients in December 2020.
But pharmacists are clearly a vaccinator of choice, delivering around 40% of weekly vaccinations since the start of the rollout.
Vaccination scope harmonisation needs to happen, NOW
The scope of practice changes that occurred during the pandemic revealed inconsistencies in vaccination legislation across Australia. While pharmacists can administer COVID-19 vaccines throughout Australia, legislation around other vaccines, such as herpes zoster (Shingrix), differs per state and territory.
The inquiry panel agreed that a nationally consistent approach is required, and Scope of Practice Review recommendations harmonising existing legislation around what services pharmacists provide should be prioritised.
Prescribing restrictions on ivermectin: wrong approach
Unapproved COVID-19 treatments such as ivermectin and hydroxychloroquine were in high demand during the height of the pandemic, with pharmacists concerned this would lead to supply shortages for those prescribed the medicines for approved indications.
But the government's approach of implementing prescribing restrictions fueled mistrust, particularly given ivermectin is a safe drug when used correctly.
Instead of restricting off-label use of the drug for COVID-19, which had no proven clinical benefit, alternative measures to better manage demand should have been used to safeguard supply for the small number of Australians prescribed the medicine for legitimate users.
Equity fail: Antivirals mainly went to the wealthy
Access to COVID-19 antivirals is not equitable, even for those more at risk of severe complications. First Nations people, who have nearly 70% higher risk of dying from COVID-19 are 25% less likely to receive antivirals. Australians based in rural areas are also 37% less likely to obtain these treatments compared to those in cities.
There’s even a pronounced disparity in cities, with individuals over 70 in Sydney’s affluent Eastern suburbs almost twice as likely to access antivirals compared to those in the Western suburbs.
Better measures to provide access to people in priority populations are required.
Vaccination rates need an urgent boost
The lack of real time evidence based policy and the lack of transparency has driven a large decline in trust, said Minister for Health and Aged Care Mark Butler in a press conference held on Tuesday (30 October).
‘The erosion of trust is not only constraining our ability to respond to a pandemic when it next occurs, but we know it's already bled into the performance of our vaccination programs, including our childhood vaccination program.’
But according to social scientist and public health expert Professor Julie Leask: ‘It’s a slight decline in public trust. It’s not collapsing. It hasn’t taken a nosedive. There is an issue, but the sky is not falling. To claim it is worse risks people responding to that perception negatively.’
But to rebuild what is lost, a key action is the development of a national strategy to instil community confidence in vaccines and improve vaccination rates by target dates is an urgent priority, particularly among priority cohorts.
There should be an emphasis on lifting early childhood vaccination rates for other communicable diseases to pre-pandemic levels.
Australians won’t accept the same restrictions next time
When the next pandemic inevitably hits, the inquiry found that Australians are unlikely to accept the same measures. So a different pandemic response will be required, based on the Australia we are today – not the pre-pandemic version.
‘Right now, we are arguably worse placed as a country to deal with a pandemic than we were in early 2020 for a range of reasons,’ said Minister Butler.
This includes a fractured and fragmented healthcare system and an exhausted healthcare workforce.
[So we need] to build … a high-level playbook for the next pandemic because we know there will be a next pandemic.’
One example of this is vaccine mandates. The report found the application of vaccine mandates to the general population during COVID-19 reduced public trust. Any future implementation of vaccine mandates must be carefully considered, weighing their potential to undermine public trust and increase hesitancy against the need to protect public health. And thresholds to remove those mandates must be defined when they are instituted.
The new CDC could re-engage Australians with vaccination, but pharmacists need to be engaged
Yesterday the Australian Government immediately implemented the recommendation to establish an Australian Centre for Disease Control (CDC) committing $217.5 million to shift from an interim to ongoing arrangements. The intent is for a more coordinated, transparent approach to decision making for both pandemics and chronic health conditions.
The independent CDC is expected to launch on 1 January 2026, pending passage of legislation through federal parliament.
Welcoming the Federal Government’s commitment to establish a CDC as part of our national response to preventable disease, PSA National President Associate Professor Fei Sim FPS said, pharmacists can and should be better utilised as trusted healthcare professionals.
‘We have long known that the skills and expertise of Australia’s pharmacists are not fully utilised in reducing the burden of preventable diseases,’ she said.
‘While pharmacists are delivering more vaccinations than ever before, there is still a long way to go to make vaccination standards consistent across the country, recognising that a pharmacist immuniser in one state is just as qualified as a pharmacist immuniser in another state, and should be able to provide the same vaccinations to the same subsect of patients.’
PSA continues to fight for all pharmacists across the country to be able to deliver all vaccines to patients of all ages, under a nationally consistent vaccination schedule.
[post_title] => What went right (and wrong) with Australia's COVID-19 response?
[post_excerpt] => COVID-19 enquiry criticises delays involving pharmacists in rollout, calling for urgent harmonisation of vaccine scope.
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[title_attribute] => What went right (and wrong) with Australia’s COVID-19 response?
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[post_content] => At the end of this month, new pack sizes will start to arrive in pharmacies – ahead of the impending scheduling change of paracetamol.
From 1 February 2025, pack sizes of paracetamol will change, with larger quantities (50 plus in most jurisdictions) shifting to Schedule 3 following the final decision on paracetamol access controls made by the Therapeutic Goods Administration (TGA) on 3 May 2023.
Why are the changes occurring?
In short, the TGA changes aim to reduce the volume of paracetamol which is kept in people’s homes.
Paracetamol is frequently involved in self-poisoning cases worldwide. Due to concerns around rising cases of paracetamol poisoning in Australia, the TGA commissioned an independent review into the risks of intentional self-poisoning with paracetamol.
The harm caused by paracetamol is commonly perceived as low, given its safety at therapeutic doses, widespread use and broad availability, said Peter Guthrey MPS, PSA Senior Pharmacist – strategic policy.
‘However, paracetamol is still overrepresented in poisoning events – both intentional and unintentional,’ he said.
Around 225 Australians are hospitalised with liver injury and 50 Australians die from paracetamol overdose every year – with intentional overdose highest in female adolescents and young adults.
Given paracetamol is a commonly used medicine in Australia, with people likely having multiple packs at home, along with several different medicines containing paracetamol – reducing access through smaller pack sizes was a key focus of action, said Kay Sorimachi MPS, PSA Manager Policy and Regulatory Affairs.
‘The access route is multifactorial, but the TGA’s report focused on the fact that it's not that people go out and say, “I'm going to buy 100 tablets and take all of them,” but really it's what they had access to at the time,’ she said.
What’s occurring internationally?
The availability and regulation of paracetamol varies significantly across countries, but those with stricter regulations generally report lower incidences of severe poisoning.
In many European countries, including France, Germany, and Italy, paracetamol is not available in supermarkets and is only available in pharmacies, with much tighter pack size limits than Australia. For example, France limits pharmacy sales to 8 g per pack, while Germany only allows up to 10 g.
Modified-release (MR) paracetamol is generally unavailable in most European nations, contrasting with its availability in countries such as Australia and New Zealand.
In countries such as the USA and Canada, there are fewer restrictions on paracetamol sales, with larger pack sizes available outside pharmacies. However, similar to Australia, the USA has reported rising cases of paracetamol-related poisonings – particularly among adolescents.
Will the changes work?
If the findings following the UK’s legislation on paracetamol pack sizes is anything to go by, size matters. Since the legislation was implemented, there was an average reduction of 17 deaths (43%) in England and Wales from paracetamol poisoning per quarter.
Change 1: Pack sizes will shrink
The TGA’s final decision involves reducing pack sizes; key changes include:
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[post_content] => After months of anticipation, the Unleashing the potential of our health workforce – Scope of practice review was released yesterday (5 November) – with many of the key recommendations echoing the long-held concerns of the PSA and pharmacists across Australia.
Australian Pharmacist has rounded up some of the key takeouts from the report.
Pharmacists are leaving the profession at an alarming rate
Pharmacy has a high attrition rate compared with other healthcare professions. Among 19 healthcare professions, pharmacy had the fifth highest exit rate of 8.7% in 2023 – almost double that of medical professionals (4.7%).
The professions with the highest exit rates are those that face significant barriers to working to their full scope of practice, the review found.
While there are several factors that impact exit rates, allowing pharmacists to work to their full scope of practice is a crucial factor for strengthening the profession’s retention rate – improving recognition for professional skills, capability and contribution to enhance continuity of care.
‘This report really makes clear that there are all sorts of artificial, inefficient restrictions on what nurses, pharmacists, GPs, and other health professionals are allowed to do that bears no relationship to their training,’ said federal Minister for Health and Aged Care Mark Butler.
Inconsistencies in vaccine schedules for pharmacists are ‘needless’
Pharmacist vaccinators are trained in accordance with the National Immunisation Education Framework, ensuring high standards in vaccine administration and competence.
But the report found that the difference in state and territory laws dictating which vaccines can be administered by pharmacists has led to disparities in access – not only causing confusion among patients but leading to significant inefficiencies.
Legislative differences between states and territories also means that a vaccine subsidised in one region might not be covered in another.
Harmonising these regulations by reviewing Drugs and Poisons Acts would promote equitable vaccine access nationwide, allowing pharmacists’ to provide consistent healthcare services regardless of location.
Aligning funding arrangements for vaccination is also crucial, the review found. While the National Immunisation Program Vaccinations in Pharmacy (NIPVIP) provides government funding for certain vaccines, access to others depends on a mix of user-pay systems and varying jurisdictional funding – creating inconsistencies in affordability and accessibility across states and territories.
Standardising funding mechanisms would ensure subsidies are uniformly applied – making vaccinations more affordable and accessible to all Australians.
It will take some time to implement change, but there are some steps governments and regulators can take now
While some of the recommendations in the review, such as harmonising vaccination legislation, can be achieved in a timely fashion, others are sweeping reforms that will take many years, such as restructuring healthcare education – which currently impacts students and qualified pharmacists’ ability to work to their full scope.
The review recommended the Commonwealth establish a primary care workforce development program to support the development and retention of a skilled, stable, and collaborative primary care workforce through enhanced curriculum, training, placement, and career development opportunities for students, supervisors, mentors, and health professionals.
The current funding model must be overhauled
The current fee-for-service arrangement in primary care incentivises high-turnover care – with payments to providers based on the number and type of care episodes delivered.
This model limits the ability of health professionals to work to their full scope and reduces multidisciplinary collaboration – with some healthcare professionals funded for certain services while others are not, including lack of funding for pharmacists to participate in multidisciplinary case conferences.
To address this, the review recommends introducing a blended payment model to complement the fee-for-service system. This model would enable access to multidisciplinary healthcare delivered by professionals working to their full scope of practice in primary care.
An independent mechanism would be established to advise on pricing and payment levels for the blended payment, ensuring adjustments based on the risk profile of patient populations.
But it’s unlikely to be a quick fix. The review suggests the model would need to be implemented progressively over a 7-year period, beginning with priority areas such as rural and remote regions, Aboriginal Community Controlled Health Organisations, and underserviced regional and outer metropolitan areas.
Pharmacist prescribing programs should be nationally consistent
Implementing pharmacists prescribing rights has been an unnecessarily complex and prolonged process, with ad-hoc investigations, one-off reviews, and small-scale pilots.
Adopting an activity-based approach would streamline regulation for community pharmacists in prescribing medications and promote consistency across jurisdictions.
Introducing a dedicated mechanism to assess health workforce models would also fill a crucial gap, facilitating the systematic adoption of multidisciplinary primary care models that include pharmacists much like the successful models implemented in the United Kingdom.
Improved use of technology should form the backbone of scope of practice changes
A key theme in the review was the need for better use of technology across the board to expand scopes of practice and efficiencies, improving quality of care.
Potential areas for reform identified by the review include establishing access to real‑time patient information, introducing platforms for secure messaging and digital referrals and mandating participation in a multidisciplinary care team for primary care providers.
‘[We need to] improve the digital capability of a system that still uses far too many fax machines and too much paper,’ said Minister Butler.
The government will respond, in time
The government is yet to respond to the key recommendations in the report, with Minister Butler confirming he will not ‘respond to each of the ideas’.
‘We want to consider them, but a lot of them do have a lot of common sense,’ he said.
Other key stakeholders will also need to be consulted.
‘Many of the recommendations will require collaboration between the Commonwealth and state and territory governments, as well as consultation with peak professional organisations, AHPRA, patient groups, and the sector more broadly. I look forward to these discussions,’ Minister Butler added.
But PSA has called for the government to accept all 18 recommendations and put forward a plan of action now.
This review confirms PSA’s view that inconsistent regulations, unnecessary restrictions on practice, and siloed workforces are having a negative impact on patient access to quality health care, said PSA National President Associate Professor Fei Sim.
‘This report recognises the core role of pharmacies and pharmacists as primary healthcare providers and recommends a multidisciplinary approach to patient care,’ she said.
‘There is a clear alignment between Cormack’s recommendations and the actions in PSA’s vision for the pharmacy profession, Pharmacists in 2030. Both present a clear vision for the future that requires collaboration for a health system that works for patients.’
What the health sector is saying
The Australian Medical Association has said that the government ‘must resist’ changes to scope of practice, maintaining its position for even more investment into general practice.
Meanwhile, the Royal Australian College of GPs said the recommendations, if implemented, would ‘raid Medicare’, setting up for a ‘two-tiered health system where those who can afford to see a GP will, and those who can’t, don’t.’
But the Australian Nursing and Midwifery Federation said the review allows highly-trained health professionals to best utilise their skills, education and experience, allowing for the delivery of integrated, quality healthcare services across the community.
Support also came from the National Rural Health Alliance, who welcomed the recommendations that seek to address some of the ‘inequalities faced by rural Australians when it comes to accessing healthcare.’
Outside of the health sector, the Business Council of Australia also welcomed the report, citing improving ‘productivity, patient experience and workforce satisfaction’ as necessary to a sustainable health system.
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[post_content] => Patients with treatment-resistant schizophrenia or who are affected by significant adverse effects from antipsychotics may soon have a treatment which works on an entirely different mechanism of action.
Schizophrenia affects between 150,000 and 200,000 Australians (one in 100), with over a third (34%) of patients experiencing treatment-resistant schizophrenia (TRS).
Patients treated with antipsychotics are often beset by adverse effects, varying from minor tolerability issues such as mild sedation and dry mouth to disfiguring changes including severe weight gain and tardive dyskinesia. Those with TRS prescribed clozapine can also face the rare but life-threatening risk of developing myocarditis or agranulocytosis.
But the first new antipsychotic to be released on the market in decades could help to change this, potentially having life-changing impacts on patients with schizophrenia.
Cobenfy, which targets the cholinergic neurotransmitter system, was recently approved by the United States Food and Drug Administration.
Australian Pharmacist sat down with Arthur Christopoulos FAA FAHMS FPS, Dean of the Faculty of Pharmacy and Pharmaceutical Sciences at Monash University, to discuss how the medicine works, whether it will appear on the Australian market and what else is the pipeline that could transform our approach to mental ill health.
Watch the video below to find out more.
https://www.youtube.com/watch?v=qX2z3SgLHa0
[post_title] => Could this medicine revolutionise schizophrenia treatment?
[post_excerpt] => Working on a new mechanism of action, this treatment could change the lives of patients with schizophrenia. But not all patients can take it.
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[post_content] => The PSA is saddened to learn of the passing of life member William (Bill) Arnold MPS, who died peacefully in his sleep on Saturday (26 October 2024).
Bill was an active community pharmacist and long-standing pharmacy owner in the ACT, who’s profound contribution to the profession and the Australian public spanned many roles and many decades.
Bill was a career-long member of the PSA, regularly attending events and lectures and volunteering his time and expertise for the benefit of the profession. Bill served on Special Interest Groups and was appointed as the pharmacy representative on a diverse range of boards and bodies including the ACT Alcohol, Tobacco and Other Drugs Taskforce Working Group, the ACT Opiate Treatment Advisory Committee and the ACT Vulnerable Families Project.
In 2013, Bill celebrated 50 years of continuous PSA membership and was made a Life Member in recognition of his service to the profession and to PSA.
Bill was the first Chairman of the ACT Division of the Pharmaceutical Society of New South Wales in 1971. He made a significant contribution to the profession as a member of the ACT Pharmacy Board from 1998-2015. He was an active contributor to the International Pharmaceutical Federation (FIP) and an inaugural member of the Pharmacy Guild of Australia’s ACT Branch Committee, who later recognised him as a life member. Bill was also one of the leaders behind Auspharmlist, one of the first online forums for pharmacists to collaborate and mentor each in the virtual world.
Outside of pharmacy, Bill had a love of the Australian bush, was a soccer tragic and undertook extensive chaplaincy work in prisons.
Upon awarding Mr Arnold the honour of life membership, then ACT Branch President Greg Kyle, recognised Bill as a stalwart of PSA for many years, describing his as ‘a very active member [whose] ongoing commitment to the profession and the community is an example that many other pharmacists look up to.’
‘He never shirks from volunteering to offer his expertise and his work has seen him appointed as the pharmacy representative on a diverse range of boards and bodies which have included the ACT Alcohol, Tobacco and Other Drugs Taskforce Working Group, the ACT Opiate Treatment Advisory Committee and the ACT Vulnerable Families Project,’ Associate Professor Kyle said.
On receiving this honour, Bill reflected:
‘I seem to remember going from the Pharmacy Board Office in Sydney after collecting that bit of paper straight round to the PSA NSW Office to join. I have always enjoyed the community pharmacy environment and being able to help people, and this continues to be a great satisfaction for me. We have an expression in Hebrew; "Tikun Olam" which is translated in different ways. Essentially the concept is that each one of us should try to make the only world we have a better place.’
‘My father's version was that if you are part of anything you should be an active participant, and leave it better than when you started. I hope I have made a contribution to the profession.’
His funeral will be held tomorrow (31 October 2024) in Canberra.
Vale Bill Arnold MPS.
[post_title] => Vale William (Bill) Arnold (1940–2024)
[post_excerpt] => The PSA is saddened to learn of the passing of life member William (Bill) Arnold MPS, who died peacefully in his sleep on 26 October 2024.
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[post_content] => Australia coped better than many countries during COVID-19, avoiding severe health system collapse, mass casualties, and deeper economic downturns.
But the government’s COVID-19 Response Inquiry Report found significant collateral damage that could have been avoided – and that pharmacists were not activated in the vaccine roll-out soon enough.
Pharmacists should have been involved in the vaccine rollout much sooner
A delayed vaccine rollout was costly for Australia – leaving people vulnerable to severe illness and death, with a $31 billion economic loss also incurred – as we transitioned to ‘living with COVID-19’.
The Inquiry found that the COVID-19 vaccine rollout was way too slow to activate pharmacists and other vaccinators.
While the vaccine rollout commenced in Australia in February 2021, community pharmacists were not included until August that year. This contrasts with international responses, including the United States – where pharmacists began vaccinating patients in December 2020.
But pharmacists are clearly a vaccinator of choice, delivering around 40% of weekly vaccinations since the start of the rollout.
Vaccination scope harmonisation needs to happen, NOW
The scope of practice changes that occurred during the pandemic revealed inconsistencies in vaccination legislation across Australia. While pharmacists can administer COVID-19 vaccines throughout Australia, legislation around other vaccines, such as herpes zoster (Shingrix), differs per state and territory.
The inquiry panel agreed that a nationally consistent approach is required, and Scope of Practice Review recommendations harmonising existing legislation around what services pharmacists provide should be prioritised.
Prescribing restrictions on ivermectin: wrong approach
Unapproved COVID-19 treatments such as ivermectin and hydroxychloroquine were in high demand during the height of the pandemic, with pharmacists concerned this would lead to supply shortages for those prescribed the medicines for approved indications.
But the government's approach of implementing prescribing restrictions fueled mistrust, particularly given ivermectin is a safe drug when used correctly.
Instead of restricting off-label use of the drug for COVID-19, which had no proven clinical benefit, alternative measures to better manage demand should have been used to safeguard supply for the small number of Australians prescribed the medicine for legitimate users.
Equity fail: Antivirals mainly went to the wealthy
Access to COVID-19 antivirals is not equitable, even for those more at risk of severe complications. First Nations people, who have nearly 70% higher risk of dying from COVID-19 are 25% less likely to receive antivirals. Australians based in rural areas are also 37% less likely to obtain these treatments compared to those in cities.
There’s even a pronounced disparity in cities, with individuals over 70 in Sydney’s affluent Eastern suburbs almost twice as likely to access antivirals compared to those in the Western suburbs.
Better measures to provide access to people in priority populations are required.
Vaccination rates need an urgent boost
The lack of real time evidence based policy and the lack of transparency has driven a large decline in trust, said Minister for Health and Aged Care Mark Butler in a press conference held on Tuesday (30 October).
‘The erosion of trust is not only constraining our ability to respond to a pandemic when it next occurs, but we know it's already bled into the performance of our vaccination programs, including our childhood vaccination program.’
But according to social scientist and public health expert Professor Julie Leask: ‘It’s a slight decline in public trust. It’s not collapsing. It hasn’t taken a nosedive. There is an issue, but the sky is not falling. To claim it is worse risks people responding to that perception negatively.’
But to rebuild what is lost, a key action is the development of a national strategy to instil community confidence in vaccines and improve vaccination rates by target dates is an urgent priority, particularly among priority cohorts.
There should be an emphasis on lifting early childhood vaccination rates for other communicable diseases to pre-pandemic levels.
Australians won’t accept the same restrictions next time
When the next pandemic inevitably hits, the inquiry found that Australians are unlikely to accept the same measures. So a different pandemic response will be required, based on the Australia we are today – not the pre-pandemic version.
‘Right now, we are arguably worse placed as a country to deal with a pandemic than we were in early 2020 for a range of reasons,’ said Minister Butler.
This includes a fractured and fragmented healthcare system and an exhausted healthcare workforce.
[So we need] to build … a high-level playbook for the next pandemic because we know there will be a next pandemic.’
One example of this is vaccine mandates. The report found the application of vaccine mandates to the general population during COVID-19 reduced public trust. Any future implementation of vaccine mandates must be carefully considered, weighing their potential to undermine public trust and increase hesitancy against the need to protect public health. And thresholds to remove those mandates must be defined when they are instituted.
The new CDC could re-engage Australians with vaccination, but pharmacists need to be engaged
Yesterday the Australian Government immediately implemented the recommendation to establish an Australian Centre for Disease Control (CDC) committing $217.5 million to shift from an interim to ongoing arrangements. The intent is for a more coordinated, transparent approach to decision making for both pandemics and chronic health conditions.
The independent CDC is expected to launch on 1 January 2026, pending passage of legislation through federal parliament.
Welcoming the Federal Government’s commitment to establish a CDC as part of our national response to preventable disease, PSA National President Associate Professor Fei Sim FPS said, pharmacists can and should be better utilised as trusted healthcare professionals.
‘We have long known that the skills and expertise of Australia’s pharmacists are not fully utilised in reducing the burden of preventable diseases,’ she said.
‘While pharmacists are delivering more vaccinations than ever before, there is still a long way to go to make vaccination standards consistent across the country, recognising that a pharmacist immuniser in one state is just as qualified as a pharmacist immuniser in another state, and should be able to provide the same vaccinations to the same subsect of patients.’
PSA continues to fight for all pharmacists across the country to be able to deliver all vaccines to patients of all ages, under a nationally consistent vaccination schedule.
[post_title] => What went right (and wrong) with Australia's COVID-19 response?
[post_excerpt] => COVID-19 enquiry criticises delays involving pharmacists in rollout, calling for urgent harmonisation of vaccine scope.
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[title_attribute] => What went right (and wrong) with Australia’s COVID-19 response?
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[post_content] => At the end of this month, new pack sizes will start to arrive in pharmacies – ahead of the impending scheduling change of paracetamol.
From 1 February 2025, pack sizes of paracetamol will change, with larger quantities (50 plus in most jurisdictions) shifting to Schedule 3 following the final decision on paracetamol access controls made by the Therapeutic Goods Administration (TGA) on 3 May 2023.
Why are the changes occurring?
In short, the TGA changes aim to reduce the volume of paracetamol which is kept in people’s homes.
Paracetamol is frequently involved in self-poisoning cases worldwide. Due to concerns around rising cases of paracetamol poisoning in Australia, the TGA commissioned an independent review into the risks of intentional self-poisoning with paracetamol.
The harm caused by paracetamol is commonly perceived as low, given its safety at therapeutic doses, widespread use and broad availability, said Peter Guthrey MPS, PSA Senior Pharmacist – strategic policy.
‘However, paracetamol is still overrepresented in poisoning events – both intentional and unintentional,’ he said.
Around 225 Australians are hospitalised with liver injury and 50 Australians die from paracetamol overdose every year – with intentional overdose highest in female adolescents and young adults.
Given paracetamol is a commonly used medicine in Australia, with people likely having multiple packs at home, along with several different medicines containing paracetamol – reducing access through smaller pack sizes was a key focus of action, said Kay Sorimachi MPS, PSA Manager Policy and Regulatory Affairs.
‘The access route is multifactorial, but the TGA’s report focused on the fact that it's not that people go out and say, “I'm going to buy 100 tablets and take all of them,” but really it's what they had access to at the time,’ she said.
What’s occurring internationally?
The availability and regulation of paracetamol varies significantly across countries, but those with stricter regulations generally report lower incidences of severe poisoning.
In many European countries, including France, Germany, and Italy, paracetamol is not available in supermarkets and is only available in pharmacies, with much tighter pack size limits than Australia. For example, France limits pharmacy sales to 8 g per pack, while Germany only allows up to 10 g.
Modified-release (MR) paracetamol is generally unavailable in most European nations, contrasting with its availability in countries such as Australia and New Zealand.
In countries such as the USA and Canada, there are fewer restrictions on paracetamol sales, with larger pack sizes available outside pharmacies. However, similar to Australia, the USA has reported rising cases of paracetamol-related poisonings – particularly among adolescents.
Will the changes work?
If the findings following the UK’s legislation on paracetamol pack sizes is anything to go by, size matters. Since the legislation was implemented, there was an average reduction of 17 deaths (43%) in England and Wales from paracetamol poisoning per quarter.
Change 1: Pack sizes will shrink
The TGA’s final decision involves reducing pack sizes; key changes include:
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[post_content] => After months of anticipation, the Unleashing the potential of our health workforce – Scope of practice review was released yesterday (5 November) – with many of the key recommendations echoing the long-held concerns of the PSA and pharmacists across Australia.
Australian Pharmacist has rounded up some of the key takeouts from the report.
Pharmacists are leaving the profession at an alarming rate
Pharmacy has a high attrition rate compared with other healthcare professions. Among 19 healthcare professions, pharmacy had the fifth highest exit rate of 8.7% in 2023 – almost double that of medical professionals (4.7%).
The professions with the highest exit rates are those that face significant barriers to working to their full scope of practice, the review found.
While there are several factors that impact exit rates, allowing pharmacists to work to their full scope of practice is a crucial factor for strengthening the profession’s retention rate – improving recognition for professional skills, capability and contribution to enhance continuity of care.
‘This report really makes clear that there are all sorts of artificial, inefficient restrictions on what nurses, pharmacists, GPs, and other health professionals are allowed to do that bears no relationship to their training,’ said federal Minister for Health and Aged Care Mark Butler.
Inconsistencies in vaccine schedules for pharmacists are ‘needless’
Pharmacist vaccinators are trained in accordance with the National Immunisation Education Framework, ensuring high standards in vaccine administration and competence.
But the report found that the difference in state and territory laws dictating which vaccines can be administered by pharmacists has led to disparities in access – not only causing confusion among patients but leading to significant inefficiencies.
Legislative differences between states and territories also means that a vaccine subsidised in one region might not be covered in another.
Harmonising these regulations by reviewing Drugs and Poisons Acts would promote equitable vaccine access nationwide, allowing pharmacists’ to provide consistent healthcare services regardless of location.
Aligning funding arrangements for vaccination is also crucial, the review found. While the National Immunisation Program Vaccinations in Pharmacy (NIPVIP) provides government funding for certain vaccines, access to others depends on a mix of user-pay systems and varying jurisdictional funding – creating inconsistencies in affordability and accessibility across states and territories.
Standardising funding mechanisms would ensure subsidies are uniformly applied – making vaccinations more affordable and accessible to all Australians.
It will take some time to implement change, but there are some steps governments and regulators can take now
While some of the recommendations in the review, such as harmonising vaccination legislation, can be achieved in a timely fashion, others are sweeping reforms that will take many years, such as restructuring healthcare education – which currently impacts students and qualified pharmacists’ ability to work to their full scope.
The review recommended the Commonwealth establish a primary care workforce development program to support the development and retention of a skilled, stable, and collaborative primary care workforce through enhanced curriculum, training, placement, and career development opportunities for students, supervisors, mentors, and health professionals.
The current funding model must be overhauled
The current fee-for-service arrangement in primary care incentivises high-turnover care – with payments to providers based on the number and type of care episodes delivered.
This model limits the ability of health professionals to work to their full scope and reduces multidisciplinary collaboration – with some healthcare professionals funded for certain services while others are not, including lack of funding for pharmacists to participate in multidisciplinary case conferences.
To address this, the review recommends introducing a blended payment model to complement the fee-for-service system. This model would enable access to multidisciplinary healthcare delivered by professionals working to their full scope of practice in primary care.
An independent mechanism would be established to advise on pricing and payment levels for the blended payment, ensuring adjustments based on the risk profile of patient populations.
But it’s unlikely to be a quick fix. The review suggests the model would need to be implemented progressively over a 7-year period, beginning with priority areas such as rural and remote regions, Aboriginal Community Controlled Health Organisations, and underserviced regional and outer metropolitan areas.
Pharmacist prescribing programs should be nationally consistent
Implementing pharmacists prescribing rights has been an unnecessarily complex and prolonged process, with ad-hoc investigations, one-off reviews, and small-scale pilots.
Adopting an activity-based approach would streamline regulation for community pharmacists in prescribing medications and promote consistency across jurisdictions.
Introducing a dedicated mechanism to assess health workforce models would also fill a crucial gap, facilitating the systematic adoption of multidisciplinary primary care models that include pharmacists much like the successful models implemented in the United Kingdom.
Improved use of technology should form the backbone of scope of practice changes
A key theme in the review was the need for better use of technology across the board to expand scopes of practice and efficiencies, improving quality of care.
Potential areas for reform identified by the review include establishing access to real‑time patient information, introducing platforms for secure messaging and digital referrals and mandating participation in a multidisciplinary care team for primary care providers.
‘[We need to] improve the digital capability of a system that still uses far too many fax machines and too much paper,’ said Minister Butler.
The government will respond, in time
The government is yet to respond to the key recommendations in the report, with Minister Butler confirming he will not ‘respond to each of the ideas’.
‘We want to consider them, but a lot of them do have a lot of common sense,’ he said.
Other key stakeholders will also need to be consulted.
‘Many of the recommendations will require collaboration between the Commonwealth and state and territory governments, as well as consultation with peak professional organisations, AHPRA, patient groups, and the sector more broadly. I look forward to these discussions,’ Minister Butler added.
But PSA has called for the government to accept all 18 recommendations and put forward a plan of action now.
This review confirms PSA’s view that inconsistent regulations, unnecessary restrictions on practice, and siloed workforces are having a negative impact on patient access to quality health care, said PSA National President Associate Professor Fei Sim.
‘This report recognises the core role of pharmacies and pharmacists as primary healthcare providers and recommends a multidisciplinary approach to patient care,’ she said.
‘There is a clear alignment between Cormack’s recommendations and the actions in PSA’s vision for the pharmacy profession, Pharmacists in 2030. Both present a clear vision for the future that requires collaboration for a health system that works for patients.’
What the health sector is saying
The Australian Medical Association has said that the government ‘must resist’ changes to scope of practice, maintaining its position for even more investment into general practice.
Meanwhile, the Royal Australian College of GPs said the recommendations, if implemented, would ‘raid Medicare’, setting up for a ‘two-tiered health system where those who can afford to see a GP will, and those who can’t, don’t.’
But the Australian Nursing and Midwifery Federation said the review allows highly-trained health professionals to best utilise their skills, education and experience, allowing for the delivery of integrated, quality healthcare services across the community.
Support also came from the National Rural Health Alliance, who welcomed the recommendations that seek to address some of the ‘inequalities faced by rural Australians when it comes to accessing healthcare.’
Outside of the health sector, the Business Council of Australia also welcomed the report, citing improving ‘productivity, patient experience and workforce satisfaction’ as necessary to a sustainable health system.
[post_title] => Key recommendations to strengthen pharmacists’ role in healthcare
[post_excerpt] => The scope of practice review recommends sweeping legislative change and solutions to funding challenges to improve healthcare services.
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[post_content] => Patients with treatment-resistant schizophrenia or who are affected by significant adverse effects from antipsychotics may soon have a treatment which works on an entirely different mechanism of action.
Schizophrenia affects between 150,000 and 200,000 Australians (one in 100), with over a third (34%) of patients experiencing treatment-resistant schizophrenia (TRS).
Patients treated with antipsychotics are often beset by adverse effects, varying from minor tolerability issues such as mild sedation and dry mouth to disfiguring changes including severe weight gain and tardive dyskinesia. Those with TRS prescribed clozapine can also face the rare but life-threatening risk of developing myocarditis or agranulocytosis.
But the first new antipsychotic to be released on the market in decades could help to change this, potentially having life-changing impacts on patients with schizophrenia.
Cobenfy, which targets the cholinergic neurotransmitter system, was recently approved by the United States Food and Drug Administration.
Australian Pharmacist sat down with Arthur Christopoulos FAA FAHMS FPS, Dean of the Faculty of Pharmacy and Pharmaceutical Sciences at Monash University, to discuss how the medicine works, whether it will appear on the Australian market and what else is the pipeline that could transform our approach to mental ill health.
Watch the video below to find out more.
https://www.youtube.com/watch?v=qX2z3SgLHa0
[post_title] => Could this medicine revolutionise schizophrenia treatment?
[post_excerpt] => Working on a new mechanism of action, this treatment could change the lives of patients with schizophrenia. But not all patients can take it.
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[post_content] => The PSA is saddened to learn of the passing of life member William (Bill) Arnold MPS, who died peacefully in his sleep on Saturday (26 October 2024).
Bill was an active community pharmacist and long-standing pharmacy owner in the ACT, who’s profound contribution to the profession and the Australian public spanned many roles and many decades.
Bill was a career-long member of the PSA, regularly attending events and lectures and volunteering his time and expertise for the benefit of the profession. Bill served on Special Interest Groups and was appointed as the pharmacy representative on a diverse range of boards and bodies including the ACT Alcohol, Tobacco and Other Drugs Taskforce Working Group, the ACT Opiate Treatment Advisory Committee and the ACT Vulnerable Families Project.
In 2013, Bill celebrated 50 years of continuous PSA membership and was made a Life Member in recognition of his service to the profession and to PSA.
Bill was the first Chairman of the ACT Division of the Pharmaceutical Society of New South Wales in 1971. He made a significant contribution to the profession as a member of the ACT Pharmacy Board from 1998-2015. He was an active contributor to the International Pharmaceutical Federation (FIP) and an inaugural member of the Pharmacy Guild of Australia’s ACT Branch Committee, who later recognised him as a life member. Bill was also one of the leaders behind Auspharmlist, one of the first online forums for pharmacists to collaborate and mentor each in the virtual world.
Outside of pharmacy, Bill had a love of the Australian bush, was a soccer tragic and undertook extensive chaplaincy work in prisons.
Upon awarding Mr Arnold the honour of life membership, then ACT Branch President Greg Kyle, recognised Bill as a stalwart of PSA for many years, describing his as ‘a very active member [whose] ongoing commitment to the profession and the community is an example that many other pharmacists look up to.’
‘He never shirks from volunteering to offer his expertise and his work has seen him appointed as the pharmacy representative on a diverse range of boards and bodies which have included the ACT Alcohol, Tobacco and Other Drugs Taskforce Working Group, the ACT Opiate Treatment Advisory Committee and the ACT Vulnerable Families Project,’ Associate Professor Kyle said.
On receiving this honour, Bill reflected:
‘I seem to remember going from the Pharmacy Board Office in Sydney after collecting that bit of paper straight round to the PSA NSW Office to join. I have always enjoyed the community pharmacy environment and being able to help people, and this continues to be a great satisfaction for me. We have an expression in Hebrew; "Tikun Olam" which is translated in different ways. Essentially the concept is that each one of us should try to make the only world we have a better place.’
‘My father's version was that if you are part of anything you should be an active participant, and leave it better than when you started. I hope I have made a contribution to the profession.’
His funeral will be held tomorrow (31 October 2024) in Canberra.
Vale Bill Arnold MPS.
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[post_content] => Australia coped better than many countries during COVID-19, avoiding severe health system collapse, mass casualties, and deeper economic downturns.
But the government’s COVID-19 Response Inquiry Report found significant collateral damage that could have been avoided – and that pharmacists were not activated in the vaccine roll-out soon enough.
Pharmacists should have been involved in the vaccine rollout much sooner
A delayed vaccine rollout was costly for Australia – leaving people vulnerable to severe illness and death, with a $31 billion economic loss also incurred – as we transitioned to ‘living with COVID-19’.
The Inquiry found that the COVID-19 vaccine rollout was way too slow to activate pharmacists and other vaccinators.
While the vaccine rollout commenced in Australia in February 2021, community pharmacists were not included until August that year. This contrasts with international responses, including the United States – where pharmacists began vaccinating patients in December 2020.
But pharmacists are clearly a vaccinator of choice, delivering around 40% of weekly vaccinations since the start of the rollout.
Vaccination scope harmonisation needs to happen, NOW
The scope of practice changes that occurred during the pandemic revealed inconsistencies in vaccination legislation across Australia. While pharmacists can administer COVID-19 vaccines throughout Australia, legislation around other vaccines, such as herpes zoster (Shingrix), differs per state and territory.
The inquiry panel agreed that a nationally consistent approach is required, and Scope of Practice Review recommendations harmonising existing legislation around what services pharmacists provide should be prioritised.
Prescribing restrictions on ivermectin: wrong approach
Unapproved COVID-19 treatments such as ivermectin and hydroxychloroquine were in high demand during the height of the pandemic, with pharmacists concerned this would lead to supply shortages for those prescribed the medicines for approved indications.
But the government's approach of implementing prescribing restrictions fueled mistrust, particularly given ivermectin is a safe drug when used correctly.
Instead of restricting off-label use of the drug for COVID-19, which had no proven clinical benefit, alternative measures to better manage demand should have been used to safeguard supply for the small number of Australians prescribed the medicine for legitimate users.
Equity fail: Antivirals mainly went to the wealthy
Access to COVID-19 antivirals is not equitable, even for those more at risk of severe complications. First Nations people, who have nearly 70% higher risk of dying from COVID-19 are 25% less likely to receive antivirals. Australians based in rural areas are also 37% less likely to obtain these treatments compared to those in cities.
There’s even a pronounced disparity in cities, with individuals over 70 in Sydney’s affluent Eastern suburbs almost twice as likely to access antivirals compared to those in the Western suburbs.
Better measures to provide access to people in priority populations are required.
Vaccination rates need an urgent boost
The lack of real time evidence based policy and the lack of transparency has driven a large decline in trust, said Minister for Health and Aged Care Mark Butler in a press conference held on Tuesday (30 October).
‘The erosion of trust is not only constraining our ability to respond to a pandemic when it next occurs, but we know it's already bled into the performance of our vaccination programs, including our childhood vaccination program.’
But according to social scientist and public health expert Professor Julie Leask: ‘It’s a slight decline in public trust. It’s not collapsing. It hasn’t taken a nosedive. There is an issue, but the sky is not falling. To claim it is worse risks people responding to that perception negatively.’
But to rebuild what is lost, a key action is the development of a national strategy to instil community confidence in vaccines and improve vaccination rates by target dates is an urgent priority, particularly among priority cohorts.
There should be an emphasis on lifting early childhood vaccination rates for other communicable diseases to pre-pandemic levels.
Australians won’t accept the same restrictions next time
When the next pandemic inevitably hits, the inquiry found that Australians are unlikely to accept the same measures. So a different pandemic response will be required, based on the Australia we are today – not the pre-pandemic version.
‘Right now, we are arguably worse placed as a country to deal with a pandemic than we were in early 2020 for a range of reasons,’ said Minister Butler.
This includes a fractured and fragmented healthcare system and an exhausted healthcare workforce.
[So we need] to build … a high-level playbook for the next pandemic because we know there will be a next pandemic.’
One example of this is vaccine mandates. The report found the application of vaccine mandates to the general population during COVID-19 reduced public trust. Any future implementation of vaccine mandates must be carefully considered, weighing their potential to undermine public trust and increase hesitancy against the need to protect public health. And thresholds to remove those mandates must be defined when they are instituted.
The new CDC could re-engage Australians with vaccination, but pharmacists need to be engaged
Yesterday the Australian Government immediately implemented the recommendation to establish an Australian Centre for Disease Control (CDC) committing $217.5 million to shift from an interim to ongoing arrangements. The intent is for a more coordinated, transparent approach to decision making for both pandemics and chronic health conditions.
The independent CDC is expected to launch on 1 January 2026, pending passage of legislation through federal parliament.
Welcoming the Federal Government’s commitment to establish a CDC as part of our national response to preventable disease, PSA National President Associate Professor Fei Sim FPS said, pharmacists can and should be better utilised as trusted healthcare professionals.
‘We have long known that the skills and expertise of Australia’s pharmacists are not fully utilised in reducing the burden of preventable diseases,’ she said.
‘While pharmacists are delivering more vaccinations than ever before, there is still a long way to go to make vaccination standards consistent across the country, recognising that a pharmacist immuniser in one state is just as qualified as a pharmacist immuniser in another state, and should be able to provide the same vaccinations to the same subsect of patients.’
PSA continues to fight for all pharmacists across the country to be able to deliver all vaccines to patients of all ages, under a nationally consistent vaccination schedule.
[post_title] => What went right (and wrong) with Australia's COVID-19 response?
[post_excerpt] => COVID-19 enquiry criticises delays involving pharmacists in rollout, calling for urgent harmonisation of vaccine scope.
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[title_attribute] => What went right (and wrong) with Australia’s COVID-19 response?
[title] => What went right (and wrong) with Australia’s COVID-19 response?
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[post_content] => At the end of this month, new pack sizes will start to arrive in pharmacies – ahead of the impending scheduling change of paracetamol.
From 1 February 2025, pack sizes of paracetamol will change, with larger quantities (50 plus in most jurisdictions) shifting to Schedule 3 following the final decision on paracetamol access controls made by the Therapeutic Goods Administration (TGA) on 3 May 2023.
Why are the changes occurring?
In short, the TGA changes aim to reduce the volume of paracetamol which is kept in people’s homes.
Paracetamol is frequently involved in self-poisoning cases worldwide. Due to concerns around rising cases of paracetamol poisoning in Australia, the TGA commissioned an independent review into the risks of intentional self-poisoning with paracetamol.
The harm caused by paracetamol is commonly perceived as low, given its safety at therapeutic doses, widespread use and broad availability, said Peter Guthrey MPS, PSA Senior Pharmacist – strategic policy.
‘However, paracetamol is still overrepresented in poisoning events – both intentional and unintentional,’ he said.
Around 225 Australians are hospitalised with liver injury and 50 Australians die from paracetamol overdose every year – with intentional overdose highest in female adolescents and young adults.
Given paracetamol is a commonly used medicine in Australia, with people likely having multiple packs at home, along with several different medicines containing paracetamol – reducing access through smaller pack sizes was a key focus of action, said Kay Sorimachi MPS, PSA Manager Policy and Regulatory Affairs.
‘The access route is multifactorial, but the TGA’s report focused on the fact that it's not that people go out and say, “I'm going to buy 100 tablets and take all of them,” but really it's what they had access to at the time,’ she said.
What’s occurring internationally?
The availability and regulation of paracetamol varies significantly across countries, but those with stricter regulations generally report lower incidences of severe poisoning.
In many European countries, including France, Germany, and Italy, paracetamol is not available in supermarkets and is only available in pharmacies, with much tighter pack size limits than Australia. For example, France limits pharmacy sales to 8 g per pack, while Germany only allows up to 10 g.
Modified-release (MR) paracetamol is generally unavailable in most European nations, contrasting with its availability in countries such as Australia and New Zealand.
In countries such as the USA and Canada, there are fewer restrictions on paracetamol sales, with larger pack sizes available outside pharmacies. However, similar to Australia, the USA has reported rising cases of paracetamol-related poisonings – particularly among adolescents.
Will the changes work?
If the findings following the UK’s legislation on paracetamol pack sizes is anything to go by, size matters. Since the legislation was implemented, there was an average reduction of 17 deaths (43%) in England and Wales from paracetamol poisoning per quarter.
Change 1: Pack sizes will shrink
The TGA’s final decision involves reducing pack sizes; key changes include:
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
