COVID-19 update for Pharmacists -  27 March 2020

The Pharmacy Council of NSW are working with NSW Health to provide pharmacists with COVID-19 updates.

NSW temporary special authority to allow supply of medicines without a prescription

To facilitate continuity of care in the COVID-19 pandemic, a NSW temporary special authority has been issued under the Poisons and Therapeutic Goods Regulation 2008 (Regulation), effective until 30 September 2020 for supply of Schedule 4 (S4) medicines, excluding Schedule 4 Appendix D medicines, without a prescription, subject to the following conditions:

1.     The pharmacist is satisfied that:

• the person is undergoing treatment essential to the person’s well-being, and
• the medicine has previously been prescribed for the treatment, and
• the person is in immediate need of the medicine for continuation of treatment, and
• it is not practicable for the person to obtain a prescription for the medicine.

2.     A S4 medicine may only be supplied if the quantity supplied is no more than:

• for a S4 medicine that is on the PBS, the standard PBS maximum quantity, or
• for a S4 medicine that is not on the PBS, the quantity that is contained in the smallest standard pack in which the substance is generally available.

The medicine must be labelled in accordance with Appendix A of the Regulation, as for any dispensed medicine.

The pharmacist must make a record of the following, as for any dispensed medicine:

1. name and address of the patient;
2. name, strength and quantity of the medicine;
3. directions for use of the substance as determined by the pharmacist;
4. name and address of the authorised practitioner who last prescribed that substance;
5. date of supply;
6. a unique reference number; and
7. name of the pharmacist by whom the substance was supplied.

To check if the supply is eligible for PBS subsidy, please visit the PBS website.

It is important to note that any supply of Schedule 4 Appendix D and Schedule 8 medicines without a written prescription must comply with NSW law.  The NSW temporary special authority does NOT apply to Schedule 4 Appendix D and Schedule 8 medicines.

However, the usual emergency provisions for dispensing without a prescription under the Regulation are also available. This means:

• a prescriber may direct a pharmacist to supply a medicine (including S4D and S8 medicines) to a patient in an emergency situation, by providing a telephone order, email or facsimile.  The prescriber must forward a paper prescription to the pharmacy as soon as practicable and within 24 hours, endorsed as such;
• a pharmacist may dispense a three day supply of S4 medicine (not S4D or S8) without a prescription, where the pharmacist is satisfied there is an immediate need for continuation of current essential treatment and it is impracticable to obtain a prescription. The medicine must have been previously prescribed by an authorised practitioner. In the case of a pre-packed liquid preparation, cream or ointment, pressurised aerosol container or an anovulant, the smallest pack may be supplied;
• a pharmacist may dispense a single PBS quantity of oral contraceptives or statins, for patients requiring urgent supply under Continued Dispensing arrangements.

In the case of supplying an S4D or an S8, pharmacists must take special care to ascertain the veracity of a telephone order, e.g. by calling back the prescriber using an independent source of the telephone number.  If the pharmacist is unable to verify the prescriber’s identity, but has no other reason for suspecting the order is not genuine, then no more than two days’ supply should be made until the written signed hardcopy prescription is received.