Pharmacy at the heart of fertility care

Morag Horton works alongside clinicians and nurses to ensure seamless IVF medicines supply and patient support.

How did you specialise in assisted reproductive therapy?

In 2013, I purchased a pharmacy involved in IVF and fertility treatment.
At that time, most medicines supply was made by IVF clinics directly to patients, and there was very little pharmacy involvement – other than for non-Medicare funded patients or medicines. I was dispensing medicines I’d never learnt about at university – nor in my career until then.

I struggled to find suitable training material, so I asked questions of IVF clinicians, nurses and pharmaceutical companies whenever the opportunity arose. I came to understand the medicines protocols used and became familiar with all the administration devices. In 2015, funding for the supply of IVF medicines changed to the Pharmaceutical Benefits Scheme (PBS) in the S100 category – meaning all supply now involved a pharmacist. The knowledge that I’d already gained meant I could support patients and their partners, as well as to the IVF clinic team, through and beyond this transition.

What does the role entail?

I help patients process huge amounts of information and complex medicines schedules, and access medicines that may not be available in their local community pharmacy. I also help to reduce or eliminate confusion or issues for patients e.g. insufficient prescribed quantities, missed items or last-minute medicines changes.

How do you help patients navigate their medicines regimen?

Being able to immediately understand the treatment protocol behind a bundle of prescriptions is important. Recognising the individual situation makes the patient feel more comfortable and understood. It also helps me tailor the information provided.

If the patient is anxious about injections and injection technique, I focus on the first item that needs to be used. This helps to ensure they’re not overwhelmed with three or more different products that may require different techniques or devices, and they feel more comfortable before adding in the next injection.

Clear and thorough labelling is also key, with storage information discussed and fridge items provided in a cooler bag with ice. I also provide written information to support verbal and online information,  offering further support by telephone.

How do you manage medicines storage, cold-chain and supply?

We’ve increased fridge capacity and back up, built in business continuity planning, and use data loggers on all refrigerators. We also have a dedicated fridge for IVF medicines, as the packaging is bulky and prescriptions can involve large quantities. Ordering is done frequently, with close attention to supplier cut-off times, particularly later in the week.
We carefully balance stock levels, expiry risk and cash flow, while monitoring prescribing patterns and staying in close contact with fertility clinics about upcoming treatment cycles. We also ensure all supporting materials – such as brochures, cooler bags, ice bricks and other consumables – are available.

How do you collaborate with fertility clinics, prescribers and nurses?

In the beginning of my involvement in the IVF field, I asked questions of others with more experience. Now, they often ask me questions. I also encourage clinicians to understand PBS listings and to prescribe in accordance with the criteria.

The IVF clinicians can be hard to reach for prescription queries, so good relationships with IVF nurses and clinic staff are essential. As a member of the Fertility Society of Australia and Fertility Nurses of Australasia, I keep up with the latest information and news, and participate in continuing education events and conferences. 

What advice do you have for ECPs keen on specialising in this area?

Build your knowledge and be confident in it, while remaining open-minded and supportive. Fertility treatment can place people under emotional, practical and financial pressure; pharmacists shouldn’t add to that burden.

A Day in the life of Morag Horton, community pharmacy owner, Adelaide, South Australia