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AUSTRALIAN PHARMACIST
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            [post_date] => 2025-07-09 10:22:04
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            [post_content] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood. 

Despite the profound impact endometriosis has on health and wellbeing, its diagnosis and management is complex –  with an average of 6–8 years between the onset of symptoms and diagnosis.

‘This delay is where pharmacists have a crucial role in recognising the symptoms of endometriosis and referring women promptly for diagnosis and treatment,’ said Grace Wong, Medication Safety Pharmacist at The Royal Women's Hospital – who will be leading a session on Championing change for endometriosis care at PSA25 next month.

      Why does endometriosis take so long to diagnose?
      
There are several interrelated factors at play. Historically, a definitive diagnosis of endometriosis required laparoscopic surgery with histopathological confirmation. 

But the limited availability of trained gynaecologists to perform these procedures has created a bottleneck in timely diagnosis.

Additionally, the variable and often non-specific nature of endometriosis symptoms – such as chronic pelvic pain, fatigue, dysmenorrhea, cyclical hematuria, dysuria and gastrointestinal disturbances – can lead to misdiagnosis of other conditions such as irritable bowel syndrome.

Patients experiencing chronic pelvic or abdominal pain may present repeatedly for symptom relief, with opioids or high-dose non-steroidal anti-inflammatory drugs (NSAIDs) often supplied without further investigation into the underlying cause. This pattern not only delays appropriate diagnosis but also increases the risk of adverse effects and medicine overuse.

Societal stigmas surrounding menstruation can lead many to normalise menstrual pain, delaying medical attention.

‘Removing stigma and making women feel confident and comfortable to speak to their pharmacist for advice is something pharmacists and pharmacy support staff can continue to improve,’ Wong said.

      When should endometriosis be suspected?
      
Endometriosis should be considered in anyone of reproductive age presenting with persistent pelvic pain – especially when it’s acyclical, unresponsive to first-line treatments, or associated with other gynaecological symptoms such as dyspareunia (painful intercourse) or dysmenorrhoea.

Atypical symptoms of endometriosis include:

        
 	
      • cyclical gastrointestinal symptoms (such as painful bowel movements)
        • 
 	
      • dyschesia (difficult defecation)
        • 
 	
      • chronic fatigue
        • 
 	
      • urinary urgency
        • 
 	
      • pain in the lower back, legs, upper abdomen or chest.
        • 

      
‘Once diagnosed, pharmacists can help women manage their symptoms through providing evidence-based advice, appropriate counselling for any prescribed medicines, and support women in their journey to managing their condition and leading high quality and productive lives,’ Wong said.

      What’s the role of pharmacists?
      
Pharmacists are often the first health professionals that people with endometriosis speak to about menstrual pain or gastrointestinal discomfort. So understanding the pathophysiology, risk factors, and wide-ranging symptoms of endometriosis is essential. 

Pharmacists can play a critical role by recognising these red flags, challenging the stigma of normalising menstrual pain and shifting symptomatic management with: 

        
 	
      • over-the-counter pain relief
        • 
 	
      • investigating the presentation and symptoms
        • 
 	
      • seeking appropriate medical assessment aids in the timely diagnosis of endometriosis
        • 
 	
      • inquiring about patients who present prescriptions for menstrual-related analgesia, who may have underlying red flags that went unrecognised by prescribers.
        • 

      
Validating patient experiences means avoiding the following terminology:

        
 	
      • ‘It's just period pain’ or ‘That's normal for women’: these phrases are dismissive and contribute to delayed diagnosis and stigma
        • 
 	
      • ‘Everyone goes through this’: minimises the patient's pain and experience
        • 
 	
      • ‘Are you sure it's not just stress?’: while stress can exacerbate symptoms, it should not be suggested as the sole cause
        • 
 	
      • ‘You don't look sick’: many chronic illnesses, including endometriosis, are invisible.
        • 

      
Instead, pharmacists could ask:

        
 	
      • ‘Could you describe if you’ve experienced painful intercourse or pain during bowel movements, particularly around your menstrual cycle?’
        • 
 	
      • ‘Do you have any urinary symptoms, such as pain or blood in your urine, and do these seem to relate to your period?’
        • 
 	
      • ‘Would you be willing to track your symptoms daily to help us identify any patterns?’
        • 

      
Pharmacists should also inquire about the impact of symptoms on quality of life and well-being to help break through the ‘suck it up’ mentality that’s often dismissed as normal menstrual pain or hormonal fluctuations.

‘As trusted health professionals, pharmacists have an important role in raising awareness about this condition and supporting efforts to improve services for women with endometriosis,’ Wong said.

      What are the treatment options?
      
Treatment of endometriosis is often medical, with a patient-centred approach based on symptoms and reproductive goals.

When pharmacological treatment is appropriate, pharmacists hold a critical role in supporting medicine adherence and counselling. 

Common pharmacological treatments include:

        
 	
      • hormonal therapies such as combined oral contraceptive pill (COCP), progestogen-only pills, or levonorgestrel-releasing intrauterine devices (IUDs)
        • 
 	
      • non-hormonal options including NSAIDs for pain control
        • 
 	
      • emerging therapies including GnRH antagonists (e.g. elagolix, relugolix) and selective progesterone receptor modulators, particularly for refractory cases.
        • 

      
As medicines experts, pharmacists play a critical role in counselling patients on endometriosis treatments, and managing adverse effects such as reduced bone density associated with GnRH therapy.

      What does the future hold?
      
Until recently, endometriosis had been largely overlooked in national funding and research priorities. However, there has been a recent welcome shift in public health policy towards acknowledging endometriosis as a serious chronic condition requiring coordinated care. 

The federal government’s National Action Plan for Endometriosis, launched in 2018, marked the first significant step toward national recognition. Since then, investment in awareness campaigns have helped improve visibility and care pathways. Building on this, the 2025–26 federal budget introduced pivotal investments in women’s health, including the establishment of 11 specialist endometriosis and pelvic pain clinics and the addition of a new Medicare Benefits Schedule item for advanced diagnostic ultrasound techniques.

‘Pharmacists are an integral part of the healthcare system, and I envisage there is potential for pharmacists to be more involved directly and indirectly in care of women with endometriosis, to help support the National Action Plan's vision,’ Wong said. ‘To prepare for further involvement, I would encourage pharmacists to find ways to upskill now to be ready and confident to step up when the time comes.’

Hear more from Grace Wong about the role of pharmacists in endometriosis by attending the ‘Championing change for endometriosis care’ session at PSA25, held in Sydney from 1–3 August. Register here to attend.
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            [post_excerpt] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood.
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    [title_attribute] => Empowering pharmacists to spot endometriosis early
    [title] => Empowering pharmacists to spot endometriosis early
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      Empowering pharmacists to spot endometriosis early

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            [post_date] => 2025-07-07 12:34:12
            [post_date_gmt] => 2025-07-07 02:34:12
            [post_content] => On  1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.

The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.

‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’

The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.

‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.

      What key changes are introduced in the updated standards?
      
Changes to the packaging, labelling and design of vaping products have been introduced.

Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.

‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.

New labelling, usage instructions and information leaflets are also required, along with name restrictions.

‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she  said. ‘And the only flavours allowed are mint, menthol or tobacco.’

Vaping devices and accessories must also meet stricter standards for:

        
 	
      • medical device quality
        • 
 	
      • risk management
        • 
 	
      • battery and electrical safety
        • 
 	
      • specific design and construction
        • 
 	
      • toxicological risk assessment.
        • 

      

      What previously met the standards but now breaches them?
      
Concentrations of nicotine over 50 mg/mL. The permitted concentration of nicotine has now changed to a maximum of 50 mg/mL, so vapes exceeding this level cannot be supplied.

While the primary onus is on manufacturers of vaping products to ensure they're adhering to the standards, pharmacists need to check that their stock is compliant.

      How can I comply with the new standards?
      
By checking all vaping products in your pharmacy against the TGA’s Notified vape list, which has changed since the reforms were initiated last year, Ms Dalla Venezia said.

‘I understand that the TGA conducts compliance assessments as part of ongoing compliance monitoring for these products,’ she said. ‘And since the reforms, a number of those items have been withdrawn.’

Therapeutic vaping products on the list of notified vapes have not been assessed by the TGA for quality, safety, efficacy or performance. But product sponsors must notify the TGA that their good complies with the minimum requirements for notified vaping goods, adhering to the product standards: 

        
 	
      • Therapeutic Goods (Standard for Therapeutic Vaping Goods) (TGO 110) Order 2021
        • 
 	
      • Therapeutic Goods (Medical Device Standard – Therapeutic Vaping Devices) Order 2023 (MDSO).
        • 

      
In addition to the notified vape list, there's a separate database on the TGA website that pharmacists can check to see which products have been withdrawn or ceased.

‘If pharmacists suspect a product they have is no longer consistent with these changes, they can  look at that withdrawn database,’ Ms Dalla Venezia said. ‘These lists can also be filtered by date.’

It’s also important to educate all pharmacy staff to ensure they are aware of the strengthened product standards, product compliance and availability – and alternative brands. 

      Do the changes apply to both prescription and Pharmacist Only vapes?
      
Yes. All therapeutic vapes, whether prescribed or supplied after a consultation with a pharmacist, must comply with the new standards. 

To ensure a smooth transition, pharmacists should communicate with prescribers – and patients – about the changes to vaping product standards, and available products.

‘The federal Department of Health, Disability and Ageing is continuously monitoring the products on the list and making sure that they adhere to the standards for vaping products,’ Ms Dalla Venezia said. 

‘So it’s a good idea to take note of all of your inventory, and if there’s anything you know you’re dispensing on a regular basis, cross reference it with the notified vape list.’ 

For more information on prescribing and dispensing vapes, refer to these PSA checklists:

        
 	
      • Pharmacist Workflow for Prescribing and Dispensing Therapeutic Vapes
        • 
 	
      • Pharmacist Workflow for Dispensing Nicotine Vaping Products.
        • 

      

      Can I sell my existing products until the stock is exhausted?
      
Only if it’s on the notified vape list. Since the standards came into effect last week on 1 July, all supplied vaping products must adhere to the new requirements.

Pharmacists should contact the manufacturer of non-compliant stock, Ms Dalla Venezia said.

‘The TGA has directed pharmacists to return non-compliant products to the supplier,’ she said. ‘If they're not able to return the products, they should dispose of them as per their state or territory regulations.’

      Do the new standards mean vapes are now first-line therapy?
      
Vapes are absolutely not the first-line treatment option for smoking cessation, Ms Dalla Venezia emphasised.

‘PSA’s recommendations and guidelines haven't [needed to] change in response to the standard changes,’ she said.

The recommended pathway for smoking cessation includes:

        
 	
      • Behavioural support: essential for all patients attempting to quit smoking, either alone or in combination with pharmacotherapy
        • 
 	
      • First-line pharmacotherapy:

          
 	
        • Nicotine Replacement Therapy (NRT)  – patches, gum, lozenges, mouth spray
          • 
 	
        • Varenicline
          • 
 	
        • Bupropion
          • 

        

        • 

      
Using combination NRT with behavioural support is more effective than NRT monotherapy.

Although therapeutic vapes are not first-line therapy for smoking cessation, the use of a therapeutic vape from the list of notified vapes is considered to be less harmful than smoking, Ms Dalla Venezia said.

‘We don’t want people to fear considering therapeutic vapes if they’re therapeutically appropriate,’ she said. ‘They are still an option for people who have gone through all the approved, first-line NRT steps and still are not able to quit smoking.’

      Is there a first-line therapy specifically for vaping cessation?
      
Not definitively, Ms Dalla Venezia said.

‘There isn't a substantial body of evidence for vaping cessation at the moment,’ she said. ‘But within the PSA guidelines, we take the same approach to vaping as we take to smoking cessation.’ 

That means pharmacists should recommend combination NRT for vaping cessation as the most effective first-line treatment option.

‘As evidence evolves, we'll continue to revisit the guidelines. But that's the best approach that we have with the evidence that's available to us at the moment,’ Ms Dalla Venezia said.

‘As recreational vapes are becoming less accessible, a new subset of the population who are nicotine dependent through vapes as the medium are going to need ongoing support from pharmacists.’

Historically, Australia's tobacco control and marketing around the harms of smoking have been successful, however they no longer reach the primary demographic – youth.

To engage young people aged 14–17 on a platform they actually use through people who speak their language, the federal Department of Health, Ageing and Disability engaged 10 influencers – one of which alone has 1.7 million followers on Tiktok in that age bracket.

‘It's a really great opportunity to reach young people  because that's the group of people who were beginning to use vapes at such rapidly increasing rates,’ Ms Dalla Venezia said.

Pharmacists should refer to the TGA vaping hub for a comprehensive overview of all changes.

Keen to learn more about smoking and vaping cessation? Attend the 'Clearing the air on smoking and vaping cessation' workshop at PSA25, held in Sydney from 1–3 August. Register here to attend.
            [post_title] => The new vaping standards explained
            [post_excerpt] => On  1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
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      The new vaping standards explained

      APC
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            [post_date] => 2025-07-02 12:25:50
            [post_date_gmt] => 2025-07-02 02:25:50
            [post_content] => PSA has announced that it will develop and maintain education standards for Continued Professional Development (CPD) for pharmacists, following the retirement of the Australian Pharmacy Council (APC) accreditation standards for CPD activities on 31 December 2025.

The APC’s accreditation standards for CPD activities have been in place since 2013.

PSA, who already publish regular CPD through Australian Pharmacist and its education catalogue, will develop and maintain industry leading standards that will certify the quality and independence of CPD.

CPD education assessed against the standards will carry a PSA approval, giving pharmacists confidence that the education they access maintains the highest quality, upholds pharmacy practice standards, guidelines and ethics, and is free from commercial bias.

PSA National President Associate Professor Fei Sim FPS said: ‘As the national peak body for pharmacists in Australia and custodians of pharmacy practice standards, guidelines and ethics, PSA is developing education standards for CPD that give our profession – and our stakeholders – confidence in the quality of pharmacist education.

‘Our members tell us that PSA’s education is of high quality, a quality they can trust, and this scheme will mean that when they see third party education that is approved as meeting the PSA education standards, they can have a similar level of trust in it,’ she said.

‘PSA’s CPD planning tool takes the stress out of planning and recording CPD education, just as these standards will give pharmacists confidence that the CPD they access is “up-to-scratch”.’

PSA’s CPD standards are set to be introduced in 2026.
            [post_title] => PSA to develop education standards for CPD activities
            [post_excerpt] => With the Australian Pharmacy Council retiring its accreditation standards for CPD activities, PSA is set to step up.
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    [title_attribute] => PSA to develop education standards for CPD activities
    [title] => PSA to develop education standards for CPD activities
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      PSA to develop education standards for CPD activities

      substitution
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            [post_date] => 2025-07-02 11:54:36
            [post_date_gmt] => 2025-07-02 01:54:36
            [post_content] => For the first time in Australian medicines history,  all Queensland-based pharmacists can make the call to substitute a therapeutically appropriate medicine without prescriber authority to solve medicine-related problems.

Australian Pharmacist explains the ins and outs of this momentous change.

      What’s changing?
      
An update to Medicines and Poisons (Medicines) Regulation 2021 (Qld) on 1 July 2025 will allow therapeutic adaptation and substitution to take place where there is a theraputic need for change.

Under section 117B of the regulation, a pharmacist dispensing a medicine may substitute an equivalent medicine for the one specified on the prescription – provided this is reasonably necessary for the patient’s therapeutic care.

An equivalent medicine is one that:

        
 	
      • appears on the Therapeutic Goods Act 1989 (Cwlth) register for the same indication as the original medicine
        • 
 	
      • is supplied in a dose and for a duration of treatment intended to achieve a therapeutic effect equivalent to that of the original medicine
        • 
 	
      • shares the same, or a substantially similar, chemical composition or pharmacological mechanism of action as the original medicine.
        • 

      
However, certain restricted medicines or those that have a risk of diversion may not be substituted.

      What was the reason behind the decision?
      
Professional bodies such as PSA and the Pharmacy Guild of Australia advocated to Queensland Health to bring about this significant change, said PSA Queensland State Manager, Karen Castle MPS.

‘PSA advocated for this strongly in our submission to the consultation on the amendments to the medicines and poisons regulation,’ she said. ‘These activities are well within the scope of any pharmacist, and we shouldn't have to do any additional training to be able to do this.’

And the benefits are myriad.

‘Patients benefit by having their medicine-problem resolved on-the-spot in the pharmacy, taxpayers benefit in reduced Medicare billing, and pharmacists benefit via increased autonomy,’ Ms Castle said. ‘But it does come with increased accountability.’

      When is it appropriate to substitute a medicine?
      
Dispensing an equivalent medicine can only take place when a therapeutic need arises, for example:

        
 	
      • patient-specific factors that may compromise the intended therapeutic effect of the prescribed medicine
        • 
 	
      • the prescribed medicine can’t be obtained within a reasonable timeframe to initiate or continue therapy.
        • 

      
For example, if a patient comes in with a prescription for atorvastatin 40 mg daily – which is not available at the pharmacy and cannot easily be sourced from another – pharmacists could supply rosuvastatin 20 mg daily. This approach will ensure an equivalent therapeutic effect in terms of the expected percentage reduction in LDL cholesterol.

Pharmacists can also therapeutically adapt a prescription for a medicine – altering the dose, strength, directions and/or quantity to maintain an equivalent therapeutic effect for the same treatment duration.

For example, if a patient is finding it challenging to comply with twice-daily dosing of metformin 500 mg tablets (quantity 100), pharmacists can amend the script to ‘metformin 1,000 mg extended-release, take one tablet in the morning (quantity 50)’.

      When should substitution not occur?
      
There are certain medicines with similar mechanisms of action that are not considered therapeutically equivalent and therefore cannot be substituted.

For example, cefalexin and cefaclor for the treatment of a urinary tract infection.

As first and second generation cephalosporins respectively, these medicines have different spectra of activity. They therefore shouldn’t be considered therapeutically equivalent.

      What about PBS medicines?
      
Medicines substituted by pharmacists are not covered under the Pharmaceutical Benefits Scheme (PBS). That means patients will need to pay full price.

      What are pharmacists' obligations?
      
Pharmacists must take enough time to determine that the substitution is appropriate, equivalent and safe for the individual patient.

‘Many adaptations are straightforward and common sense. For example, substituting two 500 mg tablets with one 1,000 mg tablet dose. But some adaptations are more complex,’ Ms Castle said.

Understanding and calculating dose equivalence will be critical for pharmacists to master. Tackling any potential contraindications with other medicines or conditions is also key. And this may be trickier for some medicines, even if they are in the same class, said Peter Guthrey, Senior Pharmacist – Strategic Policy at PSA.

‘For example, if someone has a script for rosuvastatin, which doesn't interact with grapefruit juice, and then you substitute it for simvastatin which does – you need to work through that before supplying the medicine,’ he said. ‘And if it turns out the patient is also taking another medicine that interacts with simvastatin but doesn't interact with rosuvastatin, you need to work through that as well – and then you consider substituting with simvastatin.’ 

It’s also essential to obtain informed consent from patients before making a substitution.

‘The patient has to understand that change and must agree to it,’ Mr Guthrey said. 

Equally, patients or other health professionals cannot compel pharmacists to make a substitution under this regulation. 

‘Ultimately, you are an autonomous decision maker with respect to therapeutic substitution and adaptation. You must be satisfied the change is safe and appropriate for the patient,’ he said. ‘You are under no obligation to make the adaptation. But you do now have a new option to problem-solve with the patient and provide more effective care.’

      What documentation is required?
      
Prior to dispensing an equivalent medicine, pharmacists must amend the prescription in accordance with the requirements in section 117B. 

Pharmacists are also required to make clinical notes about the substitution, Mr Guthrey said.

‘Attaching it to the dispensing record in the dispensing system is the best way to do this,’ he said.

But because pharmacists will have increased accountability, patient records must describe the rationale for why the pharmacist has made this decision.

Should pharmacists opt to make a therapeutically appropriate substitution, they must notify the prescriber after the fact, Ms Castle said.

‘Pharmacists are also required to document the details of this professional communication, including the means used to contact the prescriber,’  she added.

      Where can pharmacists turn for support?
      
The PSA will hold a member briefing for Queensland-based pharmacists to explain the finer details and practice applications.

For those in other states and territories, this is a change PSA will continue to advocate for across the nation, Mr Guthrey said.

‘As it becomes normal practice in Queensland, we would hope that other states and territories will see the benefits,’ he said.

Stay tuned for details on the upcoming member briefing.
            [post_title] => Pharmacist-led medicine substitutions now possible
            [post_excerpt] => In an Australian first, pharmacists can now adapt prescriptions to solve problems with medicines – no doctor sign-off required.
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      Pharmacist-led medicine substitutions now possible

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            [post_content] => This week pharmacists will see a suite of regulatory and funding changes take effect.

Here are the six key updates pharmacists need to know before tomorrow.

      1. Dispensing fees will marginally rise
      
Under the Eighth Community Pharmacy Agreement, pharmacists’ dispensing fee  – along with the Tier 1 Administration, Handling and Infrastructure fee and the Dangerous Drug fee – will be indexed by the Consumer Price Index (CPI) annually on 1 July.

Over the past 12 months to the March 2025 quarter, the CPI increased to 2.4%.

So from tomorrow, there will be a slight jump in the per script dispense fee, which will rise from $8.67 to $8.89.

      2. (Dis)continued dispensing as emergency measures roll back
      
As of tomorrow, temporary emergency measures that expanded the range of medicines available under Pharmaceutical Benefits Scheme (PBS) Continued Dispensing arrangements will be repealed.

The emergency authority which authorised these Continued Dispensing arrangements for private and PBS prescriptions in New South Wales, will also end at 11:59 pm tonight.

Only the standard list of 149 PBS-listed molecules will be available under Continued Dispensing in most jurisdictions, covering conditions such as asthma, diabetes, heart disease, high cholesterol and HIV. 

However, Continued Dispensing will continue for some. Just enacted in Queensland, the amount of medicine a pharmacist can supply to a patient as an ‘emergency supply’ is increasing from 3 days’ supply to the smallest available manufacturer’s pack of the medicine. This applies in addition to the supply provisions enabled under the Commonwealth Continued Dispensing Determination. And in Tasmania permanent regulation also allows full Continued Dispensing as private supply for all Prescription Only Medicines.

A full list of what’s happening in your state or territory is available via PSA’s Regulation Hub which will be updated overnight to reflect these changes.

The PSA has long advocated for the full measure to be made permanent across the nation.

‘We’ve seen temporary continued dispensing measures introduced during natural disasters, which is important, but there are several scenarios where a permanent policy would help patients, from personal emergencies to natural disasters,’ said PSA CEO Adjunct Associate Professor Steve Morris.

‘PSA is again urging the federal government to work with state and territory governments to permanently protect emergency access to medicines.’

      3. New vaping standards will come into effect
      
From 1 July, the Therapeutic Goods Administration (TGA) will implement strengthened standards for all therapeutic nicotine vaping products used for smoking-cessation and nicotine-dependence. This measure is designed to mitigate risks associated with therapeutic vaping products and ensure a consistent level of safety and quality across all products supplied through pharmacies.

Under the new standards, pharmacies will only be permitted to supply vapes that satisfy defined criteria around permitted ingredients, tamper-evident and child-resistant packaging, and clear, consistent labelling. 

Pharmacists should refer to the TGA’s notified vape list, which details all therapeutic vaping products approved for smoking cessation and the management of nicotine dependence.

      4. Pharmacists now have longer to transition to the new MMR and ACOP credential
      
Until recently, pharmacists were required to meet the revised credentialing standards by 30 June 2025 – either by obtaining Recognition of Prior Learning (RPL) towards their new credential or by undertaking further education to fulfil the updated requirements.

The deadlines to achieve both credentials have now been extended to:

        
 	
      • 31 December 2025 to transition to the Medication Management Review (MMR) credential. There will be no further extensions beyond this point.
        • 
 	
      • 30 June 2026 for transitioning to the Aged Care On-site Pharmacist (ACOP) Credential. MMR-credentialed pharmacists may continue to participate in the ACOP Measure through this date.
        • 

      
For more information on meeting the new requirements, refer to the AP article on the new MMR and ACOP credential deadlines.

      5. The Victorian pharmacy pilot will go permanent
      
Following a successful ​​evaluation, the Victorian Community Pharmacist Statewide Pilot will transition to the permanent Community Pharmacist Program tomorrow.

The program will also expand over the next 2 years, allowing appropriately trained pharmacists to offer services and prescribe certain Schedule 4 medications for 22 acute and chronic conditions, including type 2 diabetes, chronic obstructive pulmonary disease, asthma, allergies, ear infections and minor wounds. Pharmacists will also be able to administer travel vaccinations.

The Victorian government will continue to fund the program. This means most consultations will be free, with pharmacists receiving $20 per service. Pharmacists can charge an additional fee on top for services provided at their discretion.

However, the medicine subsidy that was provided during the pilot will end, with patients required to pay the full cost of and prescribed medications going forward.

Community pharmacies can submit an expression of interest to join the program via the Victorian Department of Health website.

      6. Piloted community pharmacist services in Queensland will also go permanent
      
From Tuesday, the services trialled under the Queensland Community Pharmacy Scope of Practice Pilot and the Contraception Pilot will be adopted as routine community pharmacy offerings.

Pharmacists who have undergone the requisite training will be authorised to assess and manage minor ailments, deliver targeted health and wellbeing interventions, and supply hormonal contraception as part of standard practice. The chronic conditions and medicines management services will remain in pilot phase until 30 June 2026, allowing for continued evaluation and refinement.

Planning is already under way within Queensland Health to transition the pilot services into business-as-usual workflows. In the meantime, participating pharmacies should continue to deliver pilot-phase services in line with current guidelines. Detailed implementation guidance and further updates on the ongoing chronic disease and medicines management pilots will be issued in coming months to support pharmacists through this transition.

      7. Interns and students get medicines administration rights in Queensland
      
In another 1 July update for Queensland, intern and student pharmacists working in a community pharmacy, private hospital or public hospital or health facility can administer any medicine that a pharmacist is authorised to administer, under the direct supervision of a pharmacist.
            [post_title] => Mid-year pharmacy policy overhaul begins
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      Mid-year pharmacy policy overhaul begins

  • Clinical 
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            [post_date] => 2025-07-09 10:22:04
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            [post_content] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood. 

Despite the profound impact endometriosis has on health and wellbeing, its diagnosis and management is complex –  with an average of 6–8 years between the onset of symptoms and diagnosis.

‘This delay is where pharmacists have a crucial role in recognising the symptoms of endometriosis and referring women promptly for diagnosis and treatment,’ said Grace Wong, Medication Safety Pharmacist at The Royal Women's Hospital – who will be leading a session on Championing change for endometriosis care at PSA25 next month.

      Why does endometriosis take so long to diagnose?
      
There are several interrelated factors at play. Historically, a definitive diagnosis of endometriosis required laparoscopic surgery with histopathological confirmation. 

But the limited availability of trained gynaecologists to perform these procedures has created a bottleneck in timely diagnosis.

Additionally, the variable and often non-specific nature of endometriosis symptoms – such as chronic pelvic pain, fatigue, dysmenorrhea, cyclical hematuria, dysuria and gastrointestinal disturbances – can lead to misdiagnosis of other conditions such as irritable bowel syndrome.

Patients experiencing chronic pelvic or abdominal pain may present repeatedly for symptom relief, with opioids or high-dose non-steroidal anti-inflammatory drugs (NSAIDs) often supplied without further investigation into the underlying cause. This pattern not only delays appropriate diagnosis but also increases the risk of adverse effects and medicine overuse.

Societal stigmas surrounding menstruation can lead many to normalise menstrual pain, delaying medical attention.

‘Removing stigma and making women feel confident and comfortable to speak to their pharmacist for advice is something pharmacists and pharmacy support staff can continue to improve,’ Wong said.

      When should endometriosis be suspected?
      
Endometriosis should be considered in anyone of reproductive age presenting with persistent pelvic pain – especially when it’s acyclical, unresponsive to first-line treatments, or associated with other gynaecological symptoms such as dyspareunia (painful intercourse) or dysmenorrhoea.

Atypical symptoms of endometriosis include:

        
 	
      • cyclical gastrointestinal symptoms (such as painful bowel movements)
        • 
 	
      • dyschesia (difficult defecation)
        • 
 	
      • chronic fatigue
        • 
 	
      • urinary urgency
        • 
 	
      • pain in the lower back, legs, upper abdomen or chest.
        • 

      
‘Once diagnosed, pharmacists can help women manage their symptoms through providing evidence-based advice, appropriate counselling for any prescribed medicines, and support women in their journey to managing their condition and leading high quality and productive lives,’ Wong said.

      What’s the role of pharmacists?
      
Pharmacists are often the first health professionals that people with endometriosis speak to about menstrual pain or gastrointestinal discomfort. So understanding the pathophysiology, risk factors, and wide-ranging symptoms of endometriosis is essential. 

Pharmacists can play a critical role by recognising these red flags, challenging the stigma of normalising menstrual pain and shifting symptomatic management with: 

        
 	
      • over-the-counter pain relief
        • 
 	
      • investigating the presentation and symptoms
        • 
 	
      • seeking appropriate medical assessment aids in the timely diagnosis of endometriosis
        • 
 	
      • inquiring about patients who present prescriptions for menstrual-related analgesia, who may have underlying red flags that went unrecognised by prescribers.
        • 

      
Validating patient experiences means avoiding the following terminology:

        
 	
      • ‘It's just period pain’ or ‘That's normal for women’: these phrases are dismissive and contribute to delayed diagnosis and stigma
        • 
 	
      • ‘Everyone goes through this’: minimises the patient's pain and experience
        • 
 	
      • ‘Are you sure it's not just stress?’: while stress can exacerbate symptoms, it should not be suggested as the sole cause
        • 
 	
      • ‘You don't look sick’: many chronic illnesses, including endometriosis, are invisible.
        • 

      
Instead, pharmacists could ask:

        
 	
      • ‘Could you describe if you’ve experienced painful intercourse or pain during bowel movements, particularly around your menstrual cycle?’
        • 
 	
      • ‘Do you have any urinary symptoms, such as pain or blood in your urine, and do these seem to relate to your period?’
        • 
 	
      • ‘Would you be willing to track your symptoms daily to help us identify any patterns?’
        • 

      
Pharmacists should also inquire about the impact of symptoms on quality of life and well-being to help break through the ‘suck it up’ mentality that’s often dismissed as normal menstrual pain or hormonal fluctuations.

‘As trusted health professionals, pharmacists have an important role in raising awareness about this condition and supporting efforts to improve services for women with endometriosis,’ Wong said.

      What are the treatment options?
      
Treatment of endometriosis is often medical, with a patient-centred approach based on symptoms and reproductive goals.

When pharmacological treatment is appropriate, pharmacists hold a critical role in supporting medicine adherence and counselling. 

Common pharmacological treatments include:

        
 	
      • hormonal therapies such as combined oral contraceptive pill (COCP), progestogen-only pills, or levonorgestrel-releasing intrauterine devices (IUDs)
        • 
 	
      • non-hormonal options including NSAIDs for pain control
        • 
 	
      • emerging therapies including GnRH antagonists (e.g. elagolix, relugolix) and selective progesterone receptor modulators, particularly for refractory cases.
        • 

      
As medicines experts, pharmacists play a critical role in counselling patients on endometriosis treatments, and managing adverse effects such as reduced bone density associated with GnRH therapy.

      What does the future hold?
      
Until recently, endometriosis had been largely overlooked in national funding and research priorities. However, there has been a recent welcome shift in public health policy towards acknowledging endometriosis as a serious chronic condition requiring coordinated care. 

The federal government’s National Action Plan for Endometriosis, launched in 2018, marked the first significant step toward national recognition. Since then, investment in awareness campaigns have helped improve visibility and care pathways. Building on this, the 2025–26 federal budget introduced pivotal investments in women’s health, including the establishment of 11 specialist endometriosis and pelvic pain clinics and the addition of a new Medicare Benefits Schedule item for advanced diagnostic ultrasound techniques.

‘Pharmacists are an integral part of the healthcare system, and I envisage there is potential for pharmacists to be more involved directly and indirectly in care of women with endometriosis, to help support the National Action Plan's vision,’ Wong said. ‘To prepare for further involvement, I would encourage pharmacists to find ways to upskill now to be ready and confident to step up when the time comes.’

Hear more from Grace Wong about the role of pharmacists in endometriosis by attending the ‘Championing change for endometriosis care’ session at PSA25, held in Sydney from 1–3 August. Register here to attend.
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      Empowering pharmacists to spot endometriosis early

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            [post_content] => On  1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.

The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.

‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’

The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.

‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.

      What key changes are introduced in the updated standards?
      
Changes to the packaging, labelling and design of vaping products have been introduced.

Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.

‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.

New labelling, usage instructions and information leaflets are also required, along with name restrictions.

‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she  said. ‘And the only flavours allowed are mint, menthol or tobacco.’

Vaping devices and accessories must also meet stricter standards for:

        
 	
      • medical device quality
        • 
 	
      • risk management
        • 
 	
      • battery and electrical safety
        • 
 	
      • specific design and construction
        • 
 	
      • toxicological risk assessment.
        • 

      

      What previously met the standards but now breaches them?
      
Concentrations of nicotine over 50 mg/mL. The permitted concentration of nicotine has now changed to a maximum of 50 mg/mL, so vapes exceeding this level cannot be supplied.

While the primary onus is on manufacturers of vaping products to ensure they're adhering to the standards, pharmacists need to check that their stock is compliant.

      How can I comply with the new standards?
      
By checking all vaping products in your pharmacy against the TGA’s Notified vape list, which has changed since the reforms were initiated last year, Ms Dalla Venezia said.

‘I understand that the TGA conducts compliance assessments as part of ongoing compliance monitoring for these products,’ she said. ‘And since the reforms, a number of those items have been withdrawn.’

Therapeutic vaping products on the list of notified vapes have not been assessed by the TGA for quality, safety, efficacy or performance. But product sponsors must notify the TGA that their good complies with the minimum requirements for notified vaping goods, adhering to the product standards: 

        
 	
      • Therapeutic Goods (Standard for Therapeutic Vaping Goods) (TGO 110) Order 2021
        • 
 	
      • Therapeutic Goods (Medical Device Standard – Therapeutic Vaping Devices) Order 2023 (MDSO).
        • 

      
In addition to the notified vape list, there's a separate database on the TGA website that pharmacists can check to see which products have been withdrawn or ceased.

‘If pharmacists suspect a product they have is no longer consistent with these changes, they can  look at that withdrawn database,’ Ms Dalla Venezia said. ‘These lists can also be filtered by date.’

It’s also important to educate all pharmacy staff to ensure they are aware of the strengthened product standards, product compliance and availability – and alternative brands. 

      Do the changes apply to both prescription and Pharmacist Only vapes?
      
Yes. All therapeutic vapes, whether prescribed or supplied after a consultation with a pharmacist, must comply with the new standards. 

To ensure a smooth transition, pharmacists should communicate with prescribers – and patients – about the changes to vaping product standards, and available products.

‘The federal Department of Health, Disability and Ageing is continuously monitoring the products on the list and making sure that they adhere to the standards for vaping products,’ Ms Dalla Venezia said. 

‘So it’s a good idea to take note of all of your inventory, and if there’s anything you know you’re dispensing on a regular basis, cross reference it with the notified vape list.’ 

For more information on prescribing and dispensing vapes, refer to these PSA checklists:

        
 	
      • Pharmacist Workflow for Prescribing and Dispensing Therapeutic Vapes
        • 
 	
      • Pharmacist Workflow for Dispensing Nicotine Vaping Products.
        • 

      

      Can I sell my existing products until the stock is exhausted?
      
Only if it’s on the notified vape list. Since the standards came into effect last week on 1 July, all supplied vaping products must adhere to the new requirements.

Pharmacists should contact the manufacturer of non-compliant stock, Ms Dalla Venezia said.

‘The TGA has directed pharmacists to return non-compliant products to the supplier,’ she said. ‘If they're not able to return the products, they should dispose of them as per their state or territory regulations.’

      Do the new standards mean vapes are now first-line therapy?
      
Vapes are absolutely not the first-line treatment option for smoking cessation, Ms Dalla Venezia emphasised.

‘PSA’s recommendations and guidelines haven't [needed to] change in response to the standard changes,’ she said.

The recommended pathway for smoking cessation includes:

        
 	
      • Behavioural support: essential for all patients attempting to quit smoking, either alone or in combination with pharmacotherapy
        • 
 	
      • First-line pharmacotherapy:

          
 	
        • Nicotine Replacement Therapy (NRT)  – patches, gum, lozenges, mouth spray
          • 
 	
        • Varenicline
          • 
 	
        • Bupropion
          • 

        

        • 

      
Using combination NRT with behavioural support is more effective than NRT monotherapy.

Although therapeutic vapes are not first-line therapy for smoking cessation, the use of a therapeutic vape from the list of notified vapes is considered to be less harmful than smoking, Ms Dalla Venezia said.

‘We don’t want people to fear considering therapeutic vapes if they’re therapeutically appropriate,’ she said. ‘They are still an option for people who have gone through all the approved, first-line NRT steps and still are not able to quit smoking.’

      Is there a first-line therapy specifically for vaping cessation?
      
Not definitively, Ms Dalla Venezia said.

‘There isn't a substantial body of evidence for vaping cessation at the moment,’ she said. ‘But within the PSA guidelines, we take the same approach to vaping as we take to smoking cessation.’ 

That means pharmacists should recommend combination NRT for vaping cessation as the most effective first-line treatment option.

‘As evidence evolves, we'll continue to revisit the guidelines. But that's the best approach that we have with the evidence that's available to us at the moment,’ Ms Dalla Venezia said.

‘As recreational vapes are becoming less accessible, a new subset of the population who are nicotine dependent through vapes as the medium are going to need ongoing support from pharmacists.’

Historically, Australia's tobacco control and marketing around the harms of smoking have been successful, however they no longer reach the primary demographic – youth.

To engage young people aged 14–17 on a platform they actually use through people who speak their language, the federal Department of Health, Ageing and Disability engaged 10 influencers – one of which alone has 1.7 million followers on Tiktok in that age bracket.

‘It's a really great opportunity to reach young people  because that's the group of people who were beginning to use vapes at such rapidly increasing rates,’ Ms Dalla Venezia said.

Pharmacists should refer to the TGA vaping hub for a comprehensive overview of all changes.

Keen to learn more about smoking and vaping cessation? Attend the 'Clearing the air on smoking and vaping cessation' workshop at PSA25, held in Sydney from 1–3 August. Register here to attend.
            [post_title] => The new vaping standards explained
            [post_excerpt] => On  1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
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      The new vaping standards explained

      APC
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            [post_content] => PSA has announced that it will develop and maintain education standards for Continued Professional Development (CPD) for pharmacists, following the retirement of the Australian Pharmacy Council (APC) accreditation standards for CPD activities on 31 December 2025.

The APC’s accreditation standards for CPD activities have been in place since 2013.

PSA, who already publish regular CPD through Australian Pharmacist and its education catalogue, will develop and maintain industry leading standards that will certify the quality and independence of CPD.

CPD education assessed against the standards will carry a PSA approval, giving pharmacists confidence that the education they access maintains the highest quality, upholds pharmacy practice standards, guidelines and ethics, and is free from commercial bias.

PSA National President Associate Professor Fei Sim FPS said: ‘As the national peak body for pharmacists in Australia and custodians of pharmacy practice standards, guidelines and ethics, PSA is developing education standards for CPD that give our profession – and our stakeholders – confidence in the quality of pharmacist education.

‘Our members tell us that PSA’s education is of high quality, a quality they can trust, and this scheme will mean that when they see third party education that is approved as meeting the PSA education standards, they can have a similar level of trust in it,’ she said.

‘PSA’s CPD planning tool takes the stress out of planning and recording CPD education, just as these standards will give pharmacists confidence that the CPD they access is “up-to-scratch”.’

PSA’s CPD standards are set to be introduced in 2026.
            [post_title] => PSA to develop education standards for CPD activities
            [post_excerpt] => With the Australian Pharmacy Council retiring its accreditation standards for CPD activities, PSA is set to step up.
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    [title_attribute] => PSA to develop education standards for CPD activities
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      PSA to develop education standards for CPD activities

      substitution
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            [post_content] => For the first time in Australian medicines history,  all Queensland-based pharmacists can make the call to substitute a therapeutically appropriate medicine without prescriber authority to solve medicine-related problems.

Australian Pharmacist explains the ins and outs of this momentous change.

      What’s changing?
      
An update to Medicines and Poisons (Medicines) Regulation 2021 (Qld) on 1 July 2025 will allow therapeutic adaptation and substitution to take place where there is a theraputic need for change.

Under section 117B of the regulation, a pharmacist dispensing a medicine may substitute an equivalent medicine for the one specified on the prescription – provided this is reasonably necessary for the patient’s therapeutic care.

An equivalent medicine is one that:

        
 	
      • appears on the Therapeutic Goods Act 1989 (Cwlth) register for the same indication as the original medicine
        • 
 	
      • is supplied in a dose and for a duration of treatment intended to achieve a therapeutic effect equivalent to that of the original medicine
        • 
 	
      • shares the same, or a substantially similar, chemical composition or pharmacological mechanism of action as the original medicine.
        • 

      
However, certain restricted medicines or those that have a risk of diversion may not be substituted.

      What was the reason behind the decision?
      
Professional bodies such as PSA and the Pharmacy Guild of Australia advocated to Queensland Health to bring about this significant change, said PSA Queensland State Manager, Karen Castle MPS.

‘PSA advocated for this strongly in our submission to the consultation on the amendments to the medicines and poisons regulation,’ she said. ‘These activities are well within the scope of any pharmacist, and we shouldn't have to do any additional training to be able to do this.’

And the benefits are myriad.

‘Patients benefit by having their medicine-problem resolved on-the-spot in the pharmacy, taxpayers benefit in reduced Medicare billing, and pharmacists benefit via increased autonomy,’ Ms Castle said. ‘But it does come with increased accountability.’

      When is it appropriate to substitute a medicine?
      
Dispensing an equivalent medicine can only take place when a therapeutic need arises, for example:

        
 	
      • patient-specific factors that may compromise the intended therapeutic effect of the prescribed medicine
        • 
 	
      • the prescribed medicine can’t be obtained within a reasonable timeframe to initiate or continue therapy.
        • 

      
For example, if a patient comes in with a prescription for atorvastatin 40 mg daily – which is not available at the pharmacy and cannot easily be sourced from another – pharmacists could supply rosuvastatin 20 mg daily. This approach will ensure an equivalent therapeutic effect in terms of the expected percentage reduction in LDL cholesterol.

Pharmacists can also therapeutically adapt a prescription for a medicine – altering the dose, strength, directions and/or quantity to maintain an equivalent therapeutic effect for the same treatment duration.

For example, if a patient is finding it challenging to comply with twice-daily dosing of metformin 500 mg tablets (quantity 100), pharmacists can amend the script to ‘metformin 1,000 mg extended-release, take one tablet in the morning (quantity 50)’.

      When should substitution not occur?
      
There are certain medicines with similar mechanisms of action that are not considered therapeutically equivalent and therefore cannot be substituted.

For example, cefalexin and cefaclor for the treatment of a urinary tract infection.

As first and second generation cephalosporins respectively, these medicines have different spectra of activity. They therefore shouldn’t be considered therapeutically equivalent.

      What about PBS medicines?
      
Medicines substituted by pharmacists are not covered under the Pharmaceutical Benefits Scheme (PBS). That means patients will need to pay full price.

      What are pharmacists' obligations?
      
Pharmacists must take enough time to determine that the substitution is appropriate, equivalent and safe for the individual patient.

‘Many adaptations are straightforward and common sense. For example, substituting two 500 mg tablets with one 1,000 mg tablet dose. But some adaptations are more complex,’ Ms Castle said.

Understanding and calculating dose equivalence will be critical for pharmacists to master. Tackling any potential contraindications with other medicines or conditions is also key. And this may be trickier for some medicines, even if they are in the same class, said Peter Guthrey, Senior Pharmacist – Strategic Policy at PSA.

‘For example, if someone has a script for rosuvastatin, which doesn't interact with grapefruit juice, and then you substitute it for simvastatin which does – you need to work through that before supplying the medicine,’ he said. ‘And if it turns out the patient is also taking another medicine that interacts with simvastatin but doesn't interact with rosuvastatin, you need to work through that as well – and then you consider substituting with simvastatin.’ 

It’s also essential to obtain informed consent from patients before making a substitution.

‘The patient has to understand that change and must agree to it,’ Mr Guthrey said. 

Equally, patients or other health professionals cannot compel pharmacists to make a substitution under this regulation. 

‘Ultimately, you are an autonomous decision maker with respect to therapeutic substitution and adaptation. You must be satisfied the change is safe and appropriate for the patient,’ he said. ‘You are under no obligation to make the adaptation. But you do now have a new option to problem-solve with the patient and provide more effective care.’

      What documentation is required?
      
Prior to dispensing an equivalent medicine, pharmacists must amend the prescription in accordance with the requirements in section 117B. 

Pharmacists are also required to make clinical notes about the substitution, Mr Guthrey said.

‘Attaching it to the dispensing record in the dispensing system is the best way to do this,’ he said.

But because pharmacists will have increased accountability, patient records must describe the rationale for why the pharmacist has made this decision.

Should pharmacists opt to make a therapeutically appropriate substitution, they must notify the prescriber after the fact, Ms Castle said.

‘Pharmacists are also required to document the details of this professional communication, including the means used to contact the prescriber,’  she added.

      Where can pharmacists turn for support?
      
The PSA will hold a member briefing for Queensland-based pharmacists to explain the finer details and practice applications.

For those in other states and territories, this is a change PSA will continue to advocate for across the nation, Mr Guthrey said.

‘As it becomes normal practice in Queensland, we would hope that other states and territories will see the benefits,’ he said.

Stay tuned for details on the upcoming member briefing.
            [post_title] => Pharmacist-led medicine substitutions now possible
            [post_excerpt] => In an Australian first, pharmacists can now adapt prescriptions to solve problems with medicines – no doctor sign-off required.
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      Pharmacist-led medicine substitutions now possible

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            [post_date] => 2025-06-30 12:58:25
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            [post_content] => This week pharmacists will see a suite of regulatory and funding changes take effect.

Here are the six key updates pharmacists need to know before tomorrow.

      1. Dispensing fees will marginally rise
      
Under the Eighth Community Pharmacy Agreement, pharmacists’ dispensing fee  – along with the Tier 1 Administration, Handling and Infrastructure fee and the Dangerous Drug fee – will be indexed by the Consumer Price Index (CPI) annually on 1 July.

Over the past 12 months to the March 2025 quarter, the CPI increased to 2.4%.

So from tomorrow, there will be a slight jump in the per script dispense fee, which will rise from $8.67 to $8.89.

      2. (Dis)continued dispensing as emergency measures roll back
      
As of tomorrow, temporary emergency measures that expanded the range of medicines available under Pharmaceutical Benefits Scheme (PBS) Continued Dispensing arrangements will be repealed.

The emergency authority which authorised these Continued Dispensing arrangements for private and PBS prescriptions in New South Wales, will also end at 11:59 pm tonight.

Only the standard list of 149 PBS-listed molecules will be available under Continued Dispensing in most jurisdictions, covering conditions such as asthma, diabetes, heart disease, high cholesterol and HIV. 

However, Continued Dispensing will continue for some. Just enacted in Queensland, the amount of medicine a pharmacist can supply to a patient as an ‘emergency supply’ is increasing from 3 days’ supply to the smallest available manufacturer’s pack of the medicine. This applies in addition to the supply provisions enabled under the Commonwealth Continued Dispensing Determination. And in Tasmania permanent regulation also allows full Continued Dispensing as private supply for all Prescription Only Medicines.

A full list of what’s happening in your state or territory is available via PSA’s Regulation Hub which will be updated overnight to reflect these changes.

The PSA has long advocated for the full measure to be made permanent across the nation.

‘We’ve seen temporary continued dispensing measures introduced during natural disasters, which is important, but there are several scenarios where a permanent policy would help patients, from personal emergencies to natural disasters,’ said PSA CEO Adjunct Associate Professor Steve Morris.

‘PSA is again urging the federal government to work with state and territory governments to permanently protect emergency access to medicines.’

      3. New vaping standards will come into effect
      
From 1 July, the Therapeutic Goods Administration (TGA) will implement strengthened standards for all therapeutic nicotine vaping products used for smoking-cessation and nicotine-dependence. This measure is designed to mitigate risks associated with therapeutic vaping products and ensure a consistent level of safety and quality across all products supplied through pharmacies.

Under the new standards, pharmacies will only be permitted to supply vapes that satisfy defined criteria around permitted ingredients, tamper-evident and child-resistant packaging, and clear, consistent labelling. 

Pharmacists should refer to the TGA’s notified vape list, which details all therapeutic vaping products approved for smoking cessation and the management of nicotine dependence.

      4. Pharmacists now have longer to transition to the new MMR and ACOP credential
      
Until recently, pharmacists were required to meet the revised credentialing standards by 30 June 2025 – either by obtaining Recognition of Prior Learning (RPL) towards their new credential or by undertaking further education to fulfil the updated requirements.

The deadlines to achieve both credentials have now been extended to:

        
 	
      • 31 December 2025 to transition to the Medication Management Review (MMR) credential. There will be no further extensions beyond this point.
        • 
 	
      • 30 June 2026 for transitioning to the Aged Care On-site Pharmacist (ACOP) Credential. MMR-credentialed pharmacists may continue to participate in the ACOP Measure through this date.
        • 

      
For more information on meeting the new requirements, refer to the AP article on the new MMR and ACOP credential deadlines.

      5. The Victorian pharmacy pilot will go permanent
      
Following a successful ​​evaluation, the Victorian Community Pharmacist Statewide Pilot will transition to the permanent Community Pharmacist Program tomorrow.

The program will also expand over the next 2 years, allowing appropriately trained pharmacists to offer services and prescribe certain Schedule 4 medications for 22 acute and chronic conditions, including type 2 diabetes, chronic obstructive pulmonary disease, asthma, allergies, ear infections and minor wounds. Pharmacists will also be able to administer travel vaccinations.

The Victorian government will continue to fund the program. This means most consultations will be free, with pharmacists receiving $20 per service. Pharmacists can charge an additional fee on top for services provided at their discretion.

However, the medicine subsidy that was provided during the pilot will end, with patients required to pay the full cost of and prescribed medications going forward.

Community pharmacies can submit an expression of interest to join the program via the Victorian Department of Health website.

      6. Piloted community pharmacist services in Queensland will also go permanent
      
From Tuesday, the services trialled under the Queensland Community Pharmacy Scope of Practice Pilot and the Contraception Pilot will be adopted as routine community pharmacy offerings.

Pharmacists who have undergone the requisite training will be authorised to assess and manage minor ailments, deliver targeted health and wellbeing interventions, and supply hormonal contraception as part of standard practice. The chronic conditions and medicines management services will remain in pilot phase until 30 June 2026, allowing for continued evaluation and refinement.

Planning is already under way within Queensland Health to transition the pilot services into business-as-usual workflows. In the meantime, participating pharmacies should continue to deliver pilot-phase services in line with current guidelines. Detailed implementation guidance and further updates on the ongoing chronic disease and medicines management pilots will be issued in coming months to support pharmacists through this transition.

      7. Interns and students get medicines administration rights in Queensland
      
In another 1 July update for Queensland, intern and student pharmacists working in a community pharmacy, private hospital or public hospital or health facility can administer any medicine that a pharmacist is authorised to administer, under the direct supervision of a pharmacist.
            [post_title] => Mid-year pharmacy policy overhaul begins
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      Mid-year pharmacy policy overhaul begins

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            [post_content] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood. 

Despite the profound impact endometriosis has on health and wellbeing, its diagnosis and management is complex –  with an average of 6–8 years between the onset of symptoms and diagnosis.

‘This delay is where pharmacists have a crucial role in recognising the symptoms of endometriosis and referring women promptly for diagnosis and treatment,’ said Grace Wong, Medication Safety Pharmacist at The Royal Women's Hospital – who will be leading a session on Championing change for endometriosis care at PSA25 next month.

      Why does endometriosis take so long to diagnose?
      
There are several interrelated factors at play. Historically, a definitive diagnosis of endometriosis required laparoscopic surgery with histopathological confirmation. 

But the limited availability of trained gynaecologists to perform these procedures has created a bottleneck in timely diagnosis.

Additionally, the variable and often non-specific nature of endometriosis symptoms – such as chronic pelvic pain, fatigue, dysmenorrhea, cyclical hematuria, dysuria and gastrointestinal disturbances – can lead to misdiagnosis of other conditions such as irritable bowel syndrome.

Patients experiencing chronic pelvic or abdominal pain may present repeatedly for symptom relief, with opioids or high-dose non-steroidal anti-inflammatory drugs (NSAIDs) often supplied without further investigation into the underlying cause. This pattern not only delays appropriate diagnosis but also increases the risk of adverse effects and medicine overuse.

Societal stigmas surrounding menstruation can lead many to normalise menstrual pain, delaying medical attention.

‘Removing stigma and making women feel confident and comfortable to speak to their pharmacist for advice is something pharmacists and pharmacy support staff can continue to improve,’ Wong said.

      When should endometriosis be suspected?
      
Endometriosis should be considered in anyone of reproductive age presenting with persistent pelvic pain – especially when it’s acyclical, unresponsive to first-line treatments, or associated with other gynaecological symptoms such as dyspareunia (painful intercourse) or dysmenorrhoea.

Atypical symptoms of endometriosis include:

        
 	
      • cyclical gastrointestinal symptoms (such as painful bowel movements)
        • 
 	
      • dyschesia (difficult defecation)
        • 
 	
      • chronic fatigue
        • 
 	
      • urinary urgency
        • 
 	
      • pain in the lower back, legs, upper abdomen or chest.
        • 

      
‘Once diagnosed, pharmacists can help women manage their symptoms through providing evidence-based advice, appropriate counselling for any prescribed medicines, and support women in their journey to managing their condition and leading high quality and productive lives,’ Wong said.

      What’s the role of pharmacists?
      
Pharmacists are often the first health professionals that people with endometriosis speak to about menstrual pain or gastrointestinal discomfort. So understanding the pathophysiology, risk factors, and wide-ranging symptoms of endometriosis is essential. 

Pharmacists can play a critical role by recognising these red flags, challenging the stigma of normalising menstrual pain and shifting symptomatic management with: 

        
 	
      • over-the-counter pain relief
        • 
 	
      • investigating the presentation and symptoms
        • 
 	
      • seeking appropriate medical assessment aids in the timely diagnosis of endometriosis
        • 
 	
      • inquiring about patients who present prescriptions for menstrual-related analgesia, who may have underlying red flags that went unrecognised by prescribers.
        • 

      
Validating patient experiences means avoiding the following terminology:

        
 	
      • ‘It's just period pain’ or ‘That's normal for women’: these phrases are dismissive and contribute to delayed diagnosis and stigma
        • 
 	
      • ‘Everyone goes through this’: minimises the patient's pain and experience
        • 
 	
      • ‘Are you sure it's not just stress?’: while stress can exacerbate symptoms, it should not be suggested as the sole cause
        • 
 	
      • ‘You don't look sick’: many chronic illnesses, including endometriosis, are invisible.
        • 

      
Instead, pharmacists could ask:

        
 	
      • ‘Could you describe if you’ve experienced painful intercourse or pain during bowel movements, particularly around your menstrual cycle?’
        • 
 	
      • ‘Do you have any urinary symptoms, such as pain or blood in your urine, and do these seem to relate to your period?’
        • 
 	
      • ‘Would you be willing to track your symptoms daily to help us identify any patterns?’
        • 

      
Pharmacists should also inquire about the impact of symptoms on quality of life and well-being to help break through the ‘suck it up’ mentality that’s often dismissed as normal menstrual pain or hormonal fluctuations.

‘As trusted health professionals, pharmacists have an important role in raising awareness about this condition and supporting efforts to improve services for women with endometriosis,’ Wong said.

      What are the treatment options?
      
Treatment of endometriosis is often medical, with a patient-centred approach based on symptoms and reproductive goals.

When pharmacological treatment is appropriate, pharmacists hold a critical role in supporting medicine adherence and counselling. 

Common pharmacological treatments include:

        
 	
      • hormonal therapies such as combined oral contraceptive pill (COCP), progestogen-only pills, or levonorgestrel-releasing intrauterine devices (IUDs)
        • 
 	
      • non-hormonal options including NSAIDs for pain control
        • 
 	
      • emerging therapies including GnRH antagonists (e.g. elagolix, relugolix) and selective progesterone receptor modulators, particularly for refractory cases.
        • 

      
As medicines experts, pharmacists play a critical role in counselling patients on endometriosis treatments, and managing adverse effects such as reduced bone density associated with GnRH therapy.

      What does the future hold?
      
Until recently, endometriosis had been largely overlooked in national funding and research priorities. However, there has been a recent welcome shift in public health policy towards acknowledging endometriosis as a serious chronic condition requiring coordinated care. 

The federal government’s National Action Plan for Endometriosis, launched in 2018, marked the first significant step toward national recognition. Since then, investment in awareness campaigns have helped improve visibility and care pathways. Building on this, the 2025–26 federal budget introduced pivotal investments in women’s health, including the establishment of 11 specialist endometriosis and pelvic pain clinics and the addition of a new Medicare Benefits Schedule item for advanced diagnostic ultrasound techniques.

‘Pharmacists are an integral part of the healthcare system, and I envisage there is potential for pharmacists to be more involved directly and indirectly in care of women with endometriosis, to help support the National Action Plan's vision,’ Wong said. ‘To prepare for further involvement, I would encourage pharmacists to find ways to upskill now to be ready and confident to step up when the time comes.’

Hear more from Grace Wong about the role of pharmacists in endometriosis by attending the ‘Championing change for endometriosis care’ session at PSA25, held in Sydney from 1–3 August. Register here to attend.
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      Empowering pharmacists to spot endometriosis early

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            [post_content] => On  1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.

The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.

‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’

The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.

‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.

      What key changes are introduced in the updated standards?
      
Changes to the packaging, labelling and design of vaping products have been introduced.

Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.

‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.

New labelling, usage instructions and information leaflets are also required, along with name restrictions.

‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she  said. ‘And the only flavours allowed are mint, menthol or tobacco.’

Vaping devices and accessories must also meet stricter standards for:

        
 	
      • medical device quality
        • 
 	
      • risk management
        • 
 	
      • battery and electrical safety
        • 
 	
      • specific design and construction
        • 
 	
      • toxicological risk assessment.
        • 

      

      What previously met the standards but now breaches them?
      
Concentrations of nicotine over 50 mg/mL. The permitted concentration of nicotine has now changed to a maximum of 50 mg/mL, so vapes exceeding this level cannot be supplied.

While the primary onus is on manufacturers of vaping products to ensure they're adhering to the standards, pharmacists need to check that their stock is compliant.

      How can I comply with the new standards?
      
By checking all vaping products in your pharmacy against the TGA’s Notified vape list, which has changed since the reforms were initiated last year, Ms Dalla Venezia said.

‘I understand that the TGA conducts compliance assessments as part of ongoing compliance monitoring for these products,’ she said. ‘And since the reforms, a number of those items have been withdrawn.’

Therapeutic vaping products on the list of notified vapes have not been assessed by the TGA for quality, safety, efficacy or performance. But product sponsors must notify the TGA that their good complies with the minimum requirements for notified vaping goods, adhering to the product standards: 

        
 	
      • Therapeutic Goods (Standard for Therapeutic Vaping Goods) (TGO 110) Order 2021
        • 
 	
      • Therapeutic Goods (Medical Device Standard – Therapeutic Vaping Devices) Order 2023 (MDSO).
        • 

      
In addition to the notified vape list, there's a separate database on the TGA website that pharmacists can check to see which products have been withdrawn or ceased.

‘If pharmacists suspect a product they have is no longer consistent with these changes, they can  look at that withdrawn database,’ Ms Dalla Venezia said. ‘These lists can also be filtered by date.’

It’s also important to educate all pharmacy staff to ensure they are aware of the strengthened product standards, product compliance and availability – and alternative brands. 

      Do the changes apply to both prescription and Pharmacist Only vapes?
      
Yes. All therapeutic vapes, whether prescribed or supplied after a consultation with a pharmacist, must comply with the new standards. 

To ensure a smooth transition, pharmacists should communicate with prescribers – and patients – about the changes to vaping product standards, and available products.

‘The federal Department of Health, Disability and Ageing is continuously monitoring the products on the list and making sure that they adhere to the standards for vaping products,’ Ms Dalla Venezia said. 

‘So it’s a good idea to take note of all of your inventory, and if there’s anything you know you’re dispensing on a regular basis, cross reference it with the notified vape list.’ 

For more information on prescribing and dispensing vapes, refer to these PSA checklists:

        
 	
      • Pharmacist Workflow for Prescribing and Dispensing Therapeutic Vapes
        • 
 	
      • Pharmacist Workflow for Dispensing Nicotine Vaping Products.
        • 

      

      Can I sell my existing products until the stock is exhausted?
      
Only if it’s on the notified vape list. Since the standards came into effect last week on 1 July, all supplied vaping products must adhere to the new requirements.

Pharmacists should contact the manufacturer of non-compliant stock, Ms Dalla Venezia said.

‘The TGA has directed pharmacists to return non-compliant products to the supplier,’ she said. ‘If they're not able to return the products, they should dispose of them as per their state or territory regulations.’

      Do the new standards mean vapes are now first-line therapy?
      
Vapes are absolutely not the first-line treatment option for smoking cessation, Ms Dalla Venezia emphasised.

‘PSA’s recommendations and guidelines haven't [needed to] change in response to the standard changes,’ she said.

The recommended pathway for smoking cessation includes:

        
 	
      • Behavioural support: essential for all patients attempting to quit smoking, either alone or in combination with pharmacotherapy
        • 
 	
      • First-line pharmacotherapy:

          
 	
        • Nicotine Replacement Therapy (NRT)  – patches, gum, lozenges, mouth spray
          • 
 	
        • Varenicline
          • 
 	
        • Bupropion
          • 

        

        • 

      
Using combination NRT with behavioural support is more effective than NRT monotherapy.

Although therapeutic vapes are not first-line therapy for smoking cessation, the use of a therapeutic vape from the list of notified vapes is considered to be less harmful than smoking, Ms Dalla Venezia said.

‘We don’t want people to fear considering therapeutic vapes if they’re therapeutically appropriate,’ she said. ‘They are still an option for people who have gone through all the approved, first-line NRT steps and still are not able to quit smoking.’

      Is there a first-line therapy specifically for vaping cessation?
      
Not definitively, Ms Dalla Venezia said.

‘There isn't a substantial body of evidence for vaping cessation at the moment,’ she said. ‘But within the PSA guidelines, we take the same approach to vaping as we take to smoking cessation.’ 

That means pharmacists should recommend combination NRT for vaping cessation as the most effective first-line treatment option.

‘As evidence evolves, we'll continue to revisit the guidelines. But that's the best approach that we have with the evidence that's available to us at the moment,’ Ms Dalla Venezia said.

‘As recreational vapes are becoming less accessible, a new subset of the population who are nicotine dependent through vapes as the medium are going to need ongoing support from pharmacists.’

Historically, Australia's tobacco control and marketing around the harms of smoking have been successful, however they no longer reach the primary demographic – youth.

To engage young people aged 14–17 on a platform they actually use through people who speak their language, the federal Department of Health, Ageing and Disability engaged 10 influencers – one of which alone has 1.7 million followers on Tiktok in that age bracket.

‘It's a really great opportunity to reach young people  because that's the group of people who were beginning to use vapes at such rapidly increasing rates,’ Ms Dalla Venezia said.

Pharmacists should refer to the TGA vaping hub for a comprehensive overview of all changes.

Keen to learn more about smoking and vaping cessation? Attend the 'Clearing the air on smoking and vaping cessation' workshop at PSA25, held in Sydney from 1–3 August. Register here to attend.
            [post_title] => The new vaping standards explained
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      The new vaping standards explained

      APC
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            [post_date] => 2025-07-02 12:25:50
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            [post_content] => PSA has announced that it will develop and maintain education standards for Continued Professional Development (CPD) for pharmacists, following the retirement of the Australian Pharmacy Council (APC) accreditation standards for CPD activities on 31 December 2025.

The APC’s accreditation standards for CPD activities have been in place since 2013.

PSA, who already publish regular CPD through Australian Pharmacist and its education catalogue, will develop and maintain industry leading standards that will certify the quality and independence of CPD.

CPD education assessed against the standards will carry a PSA approval, giving pharmacists confidence that the education they access maintains the highest quality, upholds pharmacy practice standards, guidelines and ethics, and is free from commercial bias.

PSA National President Associate Professor Fei Sim FPS said: ‘As the national peak body for pharmacists in Australia and custodians of pharmacy practice standards, guidelines and ethics, PSA is developing education standards for CPD that give our profession – and our stakeholders – confidence in the quality of pharmacist education.

‘Our members tell us that PSA’s education is of high quality, a quality they can trust, and this scheme will mean that when they see third party education that is approved as meeting the PSA education standards, they can have a similar level of trust in it,’ she said.

‘PSA’s CPD planning tool takes the stress out of planning and recording CPD education, just as these standards will give pharmacists confidence that the CPD they access is “up-to-scratch”.’

PSA’s CPD standards are set to be introduced in 2026.
            [post_title] => PSA to develop education standards for CPD activities
            [post_excerpt] => With the Australian Pharmacy Council retiring its accreditation standards for CPD activities, PSA is set to step up.
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      PSA to develop education standards for CPD activities

      substitution
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            [post_content] => For the first time in Australian medicines history,  all Queensland-based pharmacists can make the call to substitute a therapeutically appropriate medicine without prescriber authority to solve medicine-related problems.

Australian Pharmacist explains the ins and outs of this momentous change.

      What’s changing?
      
An update to Medicines and Poisons (Medicines) Regulation 2021 (Qld) on 1 July 2025 will allow therapeutic adaptation and substitution to take place where there is a theraputic need for change.

Under section 117B of the regulation, a pharmacist dispensing a medicine may substitute an equivalent medicine for the one specified on the prescription – provided this is reasonably necessary for the patient’s therapeutic care.

An equivalent medicine is one that:

        
 	
      • appears on the Therapeutic Goods Act 1989 (Cwlth) register for the same indication as the original medicine
        • 
 	
      • is supplied in a dose and for a duration of treatment intended to achieve a therapeutic effect equivalent to that of the original medicine
        • 
 	
      • shares the same, or a substantially similar, chemical composition or pharmacological mechanism of action as the original medicine.
        • 

      
However, certain restricted medicines or those that have a risk of diversion may not be substituted.

      What was the reason behind the decision?
      
Professional bodies such as PSA and the Pharmacy Guild of Australia advocated to Queensland Health to bring about this significant change, said PSA Queensland State Manager, Karen Castle MPS.

‘PSA advocated for this strongly in our submission to the consultation on the amendments to the medicines and poisons regulation,’ she said. ‘These activities are well within the scope of any pharmacist, and we shouldn't have to do any additional training to be able to do this.’

And the benefits are myriad.

‘Patients benefit by having their medicine-problem resolved on-the-spot in the pharmacy, taxpayers benefit in reduced Medicare billing, and pharmacists benefit via increased autonomy,’ Ms Castle said. ‘But it does come with increased accountability.’

      When is it appropriate to substitute a medicine?
      
Dispensing an equivalent medicine can only take place when a therapeutic need arises, for example:

        
 	
      • patient-specific factors that may compromise the intended therapeutic effect of the prescribed medicine
        • 
 	
      • the prescribed medicine can’t be obtained within a reasonable timeframe to initiate or continue therapy.
        • 

      
For example, if a patient comes in with a prescription for atorvastatin 40 mg daily – which is not available at the pharmacy and cannot easily be sourced from another – pharmacists could supply rosuvastatin 20 mg daily. This approach will ensure an equivalent therapeutic effect in terms of the expected percentage reduction in LDL cholesterol.

Pharmacists can also therapeutically adapt a prescription for a medicine – altering the dose, strength, directions and/or quantity to maintain an equivalent therapeutic effect for the same treatment duration.

For example, if a patient is finding it challenging to comply with twice-daily dosing of metformin 500 mg tablets (quantity 100), pharmacists can amend the script to ‘metformin 1,000 mg extended-release, take one tablet in the morning (quantity 50)’.

      When should substitution not occur?
      
There are certain medicines with similar mechanisms of action that are not considered therapeutically equivalent and therefore cannot be substituted.

For example, cefalexin and cefaclor for the treatment of a urinary tract infection.

As first and second generation cephalosporins respectively, these medicines have different spectra of activity. They therefore shouldn’t be considered therapeutically equivalent.

      What about PBS medicines?
      
Medicines substituted by pharmacists are not covered under the Pharmaceutical Benefits Scheme (PBS). That means patients will need to pay full price.

      What are pharmacists' obligations?
      
Pharmacists must take enough time to determine that the substitution is appropriate, equivalent and safe for the individual patient.

‘Many adaptations are straightforward and common sense. For example, substituting two 500 mg tablets with one 1,000 mg tablet dose. But some adaptations are more complex,’ Ms Castle said.

Understanding and calculating dose equivalence will be critical for pharmacists to master. Tackling any potential contraindications with other medicines or conditions is also key. And this may be trickier for some medicines, even if they are in the same class, said Peter Guthrey, Senior Pharmacist – Strategic Policy at PSA.

‘For example, if someone has a script for rosuvastatin, which doesn't interact with grapefruit juice, and then you substitute it for simvastatin which does – you need to work through that before supplying the medicine,’ he said. ‘And if it turns out the patient is also taking another medicine that interacts with simvastatin but doesn't interact with rosuvastatin, you need to work through that as well – and then you consider substituting with simvastatin.’ 

It’s also essential to obtain informed consent from patients before making a substitution.

‘The patient has to understand that change and must agree to it,’ Mr Guthrey said. 

Equally, patients or other health professionals cannot compel pharmacists to make a substitution under this regulation. 

‘Ultimately, you are an autonomous decision maker with respect to therapeutic substitution and adaptation. You must be satisfied the change is safe and appropriate for the patient,’ he said. ‘You are under no obligation to make the adaptation. But you do now have a new option to problem-solve with the patient and provide more effective care.’

      What documentation is required?
      
Prior to dispensing an equivalent medicine, pharmacists must amend the prescription in accordance with the requirements in section 117B. 

Pharmacists are also required to make clinical notes about the substitution, Mr Guthrey said.

‘Attaching it to the dispensing record in the dispensing system is the best way to do this,’ he said.

But because pharmacists will have increased accountability, patient records must describe the rationale for why the pharmacist has made this decision.

Should pharmacists opt to make a therapeutically appropriate substitution, they must notify the prescriber after the fact, Ms Castle said.

‘Pharmacists are also required to document the details of this professional communication, including the means used to contact the prescriber,’  she added.

      Where can pharmacists turn for support?
      
The PSA will hold a member briefing for Queensland-based pharmacists to explain the finer details and practice applications.

For those in other states and territories, this is a change PSA will continue to advocate for across the nation, Mr Guthrey said.

‘As it becomes normal practice in Queensland, we would hope that other states and territories will see the benefits,’ he said.

Stay tuned for details on the upcoming member briefing.
            [post_title] => Pharmacist-led medicine substitutions now possible
            [post_excerpt] => In an Australian first, pharmacists can now adapt prescriptions to solve problems with medicines – no doctor sign-off required.
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      Pharmacist-led medicine substitutions now possible

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            [post_date] => 2025-06-30 12:58:25
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            [post_content] => This week pharmacists will see a suite of regulatory and funding changes take effect.

Here are the six key updates pharmacists need to know before tomorrow.

      1. Dispensing fees will marginally rise
      
Under the Eighth Community Pharmacy Agreement, pharmacists’ dispensing fee  – along with the Tier 1 Administration, Handling and Infrastructure fee and the Dangerous Drug fee – will be indexed by the Consumer Price Index (CPI) annually on 1 July.

Over the past 12 months to the March 2025 quarter, the CPI increased to 2.4%.

So from tomorrow, there will be a slight jump in the per script dispense fee, which will rise from $8.67 to $8.89.

      2. (Dis)continued dispensing as emergency measures roll back
      
As of tomorrow, temporary emergency measures that expanded the range of medicines available under Pharmaceutical Benefits Scheme (PBS) Continued Dispensing arrangements will be repealed.

The emergency authority which authorised these Continued Dispensing arrangements for private and PBS prescriptions in New South Wales, will also end at 11:59 pm tonight.

Only the standard list of 149 PBS-listed molecules will be available under Continued Dispensing in most jurisdictions, covering conditions such as asthma, diabetes, heart disease, high cholesterol and HIV. 

However, Continued Dispensing will continue for some. Just enacted in Queensland, the amount of medicine a pharmacist can supply to a patient as an ‘emergency supply’ is increasing from 3 days’ supply to the smallest available manufacturer’s pack of the medicine. This applies in addition to the supply provisions enabled under the Commonwealth Continued Dispensing Determination. And in Tasmania permanent regulation also allows full Continued Dispensing as private supply for all Prescription Only Medicines.

A full list of what’s happening in your state or territory is available via PSA’s Regulation Hub which will be updated overnight to reflect these changes.

The PSA has long advocated for the full measure to be made permanent across the nation.

‘We’ve seen temporary continued dispensing measures introduced during natural disasters, which is important, but there are several scenarios where a permanent policy would help patients, from personal emergencies to natural disasters,’ said PSA CEO Adjunct Associate Professor Steve Morris.

‘PSA is again urging the federal government to work with state and territory governments to permanently protect emergency access to medicines.’

      3. New vaping standards will come into effect
      
From 1 July, the Therapeutic Goods Administration (TGA) will implement strengthened standards for all therapeutic nicotine vaping products used for smoking-cessation and nicotine-dependence. This measure is designed to mitigate risks associated with therapeutic vaping products and ensure a consistent level of safety and quality across all products supplied through pharmacies.

Under the new standards, pharmacies will only be permitted to supply vapes that satisfy defined criteria around permitted ingredients, tamper-evident and child-resistant packaging, and clear, consistent labelling. 

Pharmacists should refer to the TGA’s notified vape list, which details all therapeutic vaping products approved for smoking cessation and the management of nicotine dependence.

      4. Pharmacists now have longer to transition to the new MMR and ACOP credential
      
Until recently, pharmacists were required to meet the revised credentialing standards by 30 June 2025 – either by obtaining Recognition of Prior Learning (RPL) towards their new credential or by undertaking further education to fulfil the updated requirements.

The deadlines to achieve both credentials have now been extended to:

        
 	
      • 31 December 2025 to transition to the Medication Management Review (MMR) credential. There will be no further extensions beyond this point.
        • 
 	
      • 30 June 2026 for transitioning to the Aged Care On-site Pharmacist (ACOP) Credential. MMR-credentialed pharmacists may continue to participate in the ACOP Measure through this date.
        • 

      
For more information on meeting the new requirements, refer to the AP article on the new MMR and ACOP credential deadlines.

      5. The Victorian pharmacy pilot will go permanent
      
Following a successful ​​evaluation, the Victorian Community Pharmacist Statewide Pilot will transition to the permanent Community Pharmacist Program tomorrow.

The program will also expand over the next 2 years, allowing appropriately trained pharmacists to offer services and prescribe certain Schedule 4 medications for 22 acute and chronic conditions, including type 2 diabetes, chronic obstructive pulmonary disease, asthma, allergies, ear infections and minor wounds. Pharmacists will also be able to administer travel vaccinations.

The Victorian government will continue to fund the program. This means most consultations will be free, with pharmacists receiving $20 per service. Pharmacists can charge an additional fee on top for services provided at their discretion.

However, the medicine subsidy that was provided during the pilot will end, with patients required to pay the full cost of and prescribed medications going forward.

Community pharmacies can submit an expression of interest to join the program via the Victorian Department of Health website.

      6. Piloted community pharmacist services in Queensland will also go permanent
      
From Tuesday, the services trialled under the Queensland Community Pharmacy Scope of Practice Pilot and the Contraception Pilot will be adopted as routine community pharmacy offerings.

Pharmacists who have undergone the requisite training will be authorised to assess and manage minor ailments, deliver targeted health and wellbeing interventions, and supply hormonal contraception as part of standard practice. The chronic conditions and medicines management services will remain in pilot phase until 30 June 2026, allowing for continued evaluation and refinement.

Planning is already under way within Queensland Health to transition the pilot services into business-as-usual workflows. In the meantime, participating pharmacies should continue to deliver pilot-phase services in line with current guidelines. Detailed implementation guidance and further updates on the ongoing chronic disease and medicines management pilots will be issued in coming months to support pharmacists through this transition.

      7. Interns and students get medicines administration rights in Queensland
      
In another 1 July update for Queensland, intern and student pharmacists working in a community pharmacy, private hospital or public hospital or health facility can administer any medicine that a pharmacist is authorised to administer, under the direct supervision of a pharmacist.
            [post_title] => Mid-year pharmacy policy overhaul begins
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      Mid-year pharmacy policy overhaul begins

  • People 
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            [post_date] => 2025-07-09 10:22:04
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            [post_content] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood. 

Despite the profound impact endometriosis has on health and wellbeing, its diagnosis and management is complex –  with an average of 6–8 years between the onset of symptoms and diagnosis.

‘This delay is where pharmacists have a crucial role in recognising the symptoms of endometriosis and referring women promptly for diagnosis and treatment,’ said Grace Wong, Medication Safety Pharmacist at The Royal Women's Hospital – who will be leading a session on Championing change for endometriosis care at PSA25 next month.

      Why does endometriosis take so long to diagnose?
      
There are several interrelated factors at play. Historically, a definitive diagnosis of endometriosis required laparoscopic surgery with histopathological confirmation. 

But the limited availability of trained gynaecologists to perform these procedures has created a bottleneck in timely diagnosis.

Additionally, the variable and often non-specific nature of endometriosis symptoms – such as chronic pelvic pain, fatigue, dysmenorrhea, cyclical hematuria, dysuria and gastrointestinal disturbances – can lead to misdiagnosis of other conditions such as irritable bowel syndrome.

Patients experiencing chronic pelvic or abdominal pain may present repeatedly for symptom relief, with opioids or high-dose non-steroidal anti-inflammatory drugs (NSAIDs) often supplied without further investigation into the underlying cause. This pattern not only delays appropriate diagnosis but also increases the risk of adverse effects and medicine overuse.

Societal stigmas surrounding menstruation can lead many to normalise menstrual pain, delaying medical attention.

‘Removing stigma and making women feel confident and comfortable to speak to their pharmacist for advice is something pharmacists and pharmacy support staff can continue to improve,’ Wong said.

      When should endometriosis be suspected?
      
Endometriosis should be considered in anyone of reproductive age presenting with persistent pelvic pain – especially when it’s acyclical, unresponsive to first-line treatments, or associated with other gynaecological symptoms such as dyspareunia (painful intercourse) or dysmenorrhoea.

Atypical symptoms of endometriosis include:

        
 	
      • cyclical gastrointestinal symptoms (such as painful bowel movements)
        • 
 	
      • dyschesia (difficult defecation)
        • 
 	
      • chronic fatigue
        • 
 	
      • urinary urgency
        • 
 	
      • pain in the lower back, legs, upper abdomen or chest.
        • 

      
‘Once diagnosed, pharmacists can help women manage their symptoms through providing evidence-based advice, appropriate counselling for any prescribed medicines, and support women in their journey to managing their condition and leading high quality and productive lives,’ Wong said.

      What’s the role of pharmacists?
      
Pharmacists are often the first health professionals that people with endometriosis speak to about menstrual pain or gastrointestinal discomfort. So understanding the pathophysiology, risk factors, and wide-ranging symptoms of endometriosis is essential. 

Pharmacists can play a critical role by recognising these red flags, challenging the stigma of normalising menstrual pain and shifting symptomatic management with: 

        
 	
      • over-the-counter pain relief
        • 
 	
      • investigating the presentation and symptoms
        • 
 	
      • seeking appropriate medical assessment aids in the timely diagnosis of endometriosis
        • 
 	
      • inquiring about patients who present prescriptions for menstrual-related analgesia, who may have underlying red flags that went unrecognised by prescribers.
        • 

      
Validating patient experiences means avoiding the following terminology:

        
 	
      • ‘It's just period pain’ or ‘That's normal for women’: these phrases are dismissive and contribute to delayed diagnosis and stigma
        • 
 	
      • ‘Everyone goes through this’: minimises the patient's pain and experience
        • 
 	
      • ‘Are you sure it's not just stress?’: while stress can exacerbate symptoms, it should not be suggested as the sole cause
        • 
 	
      • ‘You don't look sick’: many chronic illnesses, including endometriosis, are invisible.
        • 

      
Instead, pharmacists could ask:

        
 	
      • ‘Could you describe if you’ve experienced painful intercourse or pain during bowel movements, particularly around your menstrual cycle?’
        • 
 	
      • ‘Do you have any urinary symptoms, such as pain or blood in your urine, and do these seem to relate to your period?’
        • 
 	
      • ‘Would you be willing to track your symptoms daily to help us identify any patterns?’
        • 

      
Pharmacists should also inquire about the impact of symptoms on quality of life and well-being to help break through the ‘suck it up’ mentality that’s often dismissed as normal menstrual pain or hormonal fluctuations.

‘As trusted health professionals, pharmacists have an important role in raising awareness about this condition and supporting efforts to improve services for women with endometriosis,’ Wong said.

      What are the treatment options?
      
Treatment of endometriosis is often medical, with a patient-centred approach based on symptoms and reproductive goals.

When pharmacological treatment is appropriate, pharmacists hold a critical role in supporting medicine adherence and counselling. 

Common pharmacological treatments include:

        
 	
      • hormonal therapies such as combined oral contraceptive pill (COCP), progestogen-only pills, or levonorgestrel-releasing intrauterine devices (IUDs)
        • 
 	
      • non-hormonal options including NSAIDs for pain control
        • 
 	
      • emerging therapies including GnRH antagonists (e.g. elagolix, relugolix) and selective progesterone receptor modulators, particularly for refractory cases.
        • 

      
As medicines experts, pharmacists play a critical role in counselling patients on endometriosis treatments, and managing adverse effects such as reduced bone density associated with GnRH therapy.

      What does the future hold?
      
Until recently, endometriosis had been largely overlooked in national funding and research priorities. However, there has been a recent welcome shift in public health policy towards acknowledging endometriosis as a serious chronic condition requiring coordinated care. 

The federal government’s National Action Plan for Endometriosis, launched in 2018, marked the first significant step toward national recognition. Since then, investment in awareness campaigns have helped improve visibility and care pathways. Building on this, the 2025–26 federal budget introduced pivotal investments in women’s health, including the establishment of 11 specialist endometriosis and pelvic pain clinics and the addition of a new Medicare Benefits Schedule item for advanced diagnostic ultrasound techniques.

‘Pharmacists are an integral part of the healthcare system, and I envisage there is potential for pharmacists to be more involved directly and indirectly in care of women with endometriosis, to help support the National Action Plan's vision,’ Wong said. ‘To prepare for further involvement, I would encourage pharmacists to find ways to upskill now to be ready and confident to step up when the time comes.’

Hear more from Grace Wong about the role of pharmacists in endometriosis by attending the ‘Championing change for endometriosis care’ session at PSA25, held in Sydney from 1–3 August. Register here to attend.
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            [post_excerpt] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood.
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      Empowering pharmacists to spot endometriosis early

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            [post_content] => On  1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.

The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.

‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’

The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.

‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.

      What key changes are introduced in the updated standards?
      
Changes to the packaging, labelling and design of vaping products have been introduced.

Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.

‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.

New labelling, usage instructions and information leaflets are also required, along with name restrictions.

‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she  said. ‘And the only flavours allowed are mint, menthol or tobacco.’

Vaping devices and accessories must also meet stricter standards for:

        
 	
      • medical device quality
        • 
 	
      • risk management
        • 
 	
      • battery and electrical safety
        • 
 	
      • specific design and construction
        • 
 	
      • toxicological risk assessment.
        • 

      

      What previously met the standards but now breaches them?
      
Concentrations of nicotine over 50 mg/mL. The permitted concentration of nicotine has now changed to a maximum of 50 mg/mL, so vapes exceeding this level cannot be supplied.

While the primary onus is on manufacturers of vaping products to ensure they're adhering to the standards, pharmacists need to check that their stock is compliant.

      How can I comply with the new standards?
      
By checking all vaping products in your pharmacy against the TGA’s Notified vape list, which has changed since the reforms were initiated last year, Ms Dalla Venezia said.

‘I understand that the TGA conducts compliance assessments as part of ongoing compliance monitoring for these products,’ she said. ‘And since the reforms, a number of those items have been withdrawn.’

Therapeutic vaping products on the list of notified vapes have not been assessed by the TGA for quality, safety, efficacy or performance. But product sponsors must notify the TGA that their good complies with the minimum requirements for notified vaping goods, adhering to the product standards: 

        
 	
      • Therapeutic Goods (Standard for Therapeutic Vaping Goods) (TGO 110) Order 2021
        • 
 	
      • Therapeutic Goods (Medical Device Standard – Therapeutic Vaping Devices) Order 2023 (MDSO).
        • 

      
In addition to the notified vape list, there's a separate database on the TGA website that pharmacists can check to see which products have been withdrawn or ceased.

‘If pharmacists suspect a product they have is no longer consistent with these changes, they can  look at that withdrawn database,’ Ms Dalla Venezia said. ‘These lists can also be filtered by date.’

It’s also important to educate all pharmacy staff to ensure they are aware of the strengthened product standards, product compliance and availability – and alternative brands. 

      Do the changes apply to both prescription and Pharmacist Only vapes?
      
Yes. All therapeutic vapes, whether prescribed or supplied after a consultation with a pharmacist, must comply with the new standards. 

To ensure a smooth transition, pharmacists should communicate with prescribers – and patients – about the changes to vaping product standards, and available products.

‘The federal Department of Health, Disability and Ageing is continuously monitoring the products on the list and making sure that they adhere to the standards for vaping products,’ Ms Dalla Venezia said. 

‘So it’s a good idea to take note of all of your inventory, and if there’s anything you know you’re dispensing on a regular basis, cross reference it with the notified vape list.’ 

For more information on prescribing and dispensing vapes, refer to these PSA checklists:

        
 	
      • Pharmacist Workflow for Prescribing and Dispensing Therapeutic Vapes
        • 
 	
      • Pharmacist Workflow for Dispensing Nicotine Vaping Products.
        • 

      

      Can I sell my existing products until the stock is exhausted?
      
Only if it’s on the notified vape list. Since the standards came into effect last week on 1 July, all supplied vaping products must adhere to the new requirements.

Pharmacists should contact the manufacturer of non-compliant stock, Ms Dalla Venezia said.

‘The TGA has directed pharmacists to return non-compliant products to the supplier,’ she said. ‘If they're not able to return the products, they should dispose of them as per their state or territory regulations.’

      Do the new standards mean vapes are now first-line therapy?
      
Vapes are absolutely not the first-line treatment option for smoking cessation, Ms Dalla Venezia emphasised.

‘PSA’s recommendations and guidelines haven't [needed to] change in response to the standard changes,’ she said.

The recommended pathway for smoking cessation includes:

        
 	
      • Behavioural support: essential for all patients attempting to quit smoking, either alone or in combination with pharmacotherapy
        • 
 	
      • First-line pharmacotherapy:

          
 	
        • Nicotine Replacement Therapy (NRT)  – patches, gum, lozenges, mouth spray
          • 
 	
        • Varenicline
          • 
 	
        • Bupropion
          • 

        

        • 

      
Using combination NRT with behavioural support is more effective than NRT monotherapy.

Although therapeutic vapes are not first-line therapy for smoking cessation, the use of a therapeutic vape from the list of notified vapes is considered to be less harmful than smoking, Ms Dalla Venezia said.

‘We don’t want people to fear considering therapeutic vapes if they’re therapeutically appropriate,’ she said. ‘They are still an option for people who have gone through all the approved, first-line NRT steps and still are not able to quit smoking.’

      Is there a first-line therapy specifically for vaping cessation?
      
Not definitively, Ms Dalla Venezia said.

‘There isn't a substantial body of evidence for vaping cessation at the moment,’ she said. ‘But within the PSA guidelines, we take the same approach to vaping as we take to smoking cessation.’ 

That means pharmacists should recommend combination NRT for vaping cessation as the most effective first-line treatment option.

‘As evidence evolves, we'll continue to revisit the guidelines. But that's the best approach that we have with the evidence that's available to us at the moment,’ Ms Dalla Venezia said.

‘As recreational vapes are becoming less accessible, a new subset of the population who are nicotine dependent through vapes as the medium are going to need ongoing support from pharmacists.’

Historically, Australia's tobacco control and marketing around the harms of smoking have been successful, however they no longer reach the primary demographic – youth.

To engage young people aged 14–17 on a platform they actually use through people who speak their language, the federal Department of Health, Ageing and Disability engaged 10 influencers – one of which alone has 1.7 million followers on Tiktok in that age bracket.

‘It's a really great opportunity to reach young people  because that's the group of people who were beginning to use vapes at such rapidly increasing rates,’ Ms Dalla Venezia said.

Pharmacists should refer to the TGA vaping hub for a comprehensive overview of all changes.

Keen to learn more about smoking and vaping cessation? Attend the 'Clearing the air on smoking and vaping cessation' workshop at PSA25, held in Sydney from 1–3 August. Register here to attend.
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            [post_excerpt] => On  1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
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      The new vaping standards explained

      APC
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            [post_content] => PSA has announced that it will develop and maintain education standards for Continued Professional Development (CPD) for pharmacists, following the retirement of the Australian Pharmacy Council (APC) accreditation standards for CPD activities on 31 December 2025.

The APC’s accreditation standards for CPD activities have been in place since 2013.

PSA, who already publish regular CPD through Australian Pharmacist and its education catalogue, will develop and maintain industry leading standards that will certify the quality and independence of CPD.

CPD education assessed against the standards will carry a PSA approval, giving pharmacists confidence that the education they access maintains the highest quality, upholds pharmacy practice standards, guidelines and ethics, and is free from commercial bias.

PSA National President Associate Professor Fei Sim FPS said: ‘As the national peak body for pharmacists in Australia and custodians of pharmacy practice standards, guidelines and ethics, PSA is developing education standards for CPD that give our profession – and our stakeholders – confidence in the quality of pharmacist education.

‘Our members tell us that PSA’s education is of high quality, a quality they can trust, and this scheme will mean that when they see third party education that is approved as meeting the PSA education standards, they can have a similar level of trust in it,’ she said.

‘PSA’s CPD planning tool takes the stress out of planning and recording CPD education, just as these standards will give pharmacists confidence that the CPD they access is “up-to-scratch”.’

PSA’s CPD standards are set to be introduced in 2026.
            [post_title] => PSA to develop education standards for CPD activities
            [post_excerpt] => With the Australian Pharmacy Council retiring its accreditation standards for CPD activities, PSA is set to step up.
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      PSA to develop education standards for CPD activities

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            [post_content] => For the first time in Australian medicines history,  all Queensland-based pharmacists can make the call to substitute a therapeutically appropriate medicine without prescriber authority to solve medicine-related problems.

Australian Pharmacist explains the ins and outs of this momentous change.

      What’s changing?
      
An update to Medicines and Poisons (Medicines) Regulation 2021 (Qld) on 1 July 2025 will allow therapeutic adaptation and substitution to take place where there is a theraputic need for change.

Under section 117B of the regulation, a pharmacist dispensing a medicine may substitute an equivalent medicine for the one specified on the prescription – provided this is reasonably necessary for the patient’s therapeutic care.

An equivalent medicine is one that:

        
 	
      • appears on the Therapeutic Goods Act 1989 (Cwlth) register for the same indication as the original medicine
        • 
 	
      • is supplied in a dose and for a duration of treatment intended to achieve a therapeutic effect equivalent to that of the original medicine
        • 
 	
      • shares the same, or a substantially similar, chemical composition or pharmacological mechanism of action as the original medicine.
        • 

      
However, certain restricted medicines or those that have a risk of diversion may not be substituted.

      What was the reason behind the decision?
      
Professional bodies such as PSA and the Pharmacy Guild of Australia advocated to Queensland Health to bring about this significant change, said PSA Queensland State Manager, Karen Castle MPS.

‘PSA advocated for this strongly in our submission to the consultation on the amendments to the medicines and poisons regulation,’ she said. ‘These activities are well within the scope of any pharmacist, and we shouldn't have to do any additional training to be able to do this.’

And the benefits are myriad.

‘Patients benefit by having their medicine-problem resolved on-the-spot in the pharmacy, taxpayers benefit in reduced Medicare billing, and pharmacists benefit via increased autonomy,’ Ms Castle said. ‘But it does come with increased accountability.’

      When is it appropriate to substitute a medicine?
      
Dispensing an equivalent medicine can only take place when a therapeutic need arises, for example:

        
 	
      • patient-specific factors that may compromise the intended therapeutic effect of the prescribed medicine
        • 
 	
      • the prescribed medicine can’t be obtained within a reasonable timeframe to initiate or continue therapy.
        • 

      
For example, if a patient comes in with a prescription for atorvastatin 40 mg daily – which is not available at the pharmacy and cannot easily be sourced from another – pharmacists could supply rosuvastatin 20 mg daily. This approach will ensure an equivalent therapeutic effect in terms of the expected percentage reduction in LDL cholesterol.

Pharmacists can also therapeutically adapt a prescription for a medicine – altering the dose, strength, directions and/or quantity to maintain an equivalent therapeutic effect for the same treatment duration.

For example, if a patient is finding it challenging to comply with twice-daily dosing of metformin 500 mg tablets (quantity 100), pharmacists can amend the script to ‘metformin 1,000 mg extended-release, take one tablet in the morning (quantity 50)’.

      When should substitution not occur?
      
There are certain medicines with similar mechanisms of action that are not considered therapeutically equivalent and therefore cannot be substituted.

For example, cefalexin and cefaclor for the treatment of a urinary tract infection.

As first and second generation cephalosporins respectively, these medicines have different spectra of activity. They therefore shouldn’t be considered therapeutically equivalent.

      What about PBS medicines?
      
Medicines substituted by pharmacists are not covered under the Pharmaceutical Benefits Scheme (PBS). That means patients will need to pay full price.

      What are pharmacists' obligations?
      
Pharmacists must take enough time to determine that the substitution is appropriate, equivalent and safe for the individual patient.

‘Many adaptations are straightforward and common sense. For example, substituting two 500 mg tablets with one 1,000 mg tablet dose. But some adaptations are more complex,’ Ms Castle said.

Understanding and calculating dose equivalence will be critical for pharmacists to master. Tackling any potential contraindications with other medicines or conditions is also key. And this may be trickier for some medicines, even if they are in the same class, said Peter Guthrey, Senior Pharmacist – Strategic Policy at PSA.

‘For example, if someone has a script for rosuvastatin, which doesn't interact with grapefruit juice, and then you substitute it for simvastatin which does – you need to work through that before supplying the medicine,’ he said. ‘And if it turns out the patient is also taking another medicine that interacts with simvastatin but doesn't interact with rosuvastatin, you need to work through that as well – and then you consider substituting with simvastatin.’ 

It’s also essential to obtain informed consent from patients before making a substitution.

‘The patient has to understand that change and must agree to it,’ Mr Guthrey said. 

Equally, patients or other health professionals cannot compel pharmacists to make a substitution under this regulation. 

‘Ultimately, you are an autonomous decision maker with respect to therapeutic substitution and adaptation. You must be satisfied the change is safe and appropriate for the patient,’ he said. ‘You are under no obligation to make the adaptation. But you do now have a new option to problem-solve with the patient and provide more effective care.’

      What documentation is required?
      
Prior to dispensing an equivalent medicine, pharmacists must amend the prescription in accordance with the requirements in section 117B. 

Pharmacists are also required to make clinical notes about the substitution, Mr Guthrey said.

‘Attaching it to the dispensing record in the dispensing system is the best way to do this,’ he said.

But because pharmacists will have increased accountability, patient records must describe the rationale for why the pharmacist has made this decision.

Should pharmacists opt to make a therapeutically appropriate substitution, they must notify the prescriber after the fact, Ms Castle said.

‘Pharmacists are also required to document the details of this professional communication, including the means used to contact the prescriber,’  she added.

      Where can pharmacists turn for support?
      
The PSA will hold a member briefing for Queensland-based pharmacists to explain the finer details and practice applications.

For those in other states and territories, this is a change PSA will continue to advocate for across the nation, Mr Guthrey said.

‘As it becomes normal practice in Queensland, we would hope that other states and territories will see the benefits,’ he said.

Stay tuned for details on the upcoming member briefing.
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            [post_content] => This week pharmacists will see a suite of regulatory and funding changes take effect.

Here are the six key updates pharmacists need to know before tomorrow.

      1. Dispensing fees will marginally rise
      
Under the Eighth Community Pharmacy Agreement, pharmacists’ dispensing fee  – along with the Tier 1 Administration, Handling and Infrastructure fee and the Dangerous Drug fee – will be indexed by the Consumer Price Index (CPI) annually on 1 July.

Over the past 12 months to the March 2025 quarter, the CPI increased to 2.4%.

So from tomorrow, there will be a slight jump in the per script dispense fee, which will rise from $8.67 to $8.89.

      2. (Dis)continued dispensing as emergency measures roll back
      
As of tomorrow, temporary emergency measures that expanded the range of medicines available under Pharmaceutical Benefits Scheme (PBS) Continued Dispensing arrangements will be repealed.

The emergency authority which authorised these Continued Dispensing arrangements for private and PBS prescriptions in New South Wales, will also end at 11:59 pm tonight.

Only the standard list of 149 PBS-listed molecules will be available under Continued Dispensing in most jurisdictions, covering conditions such as asthma, diabetes, heart disease, high cholesterol and HIV. 

However, Continued Dispensing will continue for some. Just enacted in Queensland, the amount of medicine a pharmacist can supply to a patient as an ‘emergency supply’ is increasing from 3 days’ supply to the smallest available manufacturer’s pack of the medicine. This applies in addition to the supply provisions enabled under the Commonwealth Continued Dispensing Determination. And in Tasmania permanent regulation also allows full Continued Dispensing as private supply for all Prescription Only Medicines.

A full list of what’s happening in your state or territory is available via PSA’s Regulation Hub which will be updated overnight to reflect these changes.

The PSA has long advocated for the full measure to be made permanent across the nation.

‘We’ve seen temporary continued dispensing measures introduced during natural disasters, which is important, but there are several scenarios where a permanent policy would help patients, from personal emergencies to natural disasters,’ said PSA CEO Adjunct Associate Professor Steve Morris.

‘PSA is again urging the federal government to work with state and territory governments to permanently protect emergency access to medicines.’

      3. New vaping standards will come into effect
      
From 1 July, the Therapeutic Goods Administration (TGA) will implement strengthened standards for all therapeutic nicotine vaping products used for smoking-cessation and nicotine-dependence. This measure is designed to mitigate risks associated with therapeutic vaping products and ensure a consistent level of safety and quality across all products supplied through pharmacies.

Under the new standards, pharmacies will only be permitted to supply vapes that satisfy defined criteria around permitted ingredients, tamper-evident and child-resistant packaging, and clear, consistent labelling. 

Pharmacists should refer to the TGA’s notified vape list, which details all therapeutic vaping products approved for smoking cessation and the management of nicotine dependence.

      4. Pharmacists now have longer to transition to the new MMR and ACOP credential
      
Until recently, pharmacists were required to meet the revised credentialing standards by 30 June 2025 – either by obtaining Recognition of Prior Learning (RPL) towards their new credential or by undertaking further education to fulfil the updated requirements.

The deadlines to achieve both credentials have now been extended to:

        
 	
      • 31 December 2025 to transition to the Medication Management Review (MMR) credential. There will be no further extensions beyond this point.
        • 
 	
      • 30 June 2026 for transitioning to the Aged Care On-site Pharmacist (ACOP) Credential. MMR-credentialed pharmacists may continue to participate in the ACOP Measure through this date.
        • 

      
For more information on meeting the new requirements, refer to the AP article on the new MMR and ACOP credential deadlines.

      5. The Victorian pharmacy pilot will go permanent
      
Following a successful ​​evaluation, the Victorian Community Pharmacist Statewide Pilot will transition to the permanent Community Pharmacist Program tomorrow.

The program will also expand over the next 2 years, allowing appropriately trained pharmacists to offer services and prescribe certain Schedule 4 medications for 22 acute and chronic conditions, including type 2 diabetes, chronic obstructive pulmonary disease, asthma, allergies, ear infections and minor wounds. Pharmacists will also be able to administer travel vaccinations.

The Victorian government will continue to fund the program. This means most consultations will be free, with pharmacists receiving $20 per service. Pharmacists can charge an additional fee on top for services provided at their discretion.

However, the medicine subsidy that was provided during the pilot will end, with patients required to pay the full cost of and prescribed medications going forward.

Community pharmacies can submit an expression of interest to join the program via the Victorian Department of Health website.

      6. Piloted community pharmacist services in Queensland will also go permanent
      
From Tuesday, the services trialled under the Queensland Community Pharmacy Scope of Practice Pilot and the Contraception Pilot will be adopted as routine community pharmacy offerings.

Pharmacists who have undergone the requisite training will be authorised to assess and manage minor ailments, deliver targeted health and wellbeing interventions, and supply hormonal contraception as part of standard practice. The chronic conditions and medicines management services will remain in pilot phase until 30 June 2026, allowing for continued evaluation and refinement.

Planning is already under way within Queensland Health to transition the pilot services into business-as-usual workflows. In the meantime, participating pharmacies should continue to deliver pilot-phase services in line with current guidelines. Detailed implementation guidance and further updates on the ongoing chronic disease and medicines management pilots will be issued in coming months to support pharmacists through this transition.

      7. Interns and students get medicines administration rights in Queensland
      
In another 1 July update for Queensland, intern and student pharmacists working in a community pharmacy, private hospital or public hospital or health facility can administer any medicine that a pharmacist is authorised to administer, under the direct supervision of a pharmacist.
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      Mid-year pharmacy policy overhaul begins

AUSTRALIAN PHARMACIST Australian Pharmacist
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Emerging treatments for insomnia

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CPD credits

Accreditation Code :

Group 1 : CPD credits

Group 2 : CPD credits

This activity has been accredited for hours of Group 1 CPD (or CPD credits) suitable for inclusion in an individual pharmacist's CPD plan, which can be converted to hours of Group 2 CPD (or CPD credits) upon successful completion of relevant assessment activities.

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