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AUSTRALIAN PHARMACIST
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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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          [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_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. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pharmacist-led-medicine-substitutions-now-possible [to_ping] => [pinged] => [post_modified] => 2025-07-02 16:31:22 [post_modified_gmt] => 2025-07-02 06:31:22 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29801 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Pharmacist-led medicine substitutions now possible [title] => Pharmacist-led medicine substitutions now possible [href] => https://www.australianpharmacist.com.au/pharmacist-led-medicine-substitutions-now-possible/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29813 [authorType] => )

      Pharmacist-led medicine substitutions now possible

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                  [post_date] => 2025-06-30 12:58:25
                  [post_date_gmt] => 2025-06-30 02:58:25
                  [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 [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => mid-year-pharmacy-policy-overhaul-begins [to_ping] => [pinged] => [post_modified] => 2025-06-30 15:02:59 [post_modified_gmt] => 2025-06-30 05:02:59 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29793 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Mid-year pharmacy policy overhaul begins [title] => Mid-year pharmacy policy overhaul begins [href] => https://www.australianpharmacist.com.au/mid-year-pharmacy-policy-overhaul-begins/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29795 [authorType] => )

      Mid-year pharmacy policy overhaul begins

      pop-up
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                  [post_date] => 2025-06-27 09:36:24
                  [post_date_gmt] => 2025-06-26 23:36:24
                  [post_content] => 

      Decision-support tools are designed to promote patient safety. But when here's a pop-up for everything, the message can be diluted.

      We all know the feeling. You’re in the middle of something – maybe deep into a busy shift in the pharmacy, or on the wards in the hospital, or even scrolling on your phone at home – and another pop-up appears.

      You’ve seen it before, so your instinct is to dismiss it without a second thought.

      While ignoring the latest alert from your fitness app might mean falling behind on your step count, dismissing a decision-support pop-up in a healthcare setting might mean missing something crucial.

      Yet, with so many alerts coming through, it can be overwhelming – and almost impossible – to sort the important information from the rest.

      Why do we have popups?

      Pop-ups are much like passing a sign on the road. They are meant to inform your decisions, whether this be about a hidden hazard or general navigation. In health care, they have proliferated across the increasing number of digital platforms and pieces of software health professionals use to provide patient care and nowhere more so than clinical decision-support tools.

      Decision-support pop-ups take many forms, from alerts about potential drug interactions to duplicate therapy warnings and allergy information. They are intended to aid health professionals in their decision-making and, in the case of dispensing pharmacists, are there to ‘remind pharmacists to be alert and to double-check that the medicine supplied is the medicine prescribed’, says PDL Senior Professional Officer Gary West FPS (he/him).

      ‘It might only take half a second to view them, but the difference for a patient – and for a pharmacist – can be really significant. We’ve had multiple cases where a locum or newly registered pharmacist hasn’t realised a patient is on a staged-supply arrangement because it wasn’t clear in their profile. A warning message would have prevented that patient from getting access to a larger quantity of medicines than intended.’

      Mr West says both pharmacists and dispensary technicians should understand why the alerts are there – to help mitigate risk for patients and themselves.

      ‘We would always encourage pharmacists to use that technology, and to ensure their dispensary technicians are well trained and alert to raising certain pop-up warnings with the pharmacist associated with the dispensing event,’ says Mr West.

      The pop-up paradox

      But are we currently overwhelmed by pop-ups? And are some pop-ups better than others?

      University of Sydney Professor of Health Research Melissa Baysari (she/her) suggests the answer to both questions is yes. A human factors expert, she has conducted extensive research into how digital health can support medicine management. Despite their good intentions, she says there is limited evidence that alerts change practice or improve patient outcomes, particularly in the hospital setting.

      In a 5-year study involving patients across five hospitals in New South Wales and Queensland, Prof Baysari’s team examined whether activating drug-drug interaction alerts reduced harm. One group of hospitals had the alerts enabled, the control group did not.

      Surprising results

      ‘We found overall that the alerts had no impact,’ she says.  ‘Having drug-drug interaction alerts did not reduce the number of clinically relevant interactions or harms experienced by patients. The study shows that if you’re going to turn all the drug interaction alerts on, they’re not going to deliver the safety benefits you expect.’

      In fact, she warns that poorly designed or excessive alerts can backfire. ‘There are so many negative consequences, like wasted time, frustration for clinicians and patient safety implications, that I would not recommend turning drug-drug interaction alerts on in your systems unless you’ve got some kind of smart technology in there.’

      Despite the lack of evidence about the effectiveness of alerts, organisations are often reluctant to scale them back. Prof Baysari said her team had ‘a lot of trouble’ finding hospitals that were willing to not turn on their drug interaction alerts.

      ‘Everyone assumed the alerts were effective and they were going to be removing an intervention that was providing a safety net for everyone,’ she says. ‘But the way I see it, if organisations just keep putting more and more alerts in, it becomes the end user’s responsibility to work out which ones are relevant and act appropriately. It’s shifting the responsibility away from the organisation, so if an incident occurs, it’s the clinician who’s to blame. I think that’s very unfair.’

      Information overload

      Research shows that the number of alerts a healthcare professional receives impacts how effective they are – and pharmacists see a lot, Prof Baysari says.

      ‘You might assume that there’s an evidence base for alerts, but we have a lot more research showing that when you implement large numbers of alerts, clinicians begin to ignore them. They’re seeing too many, and so they’re not reading the recommendations. I have a theory that this becomes a habitual response – an alert pops up, clinicians override it and move past it. It allows them to get through work quickly.’

      This alert fatigue has real-world safety implications. If one alert out of 12 presented is a critical warning, and the other 11 aren’t clinically relevant for the patient, it’s likely the important alert will be missed.

      ‘We’re increasingly seeing incidents where alert fatigue has been identified as a contributing factor. It’s not that there wasn’t an alert in place, but that it was lost among the other alerts the clinician saw,’ Prof Baysari says.

      Returning to the road-sign analogy, there comes a point where there are just too many and you just can’t process them all and they stop being useful. Or you drive past the same ones every day and stop paying attention to them.

      PDL has developed its own alerts based on incidents that are frequently reported to the organisation and on medicines that are more likely to have significant consequences for patients.

      ‘We’re very mindful. We put in a small number of pop-ups that we think are of high importance or significance,’ Mr West says. ‘Our warnings are not theoretical. We try to prevent alert fatigue by limiting warnings to things that occur with frequency or with such consequence that they justify the pop-up. We appreciate it’s difficult when hundreds of prescriptions are dispensed every day, but we’d really encourage pharmacists to take note of them and not just tab through without any consideration.’

      Making smarter systems

      As pharmacists continue to expand their scope of practice, Fred IT Group Partnerships Manager Regina Cowie (she/her) says the functionality of decision-support tools will need to expand to include options like preventive care recommendations and chronic disease management tools.

      ‘For example, clinical decision support may be used to identify patients eligible for chronic disease screening or to assess chronic disease management,’ she says. ‘Or a vaccination prompt for eligible patients could support pharmacists to make informed decisions by dynamically changing aspects within dispensing systems to guide on healthcare opportunities, for example to improve vaccination rates.’

      As well as being broader, alerts also need to become smarter. Artificial intelligence is already being used in some aspects of dispensing software, Ms Cowie says, and AI has the potential to revolutionise the way clinical decision support is used.

      ‘AI has the ability to analyse large amounts of patient data and provide opportunities to improve medicine safety and patient care … Fred AID (Artificial Intelligence Directions) is an optional function already in place in Fred Dispense Plus. It uses AI to predict medication directions and allows pharmacists to quickly and safely enter directions for dispensing labels, rather than typing these from scratch. 

      ‘In future, AI may suggest treatment plans or identify patients at risk of certain diseases, based on patient population data. In health care, where time pressures are a consistent burden on clinicians, a related opportunity from AI is its ability to provide administrative support by automating documentation such as clinical notes.’

      Ultimately, there isn’t anything inherently wrong with alerts, Prof Baysari says, they just need to be better. ‘We have very basic alerts at the moment. They’re not designed well, so we’re not seeing the benefits. But we could.

      ‘We need better design in the backend, using AI to make them smarter, and, in the frontend, we need to think about how they look on screen,’ she says. ‘If we had good interfaces and a good backend infrastructure we’d get good safety benefits. But we have a lot of work to do.’ 

      Fred IT Government and Industry Engagement Lead and former Medicines Safety Program Director of the Australian Digital Health Agency Andrew Matthews MPS says clinical decision-support tools such as alerts can increase detection of inappropriate prescribing and dispensing, improve disease management, reduce adverse patient outcomes and enhance appropriate treatment.

      Fred IT, for example, has introduced an optional prompt in its dispensing software to help improve vaccination rates for the shingles vaccine in target cohorts aligned with recommendations from the National Immunisation Program (NIP).

      The prompt displays only if the patient meets the NIP criteria of the patient demographics entered in the Fred Dispense Plus patient profile.

      ‘With the large volumes of patient data now available in electronic medical records and pharmacy systems, especially where patient disease complexity makes it difficult to quickly assess the available data,’ Mr Matthews says, ‘clinical decision-support can present relevant patient information to the clinician to facilitate clinical problem-solving, decision-making or provide additional knowledge consistent with best practice guidelines.’ 

      [post_title] => Are pop-ups doing more harm than good? [post_excerpt] => Are decision-support tools the problem or the cure for patient safety? Australian Pharmacist investigates. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => are-decision-support-tools-pop-ups-getting-in-the-way [to_ping] => [pinged] => [post_modified] => 2025-06-30 15:03:26 [post_modified_gmt] => 2025-06-30 05:03:26 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29777 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Are pop-ups doing more harm than good? [title] => Are pop-ups doing more harm than good? [href] => https://www.australianpharmacist.com.au/are-decision-support-tools-pop-ups-getting-in-the-way/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29791 [authorType] => )

      Are pop-ups doing more harm than good?

      vaccination
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                  [post_content] => From 1 July 2025, pharmacists will see a range of adjustments to how they deliver and bill for vaccination. 
      
      Here, Australian Pharmacist outlines the changes in vaccination services and fees pharmacists can expect from early next month.
      

      1. NIPVIP vaccine administration fees will (slightly) increase

      In 2025, the Consumer Price Index (CPI) rose by 2.4%. So from next month, there will be a CPI increase applied to all National Immunisation Program Vaccinations in Pharmacy (NIPVIP) vaccines administered. Pharmacists will receive $20.05 per vaccine administered, up from $19.60.

      2. The COVID-19 vaccination payment will (significantly) drop 

      In less than a week, community pharmacists will see a significant reduction in the COVID-19 vaccine administration fee. The new rate will be $20.05 per vaccine administration in all Australian locations. This is a significant decrease from the previous rates per dose, which were:
      • $28.35 in urban areas
      • $31.60 in regional/rural areas.
      The change in the fee structure is designed to align the COVID-19 Vaccination in Community Pharmacy (CVCP) Program administration rates with the NIPVIP rate.  The CVCP Program is a temporary initiative, which is scheduled to end on 30 June 2026. Arrangements regarding COVID-19 vaccination beyond this date have not yet been announced.

      3. There will be no more COVID-19 vaccine flag-fall fee

      Along with receiving a per-vaccine fee, pharmacists who administered COVID-19 vaccines to vulnerable patients – such as those in residential aged care, disability facilities, or patients who are house-bound – received a ‘flag fall’ Site Visit payment of $127.30. This fee will discontinue after 30 June 2025. Pharmacists can continue providing off-site vaccination services to these patients, claiming the $20.05 administration fee by lodging a CVCP service claim through the Pharmacy Programs Administrator (PPA) Portal. A one-month grace period has been granted to pharmacists for submitting claims for services delivered on or before 30 June 2025. Any claims submitted after 31 July 2025 will not be accepted. In some good news, pharmacists no longer need to notify the PPA before delivering off-site vaccination services. Radius restrictions have also been removed, so there’s no need to consider the distance between the off-site location and the pharmacy premises.

      4. The COVID-19 ordering process will remain in place, for now

      At this stage, COVID-19 vaccines are still managed by the Commonwealth – meaning vaccines will still need to be distributed through the COVID-19 Vaccine Ordering System (CVAS). However, these arrangements have only been funded until 30 June 2026 – with details on future arrangement yet to come.

      5. There will only be one measles and varicella vaccine manufacturer on the NIP

      Pharmacists can currently order multiple brands of measles-containing vaccines under the NIP – including GSK’s Priorix, Priorix-Textra and CSL’s M-M-R II. Pharmacists in some jurisdictions can also currently order multiple brands of chicken pox (varicella) vaccines for catch-up vaccination on the NIP – including Varilrix (GSK) and Varivax (CSL). From 1 July 2025, community pharmacists and other immunisation providers will no longer be able to order CSL’s M-M-R II or Varivax. New NIP orders can only be placed for GSK’s Priorix, Priorix-Tetra and Varilrix. Pharmacists should continue to administer any existing vaccine stock until exhausted or the expiry date is reached.

      6. More Victorian pharmacists can administer travel vaccines, permanently

      The Victorian Community Pharmacist Statewide Pilot is going permanent and expanding its services on July 1, 2025. That means, eligible pharmacists will be able to administer the following travel vaccines in an ongoing capacity:
      • Hepatitis A
      • Hepatitis B
      • Typhoid
      • Poliomyelitis.
      Pharmacists will administer these vaccines privately, except where NIP eligibility applies, said PSA Victorian State Manager Jarrod McMaugh MPS. ‘The funded $20 consultation fee [for travel health] will remain, and pharmacists can charge an additional fee at their discretion,’ he said. ‘However, medicines will no longer be subsidised under the program.’ There were 800 participating pharmacies in the Victorian Community Pharmacist Statewide Pilot. Now, the program will extend to other pharmacies Victoria-wide, Mr McMaugh said. ‘Pharmacists can submit an Expression of Interest to join the program.’ The EOI form is available on the Victorian Department of Health website.

      7. WA's free flu vaccine campaign extended

      With influenza cases climbing and the season yet to peak, the Western Australian government has extended its free flu vaccination program until 31 July, giving all West Australians aged 6 months and over extra time to protect themselves against serious illness. As of 15 June 2025, WA has recorded 8,708 cases of influenza and 1,579 hospitalisations – 18% in children under 10 and 37% in those aged 65 and over. More than 763,180 vaccinations administered so far, including 311,890 through the free program.

      Correction

      30 June 2025: An earlier version of this article incorrectly referred to Varilrix and Varivax as measles-containing vaccines, rather than as varicella vaccines. AP sincerely apologises for this error.
      [post_title] => Mid-year vaccine shake-up incoming [post_excerpt] => From 1 July 2025, pharmacists will see a range of adjustments to how they deliver and bill for vaccination. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => mid-year-vaccine-shake-up-incoming [to_ping] => [pinged] => [post_modified] => 2025-06-30 12:08:24 [post_modified_gmt] => 2025-06-30 02:08:24 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29766 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Mid-year vaccine shake-up incoming [title] => Mid-year vaccine shake-up incoming [href] => https://www.australianpharmacist.com.au/mid-year-vaccine-shake-up-incoming/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29768 [authorType] => )

      Mid-year vaccine shake-up incoming

  • Clinical
    • 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_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. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pharmacist-led-medicine-substitutions-now-possible [to_ping] => [pinged] => [post_modified] => 2025-07-02 16:31:22 [post_modified_gmt] => 2025-07-02 06:31:22 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29801 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Pharmacist-led medicine substitutions now possible [title] => Pharmacist-led medicine substitutions now possible [href] => https://www.australianpharmacist.com.au/pharmacist-led-medicine-substitutions-now-possible/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29813 [authorType] => )

      Pharmacist-led medicine substitutions now possible

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                  [post_date] => 2025-06-30 12:58:25
                  [post_date_gmt] => 2025-06-30 02:58:25
                  [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 [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => mid-year-pharmacy-policy-overhaul-begins [to_ping] => [pinged] => [post_modified] => 2025-06-30 15:02:59 [post_modified_gmt] => 2025-06-30 05:02:59 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29793 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Mid-year pharmacy policy overhaul begins [title] => Mid-year pharmacy policy overhaul begins [href] => https://www.australianpharmacist.com.au/mid-year-pharmacy-policy-overhaul-begins/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29795 [authorType] => )

      Mid-year pharmacy policy overhaul begins

      pop-up
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                  [post_date] => 2025-06-27 09:36:24
                  [post_date_gmt] => 2025-06-26 23:36:24
                  [post_content] => 

      Decision-support tools are designed to promote patient safety. But when here's a pop-up for everything, the message can be diluted.

      We all know the feeling. You’re in the middle of something – maybe deep into a busy shift in the pharmacy, or on the wards in the hospital, or even scrolling on your phone at home – and another pop-up appears.

      You’ve seen it before, so your instinct is to dismiss it without a second thought.

      While ignoring the latest alert from your fitness app might mean falling behind on your step count, dismissing a decision-support pop-up in a healthcare setting might mean missing something crucial.

      Yet, with so many alerts coming through, it can be overwhelming – and almost impossible – to sort the important information from the rest.

      Why do we have popups?

      Pop-ups are much like passing a sign on the road. They are meant to inform your decisions, whether this be about a hidden hazard or general navigation. In health care, they have proliferated across the increasing number of digital platforms and pieces of software health professionals use to provide patient care and nowhere more so than clinical decision-support tools.

      Decision-support pop-ups take many forms, from alerts about potential drug interactions to duplicate therapy warnings and allergy information. They are intended to aid health professionals in their decision-making and, in the case of dispensing pharmacists, are there to ‘remind pharmacists to be alert and to double-check that the medicine supplied is the medicine prescribed’, says PDL Senior Professional Officer Gary West FPS (he/him).

      ‘It might only take half a second to view them, but the difference for a patient – and for a pharmacist – can be really significant. We’ve had multiple cases where a locum or newly registered pharmacist hasn’t realised a patient is on a staged-supply arrangement because it wasn’t clear in their profile. A warning message would have prevented that patient from getting access to a larger quantity of medicines than intended.’

      Mr West says both pharmacists and dispensary technicians should understand why the alerts are there – to help mitigate risk for patients and themselves.

      ‘We would always encourage pharmacists to use that technology, and to ensure their dispensary technicians are well trained and alert to raising certain pop-up warnings with the pharmacist associated with the dispensing event,’ says Mr West.

      The pop-up paradox

      But are we currently overwhelmed by pop-ups? And are some pop-ups better than others?

      University of Sydney Professor of Health Research Melissa Baysari (she/her) suggests the answer to both questions is yes. A human factors expert, she has conducted extensive research into how digital health can support medicine management. Despite their good intentions, she says there is limited evidence that alerts change practice or improve patient outcomes, particularly in the hospital setting.

      In a 5-year study involving patients across five hospitals in New South Wales and Queensland, Prof Baysari’s team examined whether activating drug-drug interaction alerts reduced harm. One group of hospitals had the alerts enabled, the control group did not.

      Surprising results

      ‘We found overall that the alerts had no impact,’ she says.  ‘Having drug-drug interaction alerts did not reduce the number of clinically relevant interactions or harms experienced by patients. The study shows that if you’re going to turn all the drug interaction alerts on, they’re not going to deliver the safety benefits you expect.’

      In fact, she warns that poorly designed or excessive alerts can backfire. ‘There are so many negative consequences, like wasted time, frustration for clinicians and patient safety implications, that I would not recommend turning drug-drug interaction alerts on in your systems unless you’ve got some kind of smart technology in there.’

      Despite the lack of evidence about the effectiveness of alerts, organisations are often reluctant to scale them back. Prof Baysari said her team had ‘a lot of trouble’ finding hospitals that were willing to not turn on their drug interaction alerts.

      ‘Everyone assumed the alerts were effective and they were going to be removing an intervention that was providing a safety net for everyone,’ she says. ‘But the way I see it, if organisations just keep putting more and more alerts in, it becomes the end user’s responsibility to work out which ones are relevant and act appropriately. It’s shifting the responsibility away from the organisation, so if an incident occurs, it’s the clinician who’s to blame. I think that’s very unfair.’

      Information overload

      Research shows that the number of alerts a healthcare professional receives impacts how effective they are – and pharmacists see a lot, Prof Baysari says.

      ‘You might assume that there’s an evidence base for alerts, but we have a lot more research showing that when you implement large numbers of alerts, clinicians begin to ignore them. They’re seeing too many, and so they’re not reading the recommendations. I have a theory that this becomes a habitual response – an alert pops up, clinicians override it and move past it. It allows them to get through work quickly.’

      This alert fatigue has real-world safety implications. If one alert out of 12 presented is a critical warning, and the other 11 aren’t clinically relevant for the patient, it’s likely the important alert will be missed.

      ‘We’re increasingly seeing incidents where alert fatigue has been identified as a contributing factor. It’s not that there wasn’t an alert in place, but that it was lost among the other alerts the clinician saw,’ Prof Baysari says.

      Returning to the road-sign analogy, there comes a point where there are just too many and you just can’t process them all and they stop being useful. Or you drive past the same ones every day and stop paying attention to them.

      PDL has developed its own alerts based on incidents that are frequently reported to the organisation and on medicines that are more likely to have significant consequences for patients.

      ‘We’re very mindful. We put in a small number of pop-ups that we think are of high importance or significance,’ Mr West says. ‘Our warnings are not theoretical. We try to prevent alert fatigue by limiting warnings to things that occur with frequency or with such consequence that they justify the pop-up. We appreciate it’s difficult when hundreds of prescriptions are dispensed every day, but we’d really encourage pharmacists to take note of them and not just tab through without any consideration.’

      Making smarter systems

      As pharmacists continue to expand their scope of practice, Fred IT Group Partnerships Manager Regina Cowie (she/her) says the functionality of decision-support tools will need to expand to include options like preventive care recommendations and chronic disease management tools.

      ‘For example, clinical decision support may be used to identify patients eligible for chronic disease screening or to assess chronic disease management,’ she says. ‘Or a vaccination prompt for eligible patients could support pharmacists to make informed decisions by dynamically changing aspects within dispensing systems to guide on healthcare opportunities, for example to improve vaccination rates.’

      As well as being broader, alerts also need to become smarter. Artificial intelligence is already being used in some aspects of dispensing software, Ms Cowie says, and AI has the potential to revolutionise the way clinical decision support is used.

      ‘AI has the ability to analyse large amounts of patient data and provide opportunities to improve medicine safety and patient care … Fred AID (Artificial Intelligence Directions) is an optional function already in place in Fred Dispense Plus. It uses AI to predict medication directions and allows pharmacists to quickly and safely enter directions for dispensing labels, rather than typing these from scratch. 

      ‘In future, AI may suggest treatment plans or identify patients at risk of certain diseases, based on patient population data. In health care, where time pressures are a consistent burden on clinicians, a related opportunity from AI is its ability to provide administrative support by automating documentation such as clinical notes.’

      Ultimately, there isn’t anything inherently wrong with alerts, Prof Baysari says, they just need to be better. ‘We have very basic alerts at the moment. They’re not designed well, so we’re not seeing the benefits. But we could.

      ‘We need better design in the backend, using AI to make them smarter, and, in the frontend, we need to think about how they look on screen,’ she says. ‘If we had good interfaces and a good backend infrastructure we’d get good safety benefits. But we have a lot of work to do.’ 

      Fred IT Government and Industry Engagement Lead and former Medicines Safety Program Director of the Australian Digital Health Agency Andrew Matthews MPS says clinical decision-support tools such as alerts can increase detection of inappropriate prescribing and dispensing, improve disease management, reduce adverse patient outcomes and enhance appropriate treatment.

      Fred IT, for example, has introduced an optional prompt in its dispensing software to help improve vaccination rates for the shingles vaccine in target cohorts aligned with recommendations from the National Immunisation Program (NIP).

      The prompt displays only if the patient meets the NIP criteria of the patient demographics entered in the Fred Dispense Plus patient profile.

      ‘With the large volumes of patient data now available in electronic medical records and pharmacy systems, especially where patient disease complexity makes it difficult to quickly assess the available data,’ Mr Matthews says, ‘clinical decision-support can present relevant patient information to the clinician to facilitate clinical problem-solving, decision-making or provide additional knowledge consistent with best practice guidelines.’ 

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      Are pop-ups doing more harm than good?

      vaccination
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                  [post_date] => 2025-06-25 13:10:45
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                  [post_content] => From 1 July 2025, pharmacists will see a range of adjustments to how they deliver and bill for vaccination. 
      
      Here, Australian Pharmacist outlines the changes in vaccination services and fees pharmacists can expect from early next month.
      

      1. NIPVIP vaccine administration fees will (slightly) increase

      In 2025, the Consumer Price Index (CPI) rose by 2.4%. So from next month, there will be a CPI increase applied to all National Immunisation Program Vaccinations in Pharmacy (NIPVIP) vaccines administered. Pharmacists will receive $20.05 per vaccine administered, up from $19.60.

      2. The COVID-19 vaccination payment will (significantly) drop 

      In less than a week, community pharmacists will see a significant reduction in the COVID-19 vaccine administration fee. The new rate will be $20.05 per vaccine administration in all Australian locations. This is a significant decrease from the previous rates per dose, which were:
      • $28.35 in urban areas
      • $31.60 in regional/rural areas.
      The change in the fee structure is designed to align the COVID-19 Vaccination in Community Pharmacy (CVCP) Program administration rates with the NIPVIP rate.  The CVCP Program is a temporary initiative, which is scheduled to end on 30 June 2026. Arrangements regarding COVID-19 vaccination beyond this date have not yet been announced.

      3. There will be no more COVID-19 vaccine flag-fall fee

      Along with receiving a per-vaccine fee, pharmacists who administered COVID-19 vaccines to vulnerable patients – such as those in residential aged care, disability facilities, or patients who are house-bound – received a ‘flag fall’ Site Visit payment of $127.30. This fee will discontinue after 30 June 2025. Pharmacists can continue providing off-site vaccination services to these patients, claiming the $20.05 administration fee by lodging a CVCP service claim through the Pharmacy Programs Administrator (PPA) Portal. A one-month grace period has been granted to pharmacists for submitting claims for services delivered on or before 30 June 2025. Any claims submitted after 31 July 2025 will not be accepted. In some good news, pharmacists no longer need to notify the PPA before delivering off-site vaccination services. Radius restrictions have also been removed, so there’s no need to consider the distance between the off-site location and the pharmacy premises.

      4. The COVID-19 ordering process will remain in place, for now

      At this stage, COVID-19 vaccines are still managed by the Commonwealth – meaning vaccines will still need to be distributed through the COVID-19 Vaccine Ordering System (CVAS). However, these arrangements have only been funded until 30 June 2026 – with details on future arrangement yet to come.

      5. There will only be one measles and varicella vaccine manufacturer on the NIP

      Pharmacists can currently order multiple brands of measles-containing vaccines under the NIP – including GSK’s Priorix, Priorix-Textra and CSL’s M-M-R II. Pharmacists in some jurisdictions can also currently order multiple brands of chicken pox (varicella) vaccines for catch-up vaccination on the NIP – including Varilrix (GSK) and Varivax (CSL). From 1 July 2025, community pharmacists and other immunisation providers will no longer be able to order CSL’s M-M-R II or Varivax. New NIP orders can only be placed for GSK’s Priorix, Priorix-Tetra and Varilrix. Pharmacists should continue to administer any existing vaccine stock until exhausted or the expiry date is reached.

      6. More Victorian pharmacists can administer travel vaccines, permanently

      The Victorian Community Pharmacist Statewide Pilot is going permanent and expanding its services on July 1, 2025. That means, eligible pharmacists will be able to administer the following travel vaccines in an ongoing capacity:
      • Hepatitis A
      • Hepatitis B
      • Typhoid
      • Poliomyelitis.
      Pharmacists will administer these vaccines privately, except where NIP eligibility applies, said PSA Victorian State Manager Jarrod McMaugh MPS. ‘The funded $20 consultation fee [for travel health] will remain, and pharmacists can charge an additional fee at their discretion,’ he said. ‘However, medicines will no longer be subsidised under the program.’ There were 800 participating pharmacies in the Victorian Community Pharmacist Statewide Pilot. Now, the program will extend to other pharmacies Victoria-wide, Mr McMaugh said. ‘Pharmacists can submit an Expression of Interest to join the program.’ The EOI form is available on the Victorian Department of Health website.

      7. WA's free flu vaccine campaign extended

      With influenza cases climbing and the season yet to peak, the Western Australian government has extended its free flu vaccination program until 31 July, giving all West Australians aged 6 months and over extra time to protect themselves against serious illness. As of 15 June 2025, WA has recorded 8,708 cases of influenza and 1,579 hospitalisations – 18% in children under 10 and 37% in those aged 65 and over. More than 763,180 vaccinations administered so far, including 311,890 through the free program.

      Correction

      30 June 2025: An earlier version of this article incorrectly referred to Varilrix and Varivax as measles-containing vaccines, rather than as varicella vaccines. AP sincerely apologises for this error.
      [post_title] => Mid-year vaccine shake-up incoming [post_excerpt] => From 1 July 2025, pharmacists will see a range of adjustments to how they deliver and bill for vaccination. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => mid-year-vaccine-shake-up-incoming [to_ping] => [pinged] => [post_modified] => 2025-06-30 12:08:24 [post_modified_gmt] => 2025-06-30 02:08:24 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29766 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Mid-year vaccine shake-up incoming [title] => Mid-year vaccine shake-up incoming [href] => https://www.australianpharmacist.com.au/mid-year-vaccine-shake-up-incoming/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29768 [authorType] => )

      Mid-year vaccine shake-up incoming

  • CPD
    • 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_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. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pharmacist-led-medicine-substitutions-now-possible [to_ping] => [pinged] => [post_modified] => 2025-07-02 16:31:22 [post_modified_gmt] => 2025-07-02 06:31:22 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29801 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Pharmacist-led medicine substitutions now possible [title] => Pharmacist-led medicine substitutions now possible [href] => https://www.australianpharmacist.com.au/pharmacist-led-medicine-substitutions-now-possible/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29813 [authorType] => )

      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 [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => mid-year-pharmacy-policy-overhaul-begins [to_ping] => [pinged] => [post_modified] => 2025-06-30 15:02:59 [post_modified_gmt] => 2025-06-30 05:02:59 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29793 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Mid-year pharmacy policy overhaul begins [title] => Mid-year pharmacy policy overhaul begins [href] => https://www.australianpharmacist.com.au/mid-year-pharmacy-policy-overhaul-begins/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29795 [authorType] => )

      Mid-year pharmacy policy overhaul begins

      pop-up
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                  [post_date] => 2025-06-27 09:36:24
                  [post_date_gmt] => 2025-06-26 23:36:24
                  [post_content] => 

      Decision-support tools are designed to promote patient safety. But when here's a pop-up for everything, the message can be diluted.

      We all know the feeling. You’re in the middle of something – maybe deep into a busy shift in the pharmacy, or on the wards in the hospital, or even scrolling on your phone at home – and another pop-up appears.

      You’ve seen it before, so your instinct is to dismiss it without a second thought.

      While ignoring the latest alert from your fitness app might mean falling behind on your step count, dismissing a decision-support pop-up in a healthcare setting might mean missing something crucial.

      Yet, with so many alerts coming through, it can be overwhelming – and almost impossible – to sort the important information from the rest.

      Why do we have popups?

      Pop-ups are much like passing a sign on the road. They are meant to inform your decisions, whether this be about a hidden hazard or general navigation. In health care, they have proliferated across the increasing number of digital platforms and pieces of software health professionals use to provide patient care and nowhere more so than clinical decision-support tools.

      Decision-support pop-ups take many forms, from alerts about potential drug interactions to duplicate therapy warnings and allergy information. They are intended to aid health professionals in their decision-making and, in the case of dispensing pharmacists, are there to ‘remind pharmacists to be alert and to double-check that the medicine supplied is the medicine prescribed’, says PDL Senior Professional Officer Gary West FPS (he/him).

      ‘It might only take half a second to view them, but the difference for a patient – and for a pharmacist – can be really significant. We’ve had multiple cases where a locum or newly registered pharmacist hasn’t realised a patient is on a staged-supply arrangement because it wasn’t clear in their profile. A warning message would have prevented that patient from getting access to a larger quantity of medicines than intended.’

      Mr West says both pharmacists and dispensary technicians should understand why the alerts are there – to help mitigate risk for patients and themselves.

      ‘We would always encourage pharmacists to use that technology, and to ensure their dispensary technicians are well trained and alert to raising certain pop-up warnings with the pharmacist associated with the dispensing event,’ says Mr West.

      The pop-up paradox

      But are we currently overwhelmed by pop-ups? And are some pop-ups better than others?

      University of Sydney Professor of Health Research Melissa Baysari (she/her) suggests the answer to both questions is yes. A human factors expert, she has conducted extensive research into how digital health can support medicine management. Despite their good intentions, she says there is limited evidence that alerts change practice or improve patient outcomes, particularly in the hospital setting.

      In a 5-year study involving patients across five hospitals in New South Wales and Queensland, Prof Baysari’s team examined whether activating drug-drug interaction alerts reduced harm. One group of hospitals had the alerts enabled, the control group did not.

      Surprising results

      ‘We found overall that the alerts had no impact,’ she says.  ‘Having drug-drug interaction alerts did not reduce the number of clinically relevant interactions or harms experienced by patients. The study shows that if you’re going to turn all the drug interaction alerts on, they’re not going to deliver the safety benefits you expect.’

      In fact, she warns that poorly designed or excessive alerts can backfire. ‘There are so many negative consequences, like wasted time, frustration for clinicians and patient safety implications, that I would not recommend turning drug-drug interaction alerts on in your systems unless you’ve got some kind of smart technology in there.’

      Despite the lack of evidence about the effectiveness of alerts, organisations are often reluctant to scale them back. Prof Baysari said her team had ‘a lot of trouble’ finding hospitals that were willing to not turn on their drug interaction alerts.

      ‘Everyone assumed the alerts were effective and they were going to be removing an intervention that was providing a safety net for everyone,’ she says. ‘But the way I see it, if organisations just keep putting more and more alerts in, it becomes the end user’s responsibility to work out which ones are relevant and act appropriately. It’s shifting the responsibility away from the organisation, so if an incident occurs, it’s the clinician who’s to blame. I think that’s very unfair.’

      Information overload

      Research shows that the number of alerts a healthcare professional receives impacts how effective they are – and pharmacists see a lot, Prof Baysari says.

      ‘You might assume that there’s an evidence base for alerts, but we have a lot more research showing that when you implement large numbers of alerts, clinicians begin to ignore them. They’re seeing too many, and so they’re not reading the recommendations. I have a theory that this becomes a habitual response – an alert pops up, clinicians override it and move past it. It allows them to get through work quickly.’

      This alert fatigue has real-world safety implications. If one alert out of 12 presented is a critical warning, and the other 11 aren’t clinically relevant for the patient, it’s likely the important alert will be missed.

      ‘We’re increasingly seeing incidents where alert fatigue has been identified as a contributing factor. It’s not that there wasn’t an alert in place, but that it was lost among the other alerts the clinician saw,’ Prof Baysari says.

      Returning to the road-sign analogy, there comes a point where there are just too many and you just can’t process them all and they stop being useful. Or you drive past the same ones every day and stop paying attention to them.

      PDL has developed its own alerts based on incidents that are frequently reported to the organisation and on medicines that are more likely to have significant consequences for patients.

      ‘We’re very mindful. We put in a small number of pop-ups that we think are of high importance or significance,’ Mr West says. ‘Our warnings are not theoretical. We try to prevent alert fatigue by limiting warnings to things that occur with frequency or with such consequence that they justify the pop-up. We appreciate it’s difficult when hundreds of prescriptions are dispensed every day, but we’d really encourage pharmacists to take note of them and not just tab through without any consideration.’

      Making smarter systems

      As pharmacists continue to expand their scope of practice, Fred IT Group Partnerships Manager Regina Cowie (she/her) says the functionality of decision-support tools will need to expand to include options like preventive care recommendations and chronic disease management tools.

      ‘For example, clinical decision support may be used to identify patients eligible for chronic disease screening or to assess chronic disease management,’ she says. ‘Or a vaccination prompt for eligible patients could support pharmacists to make informed decisions by dynamically changing aspects within dispensing systems to guide on healthcare opportunities, for example to improve vaccination rates.’

      As well as being broader, alerts also need to become smarter. Artificial intelligence is already being used in some aspects of dispensing software, Ms Cowie says, and AI has the potential to revolutionise the way clinical decision support is used.

      ‘AI has the ability to analyse large amounts of patient data and provide opportunities to improve medicine safety and patient care … Fred AID (Artificial Intelligence Directions) is an optional function already in place in Fred Dispense Plus. It uses AI to predict medication directions and allows pharmacists to quickly and safely enter directions for dispensing labels, rather than typing these from scratch. 

      ‘In future, AI may suggest treatment plans or identify patients at risk of certain diseases, based on patient population data. In health care, where time pressures are a consistent burden on clinicians, a related opportunity from AI is its ability to provide administrative support by automating documentation such as clinical notes.’

      Ultimately, there isn’t anything inherently wrong with alerts, Prof Baysari says, they just need to be better. ‘We have very basic alerts at the moment. They’re not designed well, so we’re not seeing the benefits. But we could.

      ‘We need better design in the backend, using AI to make them smarter, and, in the frontend, we need to think about how they look on screen,’ she says. ‘If we had good interfaces and a good backend infrastructure we’d get good safety benefits. But we have a lot of work to do.’ 

      Fred IT Government and Industry Engagement Lead and former Medicines Safety Program Director of the Australian Digital Health Agency Andrew Matthews MPS says clinical decision-support tools such as alerts can increase detection of inappropriate prescribing and dispensing, improve disease management, reduce adverse patient outcomes and enhance appropriate treatment.

      Fred IT, for example, has introduced an optional prompt in its dispensing software to help improve vaccination rates for the shingles vaccine in target cohorts aligned with recommendations from the National Immunisation Program (NIP).

      The prompt displays only if the patient meets the NIP criteria of the patient demographics entered in the Fred Dispense Plus patient profile.

      ‘With the large volumes of patient data now available in electronic medical records and pharmacy systems, especially where patient disease complexity makes it difficult to quickly assess the available data,’ Mr Matthews says, ‘clinical decision-support can present relevant patient information to the clinician to facilitate clinical problem-solving, decision-making or provide additional knowledge consistent with best practice guidelines.’ 

      [post_title] => Are pop-ups doing more harm than good? [post_excerpt] => Are decision-support tools the problem or the cure for patient safety? Australian Pharmacist investigates. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => are-decision-support-tools-pop-ups-getting-in-the-way [to_ping] => [pinged] => [post_modified] => 2025-06-30 15:03:26 [post_modified_gmt] => 2025-06-30 05:03:26 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29777 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Are pop-ups doing more harm than good? [title] => Are pop-ups doing more harm than good? [href] => https://www.australianpharmacist.com.au/are-decision-support-tools-pop-ups-getting-in-the-way/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29791 [authorType] => )

      Are pop-ups doing more harm than good?

      vaccination
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                  [post_content] => From 1 July 2025, pharmacists will see a range of adjustments to how they deliver and bill for vaccination. 
      
      Here, Australian Pharmacist outlines the changes in vaccination services and fees pharmacists can expect from early next month.
      

      1. NIPVIP vaccine administration fees will (slightly) increase

      In 2025, the Consumer Price Index (CPI) rose by 2.4%. So from next month, there will be a CPI increase applied to all National Immunisation Program Vaccinations in Pharmacy (NIPVIP) vaccines administered. Pharmacists will receive $20.05 per vaccine administered, up from $19.60.

      2. The COVID-19 vaccination payment will (significantly) drop 

      In less than a week, community pharmacists will see a significant reduction in the COVID-19 vaccine administration fee. The new rate will be $20.05 per vaccine administration in all Australian locations. This is a significant decrease from the previous rates per dose, which were:
      • $28.35 in urban areas
      • $31.60 in regional/rural areas.
      The change in the fee structure is designed to align the COVID-19 Vaccination in Community Pharmacy (CVCP) Program administration rates with the NIPVIP rate.  The CVCP Program is a temporary initiative, which is scheduled to end on 30 June 2026. Arrangements regarding COVID-19 vaccination beyond this date have not yet been announced.

      3. There will be no more COVID-19 vaccine flag-fall fee

      Along with receiving a per-vaccine fee, pharmacists who administered COVID-19 vaccines to vulnerable patients – such as those in residential aged care, disability facilities, or patients who are house-bound – received a ‘flag fall’ Site Visit payment of $127.30. This fee will discontinue after 30 June 2025. Pharmacists can continue providing off-site vaccination services to these patients, claiming the $20.05 administration fee by lodging a CVCP service claim through the Pharmacy Programs Administrator (PPA) Portal. A one-month grace period has been granted to pharmacists for submitting claims for services delivered on or before 30 June 2025. Any claims submitted after 31 July 2025 will not be accepted. In some good news, pharmacists no longer need to notify the PPA before delivering off-site vaccination services. Radius restrictions have also been removed, so there’s no need to consider the distance between the off-site location and the pharmacy premises.

      4. The COVID-19 ordering process will remain in place, for now

      At this stage, COVID-19 vaccines are still managed by the Commonwealth – meaning vaccines will still need to be distributed through the COVID-19 Vaccine Ordering System (CVAS). However, these arrangements have only been funded until 30 June 2026 – with details on future arrangement yet to come.

      5. There will only be one measles and varicella vaccine manufacturer on the NIP

      Pharmacists can currently order multiple brands of measles-containing vaccines under the NIP – including GSK’s Priorix, Priorix-Textra and CSL’s M-M-R II. Pharmacists in some jurisdictions can also currently order multiple brands of chicken pox (varicella) vaccines for catch-up vaccination on the NIP – including Varilrix (GSK) and Varivax (CSL). From 1 July 2025, community pharmacists and other immunisation providers will no longer be able to order CSL’s M-M-R II or Varivax. New NIP orders can only be placed for GSK’s Priorix, Priorix-Tetra and Varilrix. Pharmacists should continue to administer any existing vaccine stock until exhausted or the expiry date is reached.

      6. More Victorian pharmacists can administer travel vaccines, permanently

      The Victorian Community Pharmacist Statewide Pilot is going permanent and expanding its services on July 1, 2025. That means, eligible pharmacists will be able to administer the following travel vaccines in an ongoing capacity:
      • Hepatitis A
      • Hepatitis B
      • Typhoid
      • Poliomyelitis.
      Pharmacists will administer these vaccines privately, except where NIP eligibility applies, said PSA Victorian State Manager Jarrod McMaugh MPS. ‘The funded $20 consultation fee [for travel health] will remain, and pharmacists can charge an additional fee at their discretion,’ he said. ‘However, medicines will no longer be subsidised under the program.’ There were 800 participating pharmacies in the Victorian Community Pharmacist Statewide Pilot. Now, the program will extend to other pharmacies Victoria-wide, Mr McMaugh said. ‘Pharmacists can submit an Expression of Interest to join the program.’ The EOI form is available on the Victorian Department of Health website.

      7. WA's free flu vaccine campaign extended

      With influenza cases climbing and the season yet to peak, the Western Australian government has extended its free flu vaccination program until 31 July, giving all West Australians aged 6 months and over extra time to protect themselves against serious illness. As of 15 June 2025, WA has recorded 8,708 cases of influenza and 1,579 hospitalisations – 18% in children under 10 and 37% in those aged 65 and over. More than 763,180 vaccinations administered so far, including 311,890 through the free program.

      Correction

      30 June 2025: An earlier version of this article incorrectly referred to Varilrix and Varivax as measles-containing vaccines, rather than as varicella vaccines. AP sincerely apologises for this error.
      [post_title] => Mid-year vaccine shake-up incoming [post_excerpt] => From 1 July 2025, pharmacists will see a range of adjustments to how they deliver and bill for vaccination. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => mid-year-vaccine-shake-up-incoming [to_ping] => [pinged] => [post_modified] => 2025-06-30 12:08:24 [post_modified_gmt] => 2025-06-30 02:08:24 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29766 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Mid-year vaccine shake-up incoming [title] => Mid-year vaccine shake-up incoming [href] => https://www.australianpharmacist.com.au/mid-year-vaccine-shake-up-incoming/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29768 [authorType] => )

      Mid-year vaccine shake-up incoming

  • People
    • 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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          [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. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pharmacist-led-medicine-substitutions-now-possible [to_ping] => [pinged] => [post_modified] => 2025-07-02 16:31:22 [post_modified_gmt] => 2025-07-02 06:31:22 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29801 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Pharmacist-led medicine substitutions now possible [title] => Pharmacist-led medicine substitutions now possible [href] => https://www.australianpharmacist.com.au/pharmacist-led-medicine-substitutions-now-possible/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29813 [authorType] => )

      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 [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => mid-year-pharmacy-policy-overhaul-begins [to_ping] => [pinged] => [post_modified] => 2025-06-30 15:02:59 [post_modified_gmt] => 2025-06-30 05:02:59 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=29793 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Mid-year pharmacy policy overhaul begins [title] => Mid-year pharmacy policy overhaul begins [href] => https://www.australianpharmacist.com.au/mid-year-pharmacy-policy-overhaul-begins/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 29795 [authorType] => )

      Mid-year pharmacy policy overhaul begins

      pop-up
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                  [post_date] => 2025-06-27 09:36:24
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                  [post_content] => 

      Decision-support tools are designed to promote patient safety. But when here's a pop-up for everything, the message can be diluted.

      We all know the feeling. You’re in the middle of something – maybe deep into a busy shift in the pharmacy, or on the wards in the hospital, or even scrolling on your phone at home – and another pop-up appears.

      You’ve seen it before, so your instinct is to dismiss it without a second thought.

      While ignoring the latest alert from your fitness app might mean falling behind on your step count, dismissing a decision-support pop-up in a healthcare setting might mean missing something crucial.

      Yet, with so many alerts coming through, it can be overwhelming – and almost impossible – to sort the important information from the rest.

      Why do we have popups?

      Pop-ups are much like passing a sign on the road. They are meant to inform your decisions, whether this be about a hidden hazard or general navigation. In health care, they have proliferated across the increasing number of digital platforms and pieces of software health professionals use to provide patient care and nowhere more so than clinical decision-support tools.

      Decision-support pop-ups take many forms, from alerts about potential drug interactions to duplicate therapy warnings and allergy information. They are intended to aid health professionals in their decision-making and, in the case of dispensing pharmacists, are there to ‘remind pharmacists to be alert and to double-check that the medicine supplied is the medicine prescribed’, says PDL Senior Professional Officer Gary West FPS (he/him).

      ‘It might only take half a second to view them, but the difference for a patient – and for a pharmacist – can be really significant. We’ve had multiple cases where a locum or newly registered pharmacist hasn’t realised a patient is on a staged-supply arrangement because it wasn’t clear in their profile. A warning message would have prevented that patient from getting access to a larger quantity of medicines than intended.’

      Mr West says both pharmacists and dispensary technicians should understand why the alerts are there – to help mitigate risk for patients and themselves.

      ‘We would always encourage pharmacists to use that technology, and to ensure their dispensary technicians are well trained and alert to raising certain pop-up warnings with the pharmacist associated with the dispensing event,’ says Mr West.

      The pop-up paradox

      But are we currently overwhelmed by pop-ups? And are some pop-ups better than others?

      University of Sydney Professor of Health Research Melissa Baysari (she/her) suggests the answer to both questions is yes. A human factors expert, she has conducted extensive research into how digital health can support medicine management. Despite their good intentions, she says there is limited evidence that alerts change practice or improve patient outcomes, particularly in the hospital setting.

      In a 5-year study involving patients across five hospitals in New South Wales and Queensland, Prof Baysari’s team examined whether activating drug-drug interaction alerts reduced harm. One group of hospitals had the alerts enabled, the control group did not.

      Surprising results

      ‘We found overall that the alerts had no impact,’ she says.  ‘Having drug-drug interaction alerts did not reduce the number of clinically relevant interactions or harms experienced by patients. The study shows that if you’re going to turn all the drug interaction alerts on, they’re not going to deliver the safety benefits you expect.’

      In fact, she warns that poorly designed or excessive alerts can backfire. ‘There are so many negative consequences, like wasted time, frustration for clinicians and patient safety implications, that I would not recommend turning drug-drug interaction alerts on in your systems unless you’ve got some kind of smart technology in there.’

      Despite the lack of evidence about the effectiveness of alerts, organisations are often reluctant to scale them back. Prof Baysari said her team had ‘a lot of trouble’ finding hospitals that were willing to not turn on their drug interaction alerts.

      ‘Everyone assumed the alerts were effective and they were going to be removing an intervention that was providing a safety net for everyone,’ she says. ‘But the way I see it, if organisations just keep putting more and more alerts in, it becomes the end user’s responsibility to work out which ones are relevant and act appropriately. It’s shifting the responsibility away from the organisation, so if an incident occurs, it’s the clinician who’s to blame. I think that’s very unfair.’

      Information overload

      Research shows that the number of alerts a healthcare professional receives impacts how effective they are – and pharmacists see a lot, Prof Baysari says.

      ‘You might assume that there’s an evidence base for alerts, but we have a lot more research showing that when you implement large numbers of alerts, clinicians begin to ignore them. They’re seeing too many, and so they’re not reading the recommendations. I have a theory that this becomes a habitual response – an alert pops up, clinicians override it and move past it. It allows them to get through work quickly.’

      This alert fatigue has real-world safety implications. If one alert out of 12 presented is a critical warning, and the other 11 aren’t clinically relevant for the patient, it’s likely the important alert will be missed.

      ‘We’re increasingly seeing incidents where alert fatigue has been identified as a contributing factor. It’s not that there wasn’t an alert in place, but that it was lost among the other alerts the clinician saw,’ Prof Baysari says.

      Returning to the road-sign analogy, there comes a point where there are just too many and you just can’t process them all and they stop being useful. Or you drive past the same ones every day and stop paying attention to them.

      PDL has developed its own alerts based on incidents that are frequently reported to the organisation and on medicines that are more likely to have significant consequences for patients.

      ‘We’re very mindful. We put in a small number of pop-ups that we think are of high importance or significance,’ Mr West says. ‘Our warnings are not theoretical. We try to prevent alert fatigue by limiting warnings to things that occur with frequency or with such consequence that they justify the pop-up. We appreciate it’s difficult when hundreds of prescriptions are dispensed every day, but we’d really encourage pharmacists to take note of them and not just tab through without any consideration.’

      Making smarter systems

      As pharmacists continue to expand their scope of practice, Fred IT Group Partnerships Manager Regina Cowie (she/her) says the functionality of decision-support tools will need to expand to include options like preventive care recommendations and chronic disease management tools.

      ‘For example, clinical decision support may be used to identify patients eligible for chronic disease screening or to assess chronic disease management,’ she says. ‘Or a vaccination prompt for eligible patients could support pharmacists to make informed decisions by dynamically changing aspects within dispensing systems to guide on healthcare opportunities, for example to improve vaccination rates.’

      As well as being broader, alerts also need to become smarter. Artificial intelligence is already being used in some aspects of dispensing software, Ms Cowie says, and AI has the potential to revolutionise the way clinical decision support is used.

      ‘AI has the ability to analyse large amounts of patient data and provide opportunities to improve medicine safety and patient care … Fred AID (Artificial Intelligence Directions) is an optional function already in place in Fred Dispense Plus. It uses AI to predict medication directions and allows pharmacists to quickly and safely enter directions for dispensing labels, rather than typing these from scratch. 

      ‘In future, AI may suggest treatment plans or identify patients at risk of certain diseases, based on patient population data. In health care, where time pressures are a consistent burden on clinicians, a related opportunity from AI is its ability to provide administrative support by automating documentation such as clinical notes.’

      Ultimately, there isn’t anything inherently wrong with alerts, Prof Baysari says, they just need to be better. ‘We have very basic alerts at the moment. They’re not designed well, so we’re not seeing the benefits. But we could.

      ‘We need better design in the backend, using AI to make them smarter, and, in the frontend, we need to think about how they look on screen,’ she says. ‘If we had good interfaces and a good backend infrastructure we’d get good safety benefits. But we have a lot of work to do.’ 

      Fred IT Government and Industry Engagement Lead and former Medicines Safety Program Director of the Australian Digital Health Agency Andrew Matthews MPS says clinical decision-support tools such as alerts can increase detection of inappropriate prescribing and dispensing, improve disease management, reduce adverse patient outcomes and enhance appropriate treatment.

      Fred IT, for example, has introduced an optional prompt in its dispensing software to help improve vaccination rates for the shingles vaccine in target cohorts aligned with recommendations from the National Immunisation Program (NIP).

      The prompt displays only if the patient meets the NIP criteria of the patient demographics entered in the Fred Dispense Plus patient profile.

      ‘With the large volumes of patient data now available in electronic medical records and pharmacy systems, especially where patient disease complexity makes it difficult to quickly assess the available data,’ Mr Matthews says, ‘clinical decision-support can present relevant patient information to the clinician to facilitate clinical problem-solving, decision-making or provide additional knowledge consistent with best practice guidelines.’ 

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      Are pop-ups doing more harm than good?

      vaccination
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                  [post_content] => From 1 July 2025, pharmacists will see a range of adjustments to how they deliver and bill for vaccination. 
      
      Here, Australian Pharmacist outlines the changes in vaccination services and fees pharmacists can expect from early next month.
      

      1. NIPVIP vaccine administration fees will (slightly) increase

      In 2025, the Consumer Price Index (CPI) rose by 2.4%. So from next month, there will be a CPI increase applied to all National Immunisation Program Vaccinations in Pharmacy (NIPVIP) vaccines administered. Pharmacists will receive $20.05 per vaccine administered, up from $19.60.

      2. The COVID-19 vaccination payment will (significantly) drop 

      In less than a week, community pharmacists will see a significant reduction in the COVID-19 vaccine administration fee. The new rate will be $20.05 per vaccine administration in all Australian locations. This is a significant decrease from the previous rates per dose, which were:
      • $28.35 in urban areas
      • $31.60 in regional/rural areas.
      The change in the fee structure is designed to align the COVID-19 Vaccination in Community Pharmacy (CVCP) Program administration rates with the NIPVIP rate.  The CVCP Program is a temporary initiative, which is scheduled to end on 30 June 2026. Arrangements regarding COVID-19 vaccination beyond this date have not yet been announced.

      3. There will be no more COVID-19 vaccine flag-fall fee

      Along with receiving a per-vaccine fee, pharmacists who administered COVID-19 vaccines to vulnerable patients – such as those in residential aged care, disability facilities, or patients who are house-bound – received a ‘flag fall’ Site Visit payment of $127.30. This fee will discontinue after 30 June 2025. Pharmacists can continue providing off-site vaccination services to these patients, claiming the $20.05 administration fee by lodging a CVCP service claim through the Pharmacy Programs Administrator (PPA) Portal. A one-month grace period has been granted to pharmacists for submitting claims for services delivered on or before 30 June 2025. Any claims submitted after 31 July 2025 will not be accepted. In some good news, pharmacists no longer need to notify the PPA before delivering off-site vaccination services. Radius restrictions have also been removed, so there’s no need to consider the distance between the off-site location and the pharmacy premises.

      4. The COVID-19 ordering process will remain in place, for now

      At this stage, COVID-19 vaccines are still managed by the Commonwealth – meaning vaccines will still need to be distributed through the COVID-19 Vaccine Ordering System (CVAS). However, these arrangements have only been funded until 30 June 2026 – with details on future arrangement yet to come.

      5. There will only be one measles and varicella vaccine manufacturer on the NIP

      Pharmacists can currently order multiple brands of measles-containing vaccines under the NIP – including GSK’s Priorix, Priorix-Textra and CSL’s M-M-R II. Pharmacists in some jurisdictions can also currently order multiple brands of chicken pox (varicella) vaccines for catch-up vaccination on the NIP – including Varilrix (GSK) and Varivax (CSL). From 1 July 2025, community pharmacists and other immunisation providers will no longer be able to order CSL’s M-M-R II or Varivax. New NIP orders can only be placed for GSK’s Priorix, Priorix-Tetra and Varilrix. Pharmacists should continue to administer any existing vaccine stock until exhausted or the expiry date is reached.

      6. More Victorian pharmacists can administer travel vaccines, permanently

      The Victorian Community Pharmacist Statewide Pilot is going permanent and expanding its services on July 1, 2025. That means, eligible pharmacists will be able to administer the following travel vaccines in an ongoing capacity:
      • Hepatitis A
      • Hepatitis B
      • Typhoid
      • Poliomyelitis.
      Pharmacists will administer these vaccines privately, except where NIP eligibility applies, said PSA Victorian State Manager Jarrod McMaugh MPS. ‘The funded $20 consultation fee [for travel health] will remain, and pharmacists can charge an additional fee at their discretion,’ he said. ‘However, medicines will no longer be subsidised under the program.’ There were 800 participating pharmacies in the Victorian Community Pharmacist Statewide Pilot. Now, the program will extend to other pharmacies Victoria-wide, Mr McMaugh said. ‘Pharmacists can submit an Expression of Interest to join the program.’ The EOI form is available on the Victorian Department of Health website.

      7. WA's free flu vaccine campaign extended

      With influenza cases climbing and the season yet to peak, the Western Australian government has extended its free flu vaccination program until 31 July, giving all West Australians aged 6 months and over extra time to protect themselves against serious illness. As of 15 June 2025, WA has recorded 8,708 cases of influenza and 1,579 hospitalisations – 18% in children under 10 and 37% in those aged 65 and over. More than 763,180 vaccinations administered so far, including 311,890 through the free program.

      Correction

      30 June 2025: An earlier version of this article incorrectly referred to Varilrix and Varivax as measles-containing vaccines, rather than as varicella vaccines. AP sincerely apologises for this error.
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      Mid-year vaccine shake-up incoming

AUSTRALIAN PHARMACIST Australian Pharmacist
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