2017 June - Vets, Scripts, Written Authorities and Online Pharmacies
There has been a growth in online pharmacies in recent years and the Board has recently received a number of reports from NSW Health concerned about the involvement of veterinarians in these businesses and potential breaches of poisons and therapeutic goods legislation in NSW.
Only a pharmacist can dispense substances specified in the Poisons List (such as S4 and S8 medications) on the prescription of a veterinarian (Poisons and Therapeutic Goods Act 1966 (s 36AA)) but this legislation does not prevent a veterinarian from supplying such medications on the written authority of another veterinarian (Veterinary Practice Regulation 2013 (clause 20)) in the ordinary course of his or her profession.
So, what is the difference between a prescription and a written authority and what is the ‘ordinary course of his or her profession’ for a veterinarian?
A prescription written by a veterinarian allows any pharmacist to dispense medication to the holder of the prescription (veterinary client) for their animal.
A written authority allows a specific veterinarian named in the authority to supply medication on behalf of another veterinarian.
In all cases the veterinarian writing the prescription or the written authority must have either physically examined the animal or have that animal under his or her direct care in compliance with clause 20 of the Veterinary practitioners code of professional conduct.
Under the previous regulation a veterinarian could supply a restricted substance on the authority of another veterinarian. This provision existed to ensure that clients who were not able to reach their own veterinarian could visit another veterinarian who could then request more medication for the animal. The other veterinarian would simply contact the first to ensure a repeat of this medication was appropriate. Similarly, a veterinarian who is unable to supply a client with medication not in stock could ensure the client could purchase this medication from a colleague.
The regulation was updated in 2013 to ensure there was documented evidence of this supply for both veterinarians; an authority to supply became a written authority to supply.
The above are examples of the ‘ordinary course of his or her profession’ for a veterinarian.
The Board considers that operating a business which is essentially a ‘pharmacy’ is not in the ‘ordinary course of his or her profession’ for a veterinarian.
In summary, the legislation provides that:
- Only a pharmacist can dispense on the prescription of a veterinarian
- Only a registered pharmacist, a partnership of registered pharmacists or a pharmacists' body corporate can be involved in the operation of a pharmacy business in NSW
- A veterinarian cannot dispense on the prescription of a veterinarian
- A veterinarian can only supply a restricted substance (S4 and S8 medication) to a person responsible for the care of an animal that he or she has physically examined or has under his or her direct care, or with the written authority of another veterinarian who has physically examined the animal or has this animal under his or her direct care
- A written authority is one that is provided from one veterinarian to another veterinarian to enable the other veterinarian to supply a restricted substance that he or she is not able to supply
The supply of substances specified on the Poisons List is not a restricted act of veterinary science. This is a privilege provided to veterinarians as authorised persons under poisons and therapeutic goods legislation. With this privilege comes a number of responsibilities including a commitment to ensure that these medications will only be supplied for veterinary use and only supplied under specific circumstances.