COVID-19 anti-virals should be available at chemists without prescription to relieve the GP shortage crisis, claims Pharmacy Guild

Pharmacy Guild of Australia national president Professor Trent Twomey said the GP shortage crisis meant patient wait times were "endangering those with COVID-19".

"This is backed by recently revealed Healthengine data. For example, in 2019 the average wait time in Victoria was 1.98 days and now it's 3.33 days. WA and NSW are the worst-performing states, where a patient has to wait an average of 4 and 4.17 days respectively to see a GP," Professor Twomey said.

But the Royal Australian College of General Practitioners has pushed back on the proposal, saying "over-the-counter pharmacy dispensing is not the answer" because of safety concerns.

Professor Twomey said New Zealand had recently followed Canada and the United Kingdom and made COVID-19 anti-viral medicines available at local community pharmacies across the country.

"Australian patients deserve the same access to the COVID-19 anti-virals," he said.

"Community pharmacists in Australia have the skills, expertise and knowledge to assist patients so there is no reason for delaying treatment to eligible patients.

"As highly trained medicine experts, pharmacists understand drug interactions, can adjust dosing as required and refer more complex patients to a medical practitioner to ensure better triaging across limited GP appointments."

However, the Royal Australian College of General Practitioners warned that allowing over-the-counter dispensing of COVID-19 anti-viral treatments could jeopardise patient safety.

RACGP President Adj. Professor Karen Price said patient safety must come first.

"We must do more to get these treatments in the hands of those who need them, but over-the-counter pharmacy dispensing is not the answer," she said.

"While oral anti-virals are critical for the management of COVID-19, they are not without risks to patients, so any changes to access must guarantee patient safety. GPs are the key to safely prescribing these treatments.

"We have a strong and, in many cases, long-standing connection with our patients and we know their health history including existing health conditions or other factors which may impact their eligibility for these medicines," Professor Price said.

"Allowing pharmacists to prescribe and dispense anti-virals will not improve access and there are significant risks to patients given these drugs have what we call 'contraindications,' which is the term used to describe when a particular treatment should not be used, as well as interactions with other common medications."

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A Therapeutic Goods Administration spokesperson told ACM that at this stage, there had been no request for the TGA to include oral anti-virals in Schedule 3 of the Poisons Standard, that is, so it could be provided by a pharmacist without a doctor's prescription.

"Should new evidence become available, including through an application from a member of the public or peak body to amend the Poisons Standard, it would be considered," the spokesperson said.

The TGA said a decision to require a prescription for oral anti-viral treatments took into account several factors, including the high number of different drugs that shouldn't be taken at the same time as oral anti-virals.

"There is a role for prescribing doctors to decide whether the COVID-19 treatment is suitable and/or whether the patient needs to change their other medications when taking anti-virals.

"Another important factor is that these medicines are not recommended in several groups of people, such as those with poor kidney function or those trying to become pregnant (and their partners)," the spokesperson said.

Professor Twomey said making anti-virals available without prescription would "greatly reduce" COVID-19 hospitalisations. It would increase the number of patients receiving treatment in a timely manner, increase productivity and save hundreds of millions of dollars in hospital expenditure, he said.

"Community pharmacists continue to demonstrate their important role in primary care with the delivery of over 8 million doses of COVID-19 vaccinations nationally," he said.