Doctors withdraw from pharmacy trial over women’s drug safety fears

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Victorian women could be given antibiotics that are unsafe for the first trimester of pregnancy and treated for urinary tract infections when they in fact have a sexually transmitted disease under the state’s future pharmacy prescription model, the peak body for doctors has warned.

In her first public comments on why the Australian Medical Association has quit a key Andrews government advisory body, Dr Jill Tomlinson said she held grave concerns that an expanded prescription pilot, due to start next month, would not be part of a registered clinical trial.

Dr Jill Tomlinson says Victoria’s pharmacy prescription plan is problematic. Credit: Wayne Taylor

Without peer-reviewed oversight, she and other doctors fear the government will cherry-pick data to forge ahead with a “feel-good election promise” to allow Victorians to bypass their GP and have their pharmacist dispense repeat scripts for oral contraceptives, administer travel vaccines and prescribe medicine for uncomplicated UTIs and minor skin conditions.

“We do not support the pilot,” Tomlinson said, adding that her concerns related to an increased risk of misdiagnosis and incorrect treatment. “The refusal to conduct this experiment as a registered clinical trial raises serious concerns about transparency and the rushed implementation of this promise.”

The AMA president said a similar pilot conducted in Queensland found six pregnant women were given antibiotics that were unsafe for their unborn child.

“And there was some misdiagnosis of sexually transmitted diseases,” Tomlinson said. “People were given UTI treatment when they didn’t have a UTI.

“We raised many concerns throughout the consultation process [in Victoria]. The concerns that we have about the risks to patients were not able to be satisfactorily addressed. As doctors, the safety and welfare of our patients is the primary focus.”

But the AMA’s concern over appropriate safeguards has received a rebuke from the Andrews government and the peak body for pharmacists, who say it’s an insult to hardworking community chemists.

The Pharmacy Guild’s Victorian president, Anthony Tassone, said pharmacists are extremely well-trained at identifying when a patient should be referred to a GP or another health professional. He added that pharmacists taking part in the trial will receive additional education.

“The AMA is calling for a clinical trial, which we don’t understand. The treatments being used in this pilot – for example, [UTI drug] trimethoprim –have been clinically proven for their safety,” he said.

“Patients don’t care about turf wars and squabbles between health professionals. What they do care about is getting the healthcare they need, when and where they need it.”

During last year’s state election campaign, Labor promised to give women greater access to oral contraceptives and UTI treatments.

A spokesman for the Andrews government said the pilot, once rolled out more broadly, would be particularly beneficial for rural and regional Victorians and others who face long wait times to see a GP.

“This could be fast treatment for a UTI, picking up a fresh supply of contraceptive pills, or getting an important vaccine,” the spokesman said.

“Prescribing by pharmacists has a long history of clinically appropriate and safe care in a number of countries, including New Zealand, Canada and the United Kingdom. Any suggestion otherwise is offensive to our hardworking community pharmacists.”

The pilot is expected to cost about $20 million, according to last year’s election commitment costings.

The public spat comes less than a week after GPs threatened to name and shame Premier Daniel Andrews on hiked medical bills as part of a dispute over payroll tax.

Asked on Thursday whether his relationship with the healthcare sector was deteriorating, the premier said Labor had far more in common with GPs’ interests “than they would perhaps let on”.

“If they want to have a go at me, if that makes them feel better, then fine,” he said. “We are delivering on our election commitments to bridge the pay gap between a hospital doctor and a trainee GP. We’re running 27 priority primary care clinics where nobody pays a cent.

“The purest form of Medicare is being run by the state government. We should all just work together and fix Medicare because it’s broken at the moment.”

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