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Nicotine vaping devices and online prescription in Australia – Discussion with Experts

There are sentiments at various levels in the healthcare delivery community to overhaul the pharmacy sector in Australia, with some ideas like online prescription in Australia becoming the dominant play which may include medication vending machines.

Doctors are advocating for a major revamp of the laws governing how Australians buy drugs, including the installation of vending machines in GP clinics and allowing supermarkets and online sellers to compete.

In a discussion paper to be released on Monday by the Australian Medical Association, tough ownership limits for pharmacies are also proposed as prospective improvements, reigniting a long-running turf battle with the powerful Pharmacy Guild.

“What we’re asking for is a liberalisation of an incredibly regulated industry,” said AMA President Omar Khorshid.

Location rules prohibiting new pharmacies from opening within 1.5 kilometres of an existing one, limiting ownership to pharmacists, and restricting online sales to brick-and-mortar operators were all part of a “closed shop approach,” according to Dr. Khorshid, which was “harming consumers” who spent nearly $11 billion on medicines each year.

The American Medical Association’s proposals were rebuffed by Pharmacy Guild president Trent Twomey, who said that consumers enjoyed having contact with their local pharmacists, who were “embracing new technology,” with many now offering online deliveries via mobile apps.

However, he said that online sales accounted for “barely 10% of the market” in both Australia and the United States, where mail-order pharmacies were well established because prescription drugs were not the type of product that consumers prefer to purchase online.

With some Australians buying prescription medicines illegally from international organisations without a prescription over the internet “outlines that there is a clear demand that is going unfilled,” according to the AMA paper, which also warned that it was “impossible to verify” that these drugs were authentic or safe.

The National Competition Policy Review proposed eliminating pharmacy location and ownership constraints in 2015, while the Productivity Commission’s Shifting the Dial report in 2017 recommended automatic dispensing “overseen by a suitably qualified person.”

Customers can fill prescriptions at Tesco and Walmart retail locations in the United Kingdom, and remote dispensing equipment in the United States, according to Dr. Khorshid.

“Let’s consider a vending service that can distribute medicines, perhaps placed it in a GP surgery supervised by a roaming pharmacist associated with the clinic,” he said.

Former health minister and Grattan Institute health economist Stephen Duckett stated the business was “ripe for modernisation,” and that the rising prevalence of chronic illness in an ageing population necessitated stronger collaboration between GPs and pharmacists.

“We’ve shifted to the internet in everything else,” Dr. Duckett said, so an online model for dispensing medicines made sense.

“We should really embrace a major change,” he remarked.

Amazon made waves in November when it applied to register the trademark Amazon Pharmacy in Australia.

After the Guild cautioned that local regulatory limits would be “a hindrance” to its ambitions, the online retail behemoth discreetly withdrew its application in June.

Our federal government “continues to back the current pharmacy concept, which serves Australians well and accounts for the supply of >300m funded scripts for PBS therapies each year,” says the Department of Health. We wonder if they have asked patients if they are satisfied with this approach?

“The government has no plans to promote changes to pharmacy ownership or placement requirements,” the official added, calling the “American model” of dispensing medications through vending machines “an unexpected and disturbing tendency.”

Some emerging medical technology concepts offer on-demand delivery of pharmaceutical and non-pharmaceutical products from a nationwide network of local pharmacies. In principle, this is how vapingscripts.com.au meets the demand for online prescription in Australia. Pharmacies within supermarkets are becoming more popular in other countries. This concept is illegal in Australia, but the Australian Medical Association wants to change that.

So, especially in regional and rural locations, it may be a more convenient way for patients to get their online prescriptions in Australia filled. Or would it have a significant impact on pharmacists’ roles? We will be following this issue in future posts.

In the new world of smoking cessation in Australia, nicotine vaping products, when combined with behavioural support, are only recommended as a second-line treatment “for people who have tried and failed to quit smoking with first-line therapy and are still motivated to quit smoking,” according to the RACGP’s Smoking cessation recommendations. Patients can use VapingScripts.com.au for online prescription in Australia and receive the full range of services outlined by the RACGP. Most online prescription services in Australia focusing on vaping do not provide consults or behavioural support; VapingScripts.com.au leads the market in these comprehensive offerings.

‘People do stop, and it makes a huge difference in their health, there’s no doubt about that.’ In the previous five years, smoking rates have dropped from around 35 per cent to around 15 per cent,’ she said.

According to Dr. Wilson, nicotine vaping devices may have a role if a patient has tried first-line therapy and is at a particularly high risk of harm from smoking cigarettes.

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