Internet Purchases by Clients

Summary

1] An owner can request a script from a veterinarian and is legally allowed to fill it at a pharmacy or, under the Code of Conduct in the Veterinary Practice Regulation 2006, at another veterinary practice.

2] Before you issue a script the Board expects you to have a client-patient relationship that is current, the prescribed dose should be appropriate, appropriate records kept etc.

3] The script should be made out on practice letterhead and be completed correctly as per legislation and guidelines (see TG 74/12 published by NSW Health on their website at http://www.health.nsw.gov.au/resources/publichealth/pharmaceutical/pdf/poisons_veterinary.pdf ).

4] The Board has no objection to you charging a fee - a visit fee or a script fee - for this service.

5] Prescriptions for internet supply from overseas may not be issued in NSW because the Stock Medicines Act 1987 specifically identifies who may fill a script.

6] Finally, there can be other problems with using imported products, and while these are generally the clients', they may have an impact on a prescribing veterinarian.

QUESTION

My client wishes to purchase drugs over the Internet, buying medications more cheaply from overseas. She is required to provide a script and has asked me to write one for her. What does the VPB think I should do?

ANSWER

The VPB has no "rule" for this, but the following relevant controls apply in this situation.

1 In NSW (or other State of registration) you may certainly write a script to be filled by a pharmacist (or another veterinarian under the Code of Conduct in the Veterinary Practice Regulation 2006), as long as the intended target animal is under your direct care and you have examined it.

You may choose to do this be because you do not stock a drug which is infrequently required or you have run out of stock, or because a client requests it.

2 You cannot be forced by a client to write a script. Each practice should look at developing and promoting their own policy on this matter. It is up to the individual veterinarian or practice whether they wish to comply with the owner's request - in this case, the issuing of the script rather than the drug. Of course the script should refer to a particular animal and only be for a reasonable amount of the drug to treat a condition you have diagnosed in that animal.

If requested to provide a script without an examination of an animal you may charge for this service or may charge a consultation fee or may not charge at all.

In NSW, LHPA district veterinarians will often write out scripts, following a farm visit, for their ratepayers to take to the local practitioner to fill. While the local practitioner is under no obligation to fill such a script they may do so.

3 Under the NSW Stock Medicines Act 1989 it is only legal to use an unregistered product on animals if they do not belong to a food producing species, if the product was used, prescribed or supplied by a veterinarian and if the product is either a registered human pharmaceutical or has been compounded by a veterinarian or a pharmacist acting under the directions (prescription) of a veterinarian.

However, an unintended consequence of the controls imposed by the Stock Medicines Act is that overseas prescriptions are not legal. The definitions within the Act state that to prescribe means to give a written instruction for supply to a "pharmacist" or a "person licensed or authorised under the Poisons and Therapeutic Goods Act". Overseas suppliers would not fit into the second group.

But the Stock Medicines Act also provides a definition of "pharmacist" which is a "person registered under the NSW Pharmacy Act 1964".

Thus an overseas (or even interstate) pharmacist, would not be compliant with the provisions of the Act.

4 Clause 69B of the Agricultural and Veterinary Chemicals (Administration) Act 1992, administered by the Australian Pesticides and Veterinary Medicines Authority (APVMA) provides that a person must not, without reasonable cause, import into Australia a chemical product, which is neither a registered chemical product nor an exempt chemical product, except with the consent in writing of the APVMA. The APVMA has recently updated its web site at: http://www.apvma.gov.au/supply/import.php in relation to this topic, with the following information.

Ordering products over the internet and importation for `private use'

Individuals should be aware that the importation of unregistered agricultural chemical products or veterinary medicines is an offence without prior written consent from the APVMA and that generally no such consent is issued to individuals for `private use'.

Veterinary medicines: Individuals must not import veterinary medicines from overseas. The APVMA will however give consideration to applications lodged by registered veterinarians for the importation of unregistered veterinary medicines when imported for application or administration to an animal under the direct care of the veterinarian. See criteria 1(g) below.

If a registered product is available in Australia, the APVMA will not provide consent to veterinarians wishing to import products with similar names that are registered overseas.

5 Other things to keep in mind, in relation to overseas product purchases, are:

  • Overseas suppliers can refuse to fill a script, or quantities and quality or brand names may be different or not guaranteed.
  • The drug requested by the owner may not be available on the internet under the same brand or composition as is registered for use in Australia. (In Australia, if you prescribe a brand name product an alternative generic product may not be issued without your consent.)
  • The product will not necessarily have passed the very stringent assessment and registration procedures of the Australian Pesticides and Veterinary Medicines Authority's (APVMA) product registration scheme.
  • The goods ordered may end up not being the same as the goods prescribed or described. There are also risks regarding payment by credit card and possible non-delivery after payment is made.
  • It is unlikely that overseas suppliers could be held accountable if an adverse drug reaction occurred. More importantly, an overseas supplier would not be available to attend to emergencies and monitoring of the condition. However, the prescribing veterinarian may place themselves is a difficult position if there was any adverse reaction to the medication by being expected to attend and perhaps being considered in some way liable for having prescribed it.
  • Finally, the Australian Customs Service polices compliance with import restrictions which are complex and may require permits and payment of duties when goods land in Australia. Customs may intercept and investigate imports of any drug to determine the type of medication and if the medication has been legitimately obtained. The NSW Department of Health may be asked for advice when this occurs and delivery may be delayed or even prevented entirely.

These are all potential issues that practitioners should be aware of if a client makes a request to facilitate their obtaining veterinary medicines from overseas.

Veterinary practitioners are advised to refer requesting client to relevant agencies such as the APVMA or the Australian Quarantine and Inspection Service (AQIS) for assistance regarding permits and importation regulations.

In summary, it would appear that a veterinarian would be well within their rights to advise a client that the APVMA legislation, and the NSW Stock Medicines Act, both restrict the supply and prescription of unregistered products from overseas and that they would be assisting someone to break the law, or even breaking it themselves, if they issued a prescription specifically for filling overseas.