Revisions to the Schedule 8 Prescribing Code

There have been a number of revisions to the Schedule 8 Prescribing Code which has resulted in changes to prescriptions that a pharmacist can dispense.

1) Interstate Stimulant Prescriptions

Pharmacists have been advised of the changes to interstate stimulant prescriptions through the weekly MPRB pharmacy updates on the 5^th and 19^th January 2024.

Interstate Stimulant Prescriptions can be dispensed in Western Australia when:

• Prescription is written on or after 13 December 2023
• Patient has a Western Australian residential address on the prescription
• Prescription is written by an approved specialist:
  • Psychiatrist
  • Paediatrician
  • Neurologist
  • Rehabilitation physician
  • Respiratory and sleep physician
  • Thoracic medicine physician

2) Long-acting buprenorphine injections for opioid substitution

Depot buprenorphine injections have been included as a treatment option in the Community Program for Opioid Pharmacotherapy (CPOP).

The Code has been updated to include details of the depot products and reference to the Mental Health Commission’s Clinical guidelines for use of depot buprenorphine (Buvidal® and Sublocade®) in the treatment of opioid dependence.

These guidelines are available online at: https://www.mhc.wa.gov.au/media/4651/cpop-clinical-guidelines-for-the-use-of-depot-buprenorphine-in-the-treatment-of-opioid-dependence.pdf

3) Esketamine

Esketamine for treatment resistant depression is restricted by the Australian sponsor to psychiatrists treating patients in particular clinics.

When a clinic is sourcing from a community pharmacy by prescription (for each patient), the dispensed product must be delivered to the clinic address. Prescriptions must be endorsed with supply to the clinic only.

4) MDMA and Psilocybine

Authorisation is required for all prescriptions for MDMA and Psilocybine as there are no products on the ARTG.

Prescriptions for these medicines must be:

• written by a psychiatrist approved as an Authorised Prescriber by the TGA; or
• for the indications specified in the S8 entry, within clinical trials that have been approved by or notified to the TGA

MDMA and psilocybine must never be provided directly to a patient or agent and should be administered in a clinic by an authorised health professional.

Pharmacists are not required to verify if a prescriber has authorisation from the Department to prescribe a particular Schedule 8 medicine, or to refuse dispensing simply based on the absence of authorisation. However, access to information regarding authorisations may be helpful for pharmacists to consider the appropriateness of prescriptions to be dispensed.

Addition of ScriptCheckWA as a resource:

ScriptCheckWA, Western Australia’s real-time prescription monitoring system, was launched in March 2023. Pharmacists can now use this system to check their patient’s history of S8 medicines and risk factors, such as drug dependency or multiple current prescribers. Further information about ScriptCheckWA, including a link to register to use this system, is available at: https://www.health.wa.gov.au/Articles/N_R/Prescription-monitoring-in-Western-Australia.