The Victorian Government is taking action to reduce the growing harms, including deaths, from high-risk prescription medicines by implementing SafeScript, Victoria’s real-time prescription monitoring system.
In 2016, there were 372 Victorian drug overdose deaths involving pharmaceutical medicines which is higher than the number of overdose deaths involving illicit drugs (257), and higher than the road toll (291).
When implementation commences in 2018, SafeScript will provide health professionals with access to their patients’ prescription history for certain high-risk medicines to enable safer clinical decisions on whether to prescribe or dispense a medicine.
Supporting initiatives for SafeScript
The system will be accompanied by a range of initiatives to support and prepare patients and health professionals for the implementation of SafeScript. This will include:
- a public awareness campaign to prepare the general public, including consumers and families, for SafeScript and improve understanding of the risks associated with some prescription medicines
- training for prescribers and pharmacists, on how to more safely prescribe and dispense and respond to the needs of patient, being delivered by a consortium comprising all Victorian Primary Health Networks and NPS MedicineWise
- additional peer to peer support for General Practitioners
- some minor enhancements to the alcohol and other drug treatment system
SafeScript Expert Advisory Group
The Victorian Government recognises the importance of ongoing consultation to ensure the successful implementation of SafeScript. An expert advisory group has been established and meet regularly to advise the Victorian Government on key policy and implementation aspects that may impact on both patients and health professionals.
The advisory group comprises representation from:
- Australian Medical Association
- Chapter of Addiction Medicine, Royal Australasian College of Physicians
- Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists
- Medical Software Industry Association
- Pharmaceutical Society of Australia
- Pharmacy Guild of Australia
- Royal Australian College of General Practitioners
- Rural Doctors Association of Victoria
- ScriptWise – a consumer advocacy group
- Victorian Aboriginal Community Controlled Health Organisation
- Victorian Alcohol and Drug Association
- Victorian Primary Health Networks
- consumer representation
Mandatory use of SafeScript
After an 18 month introductory period to allow health practitioners to familiarise themselves with the system, it will be mandatory to check SafeScript prior to writing or dispensing a prescription for a high-risk medicine. This follows worldwide best practice, as mandatory systems adopted in other countries have shown to provide greater reduction in harms from high-risk prescription medicines.
Mandatory use of SafeScript is supported by key organisations, including the Pharmacy Guild of Australia, the Royal Australian College of General Practitioners, ScriptWise and was endorsed by the expert advisory group. The system will be designed to be as quick and easy to use as possible so that patient care remains the key focus.
Medicines to be monitored through SafeScript
Based on local and international research and recommendations from key health organisations, including the Australian Medical Association, the Pharmaceutical Society of Australia, as well as other members of the expert advisory group, prescription medicines that are causing the greatest harm to the Victorian community will be monitored through SafeScript.
This includes all Schedule 8 medicines, such as oxycodone, morphine, alprazolam, methylphenidate and dexamphetamine, and some Schedule 4 medicines including all benzodiazepines such as diazepam, ‘Z-drugs’ such as zolpidem, and quetiapine. Codeine will be included at a later stage to allow clinicians time to adjust to the rescheduling of over-the-counter codeine products to prescription only.
The report that informed the medicines to be monitored through the system can be found below.
The legislative framework underpinning the implementation of SafeScript was passed through Parliament in October 2017. The key aspects of the Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017 are:
- provisions to mandate the use of SafeScript
- monitoring of Schedule 8 medicines, and scope to include other high-risk medicines (such as benzodiazepines) via regulations
- streamlining of current regulatory requirements for prescribers relating to Schedule 8 permits when SafeScript is used
The Bill, the explanatory memorandum and other associated documents may be viewed at www.legislation.vic.gov.au.
Regulatory Impact Statement and proposed Regulations
The Amendment Bill establishes the overarching legislative framework for SafeScript and allows for the making of regulations to support the primary legislation. Regulations are statutory rules which describe specific requirements outlined in the primary legislation in greater detail.
The proposed Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Regulations 2018 and Regulatory Impact Statement have been released for public consultation.
Public comments are invited on the proposed Regulations. Click here for further information on the Regulatory Impact Statement and proposed Regulations.
The following attachments contain further information about SafeScript.