What pharmacists need to know about dispensing medicinal cannabis
There has been increasing interest in the use of cannabis for medical purposes, with Governments at both Commonwealth and State and Territory levels in Australia implementing a raft of legislative and policy change to allow the cultivation, manufacture, prescribing and dispensing of medicinal cannabis products for patients in Australia.
In this article, we look at key things pharmacists should know when it comes to dispensing medicinal cannabis in Australia.
I just received a script to dispense Medicinal Cannabis, now what?
When you are presented with a script, you must ensure that all appropriate legal and regulatory approvals are in place before placing an order with the approved wholesaler.
The requirements for the prescription and dispense of Medicinal Cannabis products vary between each state/territory.
There may also be some prerequisites before a prescription can even be dispensed. Some approvals from state or territory regulatory authorities may take weeks for finalisation, so it’s important not to take action and not leave compliance to the last minute.
You can also view the regulatory requirements via the Department of Health website for your state/territory:
Legal obligations of a dispenser
Generally speaking, an approved dispenser must:
- adhere to all conditions as detailed in any TGA import licence or permit, if they are the importing party.
- comply with any conditions imposed on a TGA approval relating to the medicinal cannabis product(s) being used
- only dispense medicinal cannabis in accordance with a prescription
- comply with the Guidelines for Dispensing of Medicines published by the Pharmacy Board of Australia
- comply with all reporting and recording requirements, as set down by the relevant .
- ensure any excess or unused stock is disposed of and destroyed in line with state or territory requirements.
- report any adverse events, adverse reactions, serious adverse reactions and unexpected reactions to the TGA through the Australian Adverse Drug Reactions System
How to dispense medicinal cannabis
In NSW, a pharmacist can dispense a prescription for a Schedule 8 cannabis product (other than Schedule 4 cannabidiol) only on receipt of a hard copy written prescription. Hospital pharmacies may supply for inpatients on a copy of a medication chart order.
The other usual requirements as for Schedule 8 prescriptions apply, For instance, the pharmacist must verify the prescriber, must report any apparently forged or fraudulently altered prescriptions, and must retain the dispensed prescription, separately from other prescriptions.
Cannabis products supplied to a patient (by a pharmacy or medical practitioner) must be labeled with a dispensing label with the usual details for any dispensed medicine including name of the product, prescription number, patient name, directions for use, date of supply, name and address of supplier.
A pharmacy cannot hold stocks of a cannabis product in anticipation of an authority being issued to the medical practitioner to prescribe the product for supply from that pharmacy. Nor can a pharmacy hold stock of any unregistered medicine, unless it has been specially permitted by the Commonwealth as a substitute for a registered medicine.
All supplies and receipts of Schedule 8 cannabis products (whether dispensed on prescription or supplied directly by a medical practitioner) must be recorded in a drug register. If used in a clinical trial, a record of the NSW authority number must be made in the clinical trial records.
For more information on how to dispense medicinal cannabis in other states and territories, see:
- Queensland: https://www.health.qld.gov.au/public-health/topics/medicinal-cannabis/pharmacists
- South Australia: http://www.sahealth.sa.gov.au/wps/wcm/connect/33c73d8040db6c61a409a73ee9bece4b/Pathway-overview%28June2017%29.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-33c73d8040db6c61a409a73ee9bece4b-mbRr7Oq
- Victoria: https://www2.health.vic.gov.au/public-health/drugs-and-poisons/medicinal-cannabis/posession-sale-supply-in-victoria
- Northern Territory: https://health.nt.gov.au/professionals/environmental-health/pharmacists-and-schedule-8-medicines
- ACT: https://health.act.gov.au/sites/default/files//Medicinal%20Cannabis%20-%20Prescribers%20and%20pharmacists_CMedits.pdf
- Western Australia: https://ww2.health.wa.gov.au/Articles/A_E/Cannabis-based-products
Four new medicinal cannabis items
From the first of August 2018, four new medicinal cannabis items can be ordered by community pharmacists, with the addition of Canndeo Limited hemp-based products to the PharmaPrograms’ Medicinal Cannabis Medicines Portal.
Made available by ASX-listed compant, The Hydroponics Company (THC), these include Endoca Hemp Oil – CBD and Endoca Raw Hemp Oil – CBD + CBDA in 3% and 15% concentrations. The ‘Endoca’ products will be distributed in Australia by Anspec Pty Ltd, which will offer accounts to participating pharmacies.
Please note, these items are currently not scheduled on the Australian
Register of Therapeutic Goods, and will be available under the Approved Prescriber Scheme (APS) and Special Access Scheme (SAS) Category B the PharmaPrograms’ Medicinal Cannabis Medicines Portal (MCMP)
If the relevant state or territory health department does not issue pharmacy registration certificates, the owner pharmacist’s AHPRA
registration certificate and the pharmacy’s Medicare agreement must be provided.
Introducing the PharmaPrograms’ Medicinal Cannabis Medicines Portal
The MCMP facilitates Network Pharmacies to dispense Medicinal Cannabis in Australia, by ensuring that all regulatory requirements are fulfilled and recorded via a new IT- enabled process.
All products listed in the MCMP will be accessible through approved wholesalers, ensuring more streamlined delivery of Medicinal Cannabis products to patients.
It is important to note that in order to qualify for participation in the MCMP, you must comply with all terms and conditions.