Fears online pill pushers are a ‘recipe for disaster’

Doctors have raised concerns about the dangerous rise in “instant” online prescription businesses, which are being compared to food delivery apps.

Prescriptions for medicinal cannabis, antidepressants and sedatives are being dished out online within minutes, as GPs warn about the dangers of pop-up pill pushers.

The rise in “instant” prescription businesses, likened by the Royal Australian College of General Practitioners to food delivery apps, allows patients access to a range of medications after ticking boxes online.

Information is supposed to be reviewed by doctors, who can call patients to discuss their medical history.

But healthcare bodies fear some scripts are being issued automatically using Artificial Intelligence, without adequate assessments.

The online prescription businesses have been likened to food delivery apps. Picture: iStock

One whistleblower has outlined how they obtained dangerous drugs on which they had previously overdosed, via a website that did not require a consultation.

The Herald Sun can also reveal that the Australian Health Practitioner Regulation Agency is investigating cases where “drugs of dependence” appear to have been prescribed without proper medical history assessments, amid a broader review of telehealth guidelines.

President of the RACGP, Dr Nicole Higgins, said she held “grave concerns about the proliferation of ‘pop-up’ online prescription business models”.

“I know that just like food delivery services they may seem like a modern, convenient option, but in the long-run these services are a recipe for disaster,” she said.

In some cases ‘drugs of dependence’ are being prescribed without proper medical history assessments. Picture: AFP

Concerns have also been raised about patients getting pills that create a dangerous cocktail with their other medication, and about businesses bypassing the Pharmaceutical Benefits Scheme which adds to patient costs.

Dr Higgins said patients obtaining medicinal cannabis or nicotine vaping products via online services should “tread very carefully” due to long-term health effects caused by misuse.

“Continuity of care matters and these services are a quick fix that may, in the long run, compromise your health and wellbeing,” she said.

A rise in telehealth appointments since Covid-19 has seen an explosion in online script services.
Many web reviews of those businesses praise the quick turnaround and ease of accessing medications, with some mentioning how hard it is to get a GP appointment in regional Australia.

A broader review of guidelines governing telehealth — which is how online script services operate — is now underway by the Australian Health Practitioner Regulation Agency.

A rise in telehealth appointments since Covid-19 has seen an explosion in online script services.

Over the past two years, complaints about telehealth appointments have soared from fewer than 100 to more 726 in the past financial year, while a spokesperson for the AHPRA confirmed there were ongoing investigations into practitioners prescribing “drugs of dependence” through online consultations “where a patient’s prescription history does not appear to have been appropriately considered”.

“We have also been informed through notifications of instances where patients have been prescribed a medication that could be harmful due to an existing symptom or condition,” a spokesperson said.

Medical Board of Australia chair Dr Anne Tonkin, who was trained as a general physician with a subspecialty in clinical pharmacology, said the telehealth review aims to “close the gap that’s sprung up between online prescribing business models and good medical practice”.

“There is no threat to telehealth from the draft guidelines. Telehealth is here to stay and can be used to obtain a prescription from a doctor,” she said.

“We’re interested in strengthening the link between access to prescribing and patient safety. Access to prescribing, without the safeguards of clinical assessment, is not good care.”

Dr Tonkin said some prescribing after a tick box consultation “looks suspiciously like algorithm-driven prescribing and is not safe care”.

“There are loads of red flags. Where is the consideration of the patient’s medical history? Who is checking for contraindications? Who is explaining the cost implications to patients of prescribing with no rebate?”