The PDL Professional Officers have previously provided guidance on detecting forged prescriptions and wish to raise awareness that fraudulent prescriptions continue to be identified in incidents reported to PDL.
Members have recently reported receiving prescriptions for large quantities of anabolic steroids, such as testosterone injections, with directions that may not align with current therapeutic guidelines and/or include an unusual number of repeats and are often marked as regulation 49. Some of these prescriptions have been presented as electronic prescriptions from a South Australian-based prescriber registered as practising in Munno Para with prescriber number 2368799. Health departments in NSW, Qld and WA have provided warnings about the validity of some prescriptions and suggest pharmacists verify the authenticity and therapeutic need before supplying any medicine. PDL encourages pharmacists to check websites or notices from these agencies.
Fraudulent electronic prescriptions are rare; however, pharmacists need to apply the same scrutiny and clinical review as for any other prescription. Our previous Practice Alert on forged prescriptions outlined red flags that are often seen in forgeries. Pharmacists are encouraged to refresh their knowledge on these to remain vigilant in detecting forged prescriptions.
Pharmacists are also obliged to ensure all medications are supplied in a quantity that is safe and appropriate for the patient. Forged prescriptions are often for high-risk medicines with high doses and large quantities. If you are presented with a prescription, particularly those at high risk of abuse or diversion, consider the following:
- Indication for the medication
- Dose and directions in alignment with current therapeutic guidelines
- Patient history, e.g. Real Time Prescription Monitoring (RTPM) and My Health Record
- Appropriateness of quantity ordered
If you are concerned about the appropriateness of a prescription and suspect it may have been fraudulently obtained, ensure that you contact the prescriber using independent sources to obtain contact details, rather than those displayed on the prescription.
A note regarding RTPM
The use of RTPM is now mandatory in most jurisdictions of Australia. In non-mandatory states, its use is still strongly encouraged as pharmacists are expected to utilise all available tools to make professional judgements on the safety of medication supplied. While jurisdictional RTPM systems are not currently linked, pharmacists seeking RTPM records from interstate may be able to apply for access via the relevant jurisdiction’s RTPM portal.
PDL has heard from members who have utilised RTPM to detect forgeries. The following points, while they may not definitively identify a forgery, may assist you in detecting fraudulent behaviour:
- Prescribing not recorded in RTPM
- Prescription has already been dispensed at other pharmacies
- Limited history on RTPM but patient is prescribed high doses of medication
Not all medications are recorded on RTPM, e.g. anabolic steroids. Consider viewing a patient’s My Health Record, in line with the My Health Records Act 2012. Training is available for pharmacists if you are unfamiliar with your obligations when using this platform.
Check with your local Department of Health regarding your obligations to report fraudulently obtained prescriptions.
PDL members can call 1300 854 838 for advice and incident support from one of our Professional Officers.
