Clarification of prescription and supply obligations
In recent months, the Board has received queries about prescribing medicines following a telehealth consultation, vets supplying medicines to third parties such as wildlife carers, and vets supplying medicines on the basis of a prescription issued by another vet. These queries indicate that there may be some confusion about veterinary practitioners’ obligations around the prescribing and supply of medicine in Victoria. This article provides clarification on prescription and supply obligations in relation to individual animals and groups of animals, i.e. herds.
Terminology and background
Prescribing is a complex clinical skill and occurs when a vet establishes a therapeutic need to treat an animal or group of animals under their care with a scheduled medicine. Once this decision has been made, a vet may administer the medicine to the animal or herd, supply the medicine to the owner/agent of the animal or herd, or may issue a prescription so a pharmacist can supply the medicine for the animal or herd.
Dispensing is a step that occurs before a medicine is supplied and involves placing a dispensing label on a medicine.
Due to vets’ extensive education and professional standing, they hold a unique position in society as the only persons who can lawfully prescribe a scheduled medicine for the treatment of animals.
Only a pharmacist may supply a medicine on a prescription that has been issued by a vet.
Law on issuing a prescription and supply of scheduled medicines
The requirements a veterinary practitioner must meet before they prescribe, sell or supply a scheduled medicine have not changed in recent years.
Under sections 19 and 38 of the Drugs, Poisons and Controlled Substances Regulations 2017, a veterinary practitioner must not issue a prescription, sell or supply Schedule 4, 8 or 9 poisons (“medicine”) unless:
- the prescription, sale or supply is for treatment of an animal under the veterinary practitioner's care (and the animal is described in any prescription)
- the vet has taken all reasonable steps to ensure a therapeutic need exists for the medicine
- the animal is owned by, or is in the custody or care of, the person to whom the medicine is sold or supplied
- before prescribing:
- if the poison is a drug of dependence, a Schedule 8 poison or a Schedule 9 poison, the vet must take all reasonable steps to ascertain the identity of the person who owns or has custody or care of the animal for whose treatment the prescription is issued
- for Schedule 9 poisons, the vet must hold a general Schedule 9 permit that authorises the issuing of the prescription.
There are also other regulations relating to stock foods containing Schedule 4 poisons.
When are animals under a vet's care?
For an animal or herd to be under a vet’s care, a veterinary practitioner-owner-animal relationship (VOA) must have been established and care must be real and ongoing after that.
Establishing a VOA relationship
A VOA relationship is established in an in-person consultation, during which a vet examines the animal.
For herds and production facilities, the vet must visit the property, be fully aware of husbandry and management conditions and physically examine enough animals to determine treatment requirements.
The vet or practice staff will also create an official record for the client and the animal or herd in their customer records management system and make notes about the initial consultation or site visit.
Care after VOA relationship established
After the VOA relationship commences, care should be real and not merely nominal. A therapeutic need for a medicine cannot be established if care is not real. The vet must personally have had contact with the animal or herd for the
purposes of diagnosis and treatment/management, and must have assumed responsibility for diagnosis, treatment and outcome. The vet should directly observe the animal or herd at least once a year and when necessary (see reasonable steps below).
Telehealth
Consultation via telehealth can only be undertaken after a VOA relationship is established and if the vet is familiar with the current management and health status of the animal or herd. Based on the animal or herd’s location and access to veterinary services, the vet should also make necessary arrangements/provide information to the owner or agent to ensure continuing care for the animal or herd after the consultation.
Deciding whether there is a therapeutic need to prescribe or supply a medicine
Reasonable steps in every situation
In all instances, a vet must consider the factors listed below when deciding if there is a therapeutic need to prescribe or supply a medicine.
Factors to consider:
- In relation to the animal or herd, consider:
- the medical history of the patient or husbandry and management history of a herd
- the prescribing history of the patient or herd
- the presenting symptoms or described condition (and the stability of the condition).
- In relation to the medicine, consider:
- its suitability for the treatment of the presenting symptoms or described condition (e.g. refer to prescribing guidelines for antibiotics), or for the husbandry and management of a herd
- the quantity to be prescribed or supplied. For example, the steps that could be considered reasonable to justify prescribing a minimal quantity of a drug of dependence may not be sufficient to justify prescribing a larger quantity or repeat supplies.
- In relation to the client, consider signs or knowledge of misuse or abuse of medicines or illicit drugs
When an animal has been examined by a veterinary specialist, the veterinary specialist may issue a letter outlining the outcome of the examination and including recommended treatment with a scheduled medicine. While such a letter may assist a vet to establish a therapeutic need to supply a scheduled medicine, the animal would still need to be under the vet’s care.
Known patients vs new conditions or new patients
Vets must exercise their discretion in relation to an animal or herd and its health status when deciding which steps to take to establish therapeutic need for a medicine.
If a patient/herd and client are well known to a vet, a therapeutic need to prescribe was previously established for the same condition, and there has been no change in health status, it may not take a lot of time or effort to consider the factors listed above. A few questions to establish that nothing has changed may be all that is needed, and medicine may be supplied or a prescription may be issued without a consultation or site visit if the animal or herd was last observed less than 12 months ago.
However, more thorough steps will be required to establish a therapeutic need for a medicine in existing patients with conditions that require more frequent monitoring, existing patients with new conditions, or completely new patients,
including:
- examining the patient or herd
- [where applicable] arranging diagnostic tests to justify initial or ongoing treatment
- confirming information provided by the owner, e.g. referral letters, medical/herd management records, results of tests and other diagnostics.
Practical application of obligations
Based on current regulations - if you have NOT, following the information outlined above,
- established a VOA relationship via examination
- demonstrated that the animal or herd is under your care, and
- taken reasonable steps to establish a therapeutic need for the medicine requested, then
you CANNOT issue a prescription, sell or supply medicines.
This applies to the following examples and queries the Board has received:
- to a person who presents a prescription issued by another vet
- by telehealth to an animal owner who lives interstate and says their animal has a pre-existing condition
- for a litter of puppies bred by a breeder you know
- to an owner who says their horse has a condition they’ve seen before and which they know can be treated with a particular medicine
- to wildlife carers to stock in quantity to treat injured wildlife in the future.
- to a person with a darting licence so they can tranquillise animals. Even if they were authorised to undertake this activity under wildlife law, you would need to be physically present when the darting occurred and the darting would have to be undertaken on your behalf under your supervision.
Explaining these obligations to animal owners
The Board understands that owners can be unhappy about the extra consultation costs and time involved in obtaining veterinary medicines in examples such as those described above. However, the regulations are designed to provide for public health and safety, prevent misuse and abuse, and ensure medicines are used safely and appropriately.
In addition to complying with the regulations, there are many good reasons why vets may need to examine an animal or visit a herd, arrange tests and consider patient histories before prescribing or supplying medicines.
Primarily, vets’ reasons are for the wellbeing of the animal or herd. Medicines are classified as poisons and they can:
- harm an animal or herd if administered inappropriately or incorrectly
- stop being effective when overused or used incorrectly, e.g. antimicrobial resistance
- be misused by humans.
Vets are highly skilled professionals who are in the best position to examine an animal or herd, consider its history and decide if any medicine is required in a particular situation. They have the knowledge and experience to
determine which medicine may be required for an animal or herd and how much of that medicine may be needed. They can explain to the owner or agent how the medicine should be administered and what side effects to look out for. They can also provide instructions about the safe storage of medicines.
In exercising their obligations, vets must also be alert to the potential that a client is seeking a drug of dependence.
Animal owners should be encouraged to plan and prepare for their animal or herd’s treatment needs. They should be advised when their animal or herd will need to be examined again, and that this may change depending on its health status.
Animal owners should understand that it may take time to issue a prescription or dispense a medicine (even where a consultation is not required).
This information can be provided at a consultation or site visit and repeated in writing on a prescription or other materials given to the owner or agent.
Board review of Guidelines 1, 13 and 14
The Board is reviewing and updating Guidelines 1, 13 and 14 on the veterinary practitioner-owner-animal relationship, telemedicine and supply and use of medications. A targeted consultation on proposed changes to these guidelines will take place in 2026.