Regulatory guidance should set out an expectation for prescribers to conduct a 'full two-way consultation' with patients before supplying weight loss injections and other 'higher risk' medication, the National Pharmacy Association (NPA) has said.

It comes amid rising demand for private, medicated weight loss treatments, as well as concerns raised over a ‘worrying trend’ in pharmacists being asked to sign off on weight loss prescriptions based solely on a patient questionnaire, without any prescriber/patient interaction.

What does the current draft guidance say?

Draft guidance proposed by the pharmacy regulator in September requires online pharmacies to 'arrange the website so there is an appropriate consultation with the prescriber before any supply of a POM [prescription only medicine] is made'.

In particular, it specifies that 'it should be made clear that the decisions about treatment are for both the prescriber and the person to consider together during the consultation'.

And it says that 'there should be a means to allow two-way communication between the prescriber and the person' so that the prescriber can ask for more information from the person if they need it.

'If the operating model involves prescribing decisions being made remotely, based just on answers given to a questionnaire, there must be careful consideration of whether it is safe to prescribe and supply medicines,' the General Pharmaceutical Council (GPhC) draft guidance adds.

Concerns that patients could access weight loss jabs 'without proper consultation'

But the NPA has today warned that the proposed guidance does not go far enough and has urged the regulator to require that pharmacies conduct 'a full two-way consultation with patients before dispensing "higher risk" medication such as weight loss jabs'.

'This includes not just relying on an information provided in online questionnaires but also gathering important historical medical information prior to a full two-way consultation between the prescriber and patient,' the NPA said.

NPA chair Nick Kaye added: 'We are concerned that the current regulations allow some patients to inappropriately access weight loss injections without proper consultation or examination of historical medical records.

'There’s nothing wrong with online services in principle, but it’s important the regulator takes this opportunity to make compulsory a full consultation before dispensing high risk medication such as weight loss injections.'

And he also suggested that more stringent measures could 'ensure supply is prioritised for those in most clinical need, including those with type two diabetes'.

CCA: 'No need for additional regulation'

But the Company Chemists' Association (CCA), which represents large pharmacy multiples such as Boots, Superdrug and Pharmacy2U, said it did not see the need for additional regulation.

CCA chief executive Malcolm Harrison said in a statement today: 'CCA members have been remotely providing weight loss medicines to patients for many years with a proven track record of safety. When current regulation and guidance is followed, the prescribing and supply of these medicines is safe and meets a clear patient need.

'We do not see the need for any additional regulation.'

GPhC to update guidance 'shortly'

A GPhC spokesperson told The Pharmacist that it would be updating its guidance 'shortly' following a consultation on its draft guidelines.

'We have listened carefully to feedback we had on key changes to the updated guidance,' the spokesperson added.

And they said the regulator required 'all pharmacies, including those operating online, to ensure that the way in which pharmacy services are delivered safeguards the health, safety and wellbeing of patients and the public'.