Q. Can I supply a POM to a patient from abroad requesting an emergency supply?

A. From a strictly legal standpoint? It depends on which country they are from.

Current emergency supply legislation permits the supply of POMs to patients registered with a prescriber within a country in the European Economic Area and Switzerland, provided the usual emergency supply criteria are met (see below). In this context a prescriber refers to a doctor or dentist.

But there is no provision in law to make a supply to a patient registered with a doctor outside the EEA. Does this mean you cannot make a supply to a patient visiting from, say, Australia? Or America?

From a purely moral standpoint, what is the difference between a patient from Europe and a patient from America? Should an American visitor be denied treatment where a European visitor can be accommodated?

Ethically, the patient must be your primary concern, regardless of country of origin. Where there is a clear need for an emergency supply, could you justify withholding treatment?

Consider the clinical consequences of not supplying drugs such as warfarin, digoxin or salbutamol (as examples). In all cases, your professional judgement should be informed by the following:

Before making an emergency supply the pharmacist must:

  • Interview the patient, preferably face to face but if this is not possible consider using the telephone to gather the necessary information.
  • Confirm that there is an immediate need for the POM and that it is not practical to obtain a prescription.
  • Be confident that the POM has been previously prescribed and that treatment is ongoing.

The pharmacist would need to use their professional judgement over the time interval from when the medicine was last prescribed and the emergency request made.

The pharmacist should confirm the dose that the patient needs to takes.

The legislation prevents emergency supplies of Schedule 1, 2 and 3 controlled drugs.

The legislation also prevents emergency supplies of medicines without a UK Marketing Authorisation.

An emergency supply can be made for a maximum of 5 days treatment of a controlled drug (i.e. schedule 4 or 5 drugs) or up to 30 days of a POM.

Note that emergency supplies are not permitted for P or GSL medicines.

Emergency supplies must be labelled “Emergency Supply” in addition to standard labelling requirements.

A record of the supply must be made in the prescription register including the reason it was considered an emergency and why a prescription could not be obtained.

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