Who can prescribe alternative therapies in Australia?

In Australia, the provision of alternative healthcare services is regulated by the Therapeutic Goods Administration (TGA). Medical doctors can recommend and facilitate these treatments when deemed clinically appropriate and supported by evidence for the patient's condition. In certain states and territories, Nurse Practitioners may also provide alternative healthcare consultations.

Authorisation Pathways for Prescribing Alternative Healthcare Services

To prescribe or recommend unapproved alternative healthcare products not listed on the Australian Register of Therapeutic Goods (ARTG), practitioners must obtain TGA approval through one of two pathways:

1. Special Access Scheme (SAS)
   This pathway allows practitioners to prescribe or recommend unapproved services or products to individual patients. Applications must include details about the patient, the medical condition, the rationale for the recommendation, and a plan for monitoring treatment effectiveness.
2. The SAS has three categories:
3. • Category A: For patients who are seriously ill, where death is reasonably likely without timely treatment. Only medical practitioners can apply under this category.
   • Category B: Practitioners must submit an application with clinical justification for using the unapproved product for a specific patient. A specialist's support letter may be needed if the practitioner lacks expertise in the treatment area.
   • Category C: A notification pathway for certain low-risk, unapproved products included on a list determined by the TGA.
4. Authorised Prescriber Scheme (AP)
   This scheme allows practitioners to prescribe or recommend specific unapproved alternative healthcare options to multiple patients without requiring individual TGA approval for each case.
5. Any Australian-registered medical practitioner can apply to become an Authorised Prescriber, although this pathway is not available to Nurse Practitioners. Authorised Prescribers must report biannually on the number of patients treated and any adverse effects.

State and Territory Regulations

Regulations for prescribing or recommending alternative healthcare services vary across Australian states and territories:

• Western Australia: Medical practitioners can provide alternative healthcare recommendations. TGA approval is required for unregistered products; state approval is not needed for Schedule 4 treatments.
• Northern Territory: Only NT-based doctors can offer alternative healthcare recommendations, requiring TGA authorisation. State approval is unnecessary for Schedule 4 products.
• South Australia: Practitioners must meet both Commonwealth and South Australian legislative requirements. A specialist report may be necessary for treatments outside the practitioner’s expertise. State approval is not required for Schedule 4 treatments.
• Queensland: Both Queensland-based and interstate practitioners can offer alternative healthcare services with TGA approval. State approval is not required for Schedule 4 or Schedule 8 options.
• New South Wales: Registered practitioners can provide alternative healthcare recommendations with TGA approval. State approval is required for Schedule 8 treatments prescribed for patients with drug dependency, children under 16, or as part of clinical trials.
• Australian Capital Territory: Practitioners need approval from both the TGA and the ACT Chief Health Officer. The ACT Controlled Medicines Prescribing Standards specify approved conditions for alternative healthcare, such as chemotherapy-induced nausea or anxiety in life-limiting diseases.
• Victoria: Practitioners can provide alternative healthcare recommendations for any condition, provided they obtain the necessary TGA and state approvals.

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