Optometry Australia (OA) has released a costs analysis, highlighting that tens of millions of dollars could be saved by government and patients, if optometrists’ prescribing rights expanded to include the ability to prescribe oral medications.
The analysis has identified health budget savings of around AU$50m per year, patient savings of approximating $27m per year, as well as “significant improvements to productivity and access to care through optometrist oral prescribing”.
Currently, Australian optometrists are limited to prescribing topical treatments, which requires patients to visit general practitioners (GPs) or specialists for oral medications when needed.
“This system results in delays in care, additional healthcare costs, and increased strain on healthcare resources,” the OA report said.
The report, The Value of Expanding Optometrists’ Prescribing Rights in Australia,1 was prepared by HTAnalysts for Optometry Australia and has been released together with an OA Position Statement on Prescribing of Medicines by Optometrists.2
OA said around 76% of Australia’s approximately 7,000 optometrists are endorsed to prescribe scheduled medicines, but unlike their counterparts in New Zealand and other countries, cannot prescribe oral medications.
The analysis has identified health budget savings of around AU$50m per year
Adding up the Costs
The OA’s cost analysis uses case studies to demonstrate the impact of expanding optometrists’ prescribing rights.
Severe dry eye is the most startling case example. It provides the case of a patient with chronic evaporative dry eye disease, secondary to meibomian gland dysfunction (MGD). If the patient does not respond to ocular lubricants and warm compresses, the next step in treatment is an oral antibiotic.
“In New Zealand, oral antibiotics account for 60% of all oral prescriptions issued by optometrists, with the majority prescribed for the treatment of MGD,” the report noted.
The OA report said a referral to a GP for a prescription for antibiotics feasibly results in a further referral to an ophthalmologist, incurring additional costs and delays.
The report estimates that, given the prevalence of MGD, allowing optometrists to prescribe oral antibiotics directly could result in “700,844 fewer GP visits saving $38 million per year” ($30m saved by government; $8m by patients).
The report analysis estimates there would be “196,236 fewer ophthalmologist appointments, saving $36 million per year” ($17 million by government; $18m by patients).
Lost productivity to patients having to attend additional appointments is estimated at $35m.
The report estimates that allowing optometrists to prescribe oral antibiotics would also save 172,875 GP hours and 54,423 ophthalmology hours over a year.
Similar analyses were provided for herpes zoster ophthalmicus (HZO) with prescription of oral antivirals; acute angle-closure (AAC) glaucoma and prescription of oral carbonic anhydrase inhibitors; and preseptal cellulitis with prescription of oral penicillin antibiotics.
- HZO: Estimated 13,358 fewer GP visits saving $722,000 per year and 6,679 fewer ophthalmologist appointments, saving $1.2m per year.
- AAC glaucoma: Estimated prevention of 126 glaucoma cases per year, with $8,570,22 saved per patient in ongoing treatment costs.
- Preseptal cellulitis: Patients can be effectively managed at no additional cost, with timely access to treatment.
OA’s Position Statement
Alongside the report, OA’s position statement calls on the Optometry Board of Australia to review and contemporise the guidelines for scheduled medicines, to enable therapeutically endorsed optometrists to prescribe oral medications for the purposes of practising optometry and working collaboratively with other health professionals managing chronic eye health conditions.
References
- HTAnalysts for Optometry Australia, The value of expanding optometrists’ prescribing rights in Australia, available at: optometry.org.au/wp-content/uploads/Policy/Advocacy/OPT02_The-Value-of-Expanding-Optom-Prescribing-Rights_FINAL.pdf [accessed Feb 2025].
- Optometry Australia, Position statement on prescribing of medicines by optometrists, available at: optometry.org.au/wp-content/uploads/Policy/Position_Statements/20250204_Position-Statement-on-Medicines_final.pdf [accessed Feb 2025].
