Optometry Australia urges removal of medicines list to ensure effective prescribing reform

Optometry Australia has lodged a comprehensive submission to the Optometry Board of Australia strongly supporting the proposal to enable endorsed optometrists to prescribe oral medicines.  

This reform is timely, necessary, and consistent with the skills and training of the profession. However, we have emphasised that the reform will not achieve its intended benefits if the Board retains the proposed medicines list. The list must be removed. Whether embedded in the registration standard or relocated to a website, it creates regulatory uncertainty, slows patient access to treatment, and imposes administrative constraints that offer no improvement in safety. Safe prescribing is governed by competency and accreditation and existing medicines laws across all jurisdictions, not by a restrictive formulary. 

Australia has a highly trained and skilled optometry workforce that is well distributed and deliver essential eye care across metropolitan, regional and remote communities. Allowing optometrists to prescribe oral medicines within scope will improve timely access to treatment reduce inefficiency within the health system by reducing unnecessary GP and ophthalmology appointments. Independent modelling demonstrates that this also saves millions each year, reduces patient travel requirements and out-of-pocket expenditure for patients. In addition, optometrists prescribing oral therapeutics also minimises productivity loss when individuals need to access further care and creates time to utilise GP and ophthalmologist for more complex care.  

Optometry Australia propose that the simplest and safest regulatory model for therapeutic prescribing is a scope-based endorsement with no medicines list (though it is appropriate to restrict prescribing of Schedule 4 and Schedule 8 medicines by optometrists). This approach mirrors successful practice in comparable countries, especially New Zealand, where equally trained and qualified optometrists have safely prescribed oral medicines for over ten years. Retaining a list duplicates existing regulation, delays access to contemporary treatments, restricts clinical autonomy and complicates responses to medicine shortages. A no-list approach, allowing optometrists to prescribe within their competencies and in alignment with evolving evidence and practice, aligns with successful international practice and reflects national health policy directions to remove artificial barriers that prevent health practitioners from working to full scope. 

Leadership perspective 

Optometry Australia CEO Skye Cappuccio said this reform is a critical step toward a more responsive and equitable eye care system. 

‘This reform will be a significant win for both our profession and the patients we serve. Optometrists already have the training, accreditation and clinical expertise to prescribe oral medicines safely, and removing the medicines list will finally allow them to use those skills without unnecessary red tape,’ she said.

‘Our members will be able to provide more complete care, and patients – particularly those in rural and regional communities – will get faster access to the treatments they need. Everyone benefits when regulation reflects capability, not outdated constraints.’