AI expert Alexander Amatus (pictured) provides insights into what pharmacists should watch for as GP access to ADHD medication prescribing expands.
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Australia's ADHD treatment landscape is shifting, and community pharmacy will be one of the first places those changes become visible.
At the same time, generative AI is being introduced into prescribing and dispensing workflows, often as a documentation or decision-support layer.
This raises a practical question for pharmacists: how do we protect safety, supply continuity and patient experience when more prescribers enter the pathway and more software sits between the clinician and the script?
In NSW, reforms are strengthening the role of general practice in ADHD management, enabling appropriately authorised GPs, for defined cohorts and criteria, to issue psychostimulant prescriptions for patients with a prior diagnosis and stable treatment, subject to program requirements and prescriber status.
In parallel, pharmacists are seeing "system" change through PBS process updates.
The Royal Australian and New Zealand College of Psychiatrists has outlined PBS authority amendments effective 01 Jun 2025 that alter the information required when seeking stimulant approvals via the Online PBS Authorities system.
Because these changes have been discussed widely and inconsistently, patient-facing summaries generally describe them as expanding GP prescribing in defined circumstances rather than allowing unrestricted first-line initiation.
The operational effect is predictable: more ADHD medication prescribing activity will be initiated or continued in general practice, increasing the number of handovers and the administrative variability pharmacies need to manage.
However, there is a supply backdrop pharmacists cannot ignore, with access reform arriving in an environment of constrained supply for some ADHD drugs.
The TGA continues to publish shortage updates, which should be checked before advising substitutions or expected availability.
Expanded prescribing access can expose fragility in supply earlier and more widely, particularly in regional areas where substitution options are limited and timely prescriber contact can be harder.
And now AI is entering the workflow.
Most AI pharmacists encounter sits in drafting and triage layers: documentation tools that summarise consult notes, prescribing systems that suggest doses or PBS pathways, patient-facing chatbots that shape expectations, and pharmacy tools that draft counselling points or follow-ups.
The risk is not their existence, but that they are treated as authoritative.
Health-system evaluations show large language models can still generate fluent but misleading health content despite safeguards.
In ADHD care, where medicines are tightly regulated, "almost right" is not good enough.
There are two practical risk areas for pharmacy, the first being administrative mismatch.
As GP continuation prescribing expands, pharmacies may see more variation in authority details, documentation and handover timing.
A consistent approach to verification and escalation is critical, particularly for first presentations from newly authorised prescribers or when care is transitioning.
The second area of risk is AI-amplified expectations.
When patients arrive with AI-generated prompts about specific stimulants or early supply, pharmacists often become the first point of friction and need clear pathways for prescriber clarification.
A pragmatic approach includes pharmacist verification of any AI-drafted content, avoiding identifiable patient data in unapproved tools, hard-stop checks for first fills and transitions, shortage-aware counselling, and documentation of interventions.
Expanded GP participation is likely to improve access for stable patients, particularly outside major cities, but it also increases interfaces, handovers and variability, and with AI on top, the risk comes less from a single error than from accumulated friction.
Pharmacies can reduce that risk by standardising checks, remaining shortage-literate, and using AI as a drafting aid, not a decision-maker.
Alexander Amatus is Business Development Lead at national mental health service TherapyNearMe.com.au.
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