For nurses who have or who are contemplating undertaking botox training and have not completed the V300 nurse independent and supplementary prescribing course, an understanding of how to obtain prescription only medicines (POM) such as BOTOX® and Azzalure® for your clients is important.
If you work within the same legal entity as a doctor, dentist or independent nurse prescriber, they can supply you with stock in advance. If you are self employed and use a prescriber from another company, you are then not within the same legal entity and therefore cannot receive stock in advance. In the case of wholesale stock, where the product has not been dispensed from a private prescription, VAT becomes payable on the POM, which will have to be factored into the cost to the patient.
If you are self employed the only way to receive a supply of botox is if it is prescribed on a named patient basis. In this instance, the prescriber will need to undertake an assessment of the patient before the POM is dispensed by a pharmacy. The law surrounding medicine dispensed on a prescription means that it can only be used on that particular patient, if you multi use the vial you are breaking the law. The only POM that can be multi used is wholesale stock.
The same rules apply in hospital wards, during a drug round a nurse will administer medication that has been prescribed on a drug kardex or drug chart. The nurse will take the medicine from the drugs trolley filled with containers that do not have a pharmacy dispensary label on it, this is wholesale stock, which can be dispensed to multiple patients.
If you have completed the independent nurse prescribing course and are self employed you cannot receive wholesale stock and need to write private prescriptions for each client you see. If however, you work within the same legal entity as a doctor you can be supplied with and prescribe from stock accordingly. This method of prescribing reduces product wastage as any prescribed botox that is not used for each patient needs to be discarded in an appropriate manner.