This year sees the operations of Australian Prescriber enter a new era. Change is a challenging concept in any context, but can be construed to be particularly so when the focus of that change is a drug review journal, acknowledged both within Australia and internationally as one of the leading independent publications concerned with critical review and the Quality Use of Medicines (QUM).Australian Prescriber has been a significant component of the evolution of Australia's QUM movement over the past quarter-century.
As the National Prescribing Service assumes proprietorship of this bulletin, it is timely to outline the history of the change, and to give some insight into what the future may bring. It is also important to address the concerns, about the vitality of Australian Prescriber under the new management, which were aired in the previous issue.1
The National Prescribing Service is a product of the increasing momentum of QUM activities in Australia. Formed in 1998, the National Prescribing Service has as its mission 'to create an awareness, culture and environment that supports quality prescribing in Australia', and its primary goal is 'to improve health outcomes for all Australians through Quality Use of Medicines' - use that is judicious, safe, effective and cost-effective. The National Prescribing Service is a public company and as such, maintains total operational independence (from the Government, the pharmaceutical industry and others). This is essential if the vision of being 'the most trusted source of independent information about medicines in Australia' is to be realised.
Australia's National Medicines Policy is built on the concept of partnerships, and delivery of its objectives (of which QUM is one) cannot be achieved without the appropriate engagement of all potential contributors to the therapeutic relationship - prescribers, dispensers, consumers, regulators and producers of medicines. Another critical ingredient is the guaranteed independent evidence-based derivation of information about medicines. These themes were prominent in the report of the review of Australian Prescriber undertaken by Dr Andrew Herxheimer in 1997, under the auspices of the Pharmaceutical Health and Rational use of Medicines (PHARM) Committee. They are also major pillars in the philosophy of the National Prescribing Service.
There is significant congruence between the objectives of the National Prescribing Service and Australian Prescriber. The journal carries the formal endorsement of the National Prescribing Service as a valuable academic and pharmaceutical decision-support resource. There is a history of effective bilateral collaboration at many levels since the inception of the National Prescribing Service. The assumption by the National Prescribing Service of responsibility for publishing Australian Prescriber as from January 2002 can be seen as a logical integration. It could add significant value to the sum effect of QUM educational activities in Australia.
The decision to outsource production of Australian Prescriber was made by the Commonwealth Department of Health and Ageing. This editorial will not examine the dynamics of that decision, but it is important to point out that at all times in its deliberations on this matter, the National Prescribing Service Board's primary concern was to guard not only the survival of Australian Prescriber, but also its national and international stature. It has always been our understanding that the outsourcing ofAustralian Prescriber had as its main driver, the isolation of the journal from the dynamics of the Government's annual budget cycle. In this context, tenure with the National Prescribing Service brings with it a minimum four-year guarantee of operational stability.
Another central concern in our negotiations with the Department of Health and Ageing has been to see sufficient funding allocated to Australian Prescriber to allow continued production of the journal along with the full roll-out of National Prescribing Service programs, without either impinging on the capacity of the other. The National Prescribing Service was able to convince the Department of the importance of these goals and has secured the funding needed to achieve them.
Two other factors were crucial to maintain the authority of Australian Prescriber in the transition to private ownership: continuity of expertise and editorial independence. The National Prescribing Service has been able to recruit key members of Australian Prescriber staff which in itself is a measure of their professional commitment to this public health enterprise. Our relationship with the Executive Editorial Board ofAustralian Prescriber has always been mutually productive, and an absolute commitment to its continued editorial authority has been given by the National Prescribing Service Board. The National Prescribing Service has several policies and procedures which effectively deal with the potential conflicts of interest which may arise when multi-stakeholder activities are undertaken, and I am confident these will serve us well in our management of Australian Prescriber.
What of the future? Business as usual in respect of the core functioning of Australian Prescriber. However, evolution is essential for enhanced effectiveness. We will, in consultation with the new Editorial Executive Committee of Australian Prescriber, professional, consumer and other stakeholders, focus on issues including greater integration of QUM messages, better penetration of target constituencies, and more efficient and interactive methods of distribution.
In this new phase of Australian Prescriber operations, a sense of insecurity is understandable, caution is required and scrutiny will be welcomed. The National Prescribing Service looks forward however to bringing the power of this venture to the pursuit of QUM in Australia.