Many nurse-led clinics in Queensland have been alarmed to learn they are probably operating illegally, following publication of a 5-page ‘guidance sheet’ from Queensland Health’s Medicines Approvals and Regulation Unit (MARU).
The formal statement of the current law relating to “authorisations for prescribing and administering S4 cosmetic injectables” emphasises:
- the specific requirement for a doctor to be on-site at facilities where cosmetic injectables botulinum toxin (sold under the brand names Botox or Dysport) and dermal fillers (such as collagen, hyaluronic acid and polylactic acid) are administered; and
- that only doctors or the highest qualified nurses can buy and store the products.
The MARU notice – issued without fanfare in December but only widely interpreted and understood in the past week – means hundreds of nurse-operated beauty clinics and day spas have been operating in breach of the law for several years.
In addition, the notice jeopardises the legality of the nurse-led business models: many don’t have on-site doctors and rely on partnerships with companies providing cosmetic telehealth services to prescribe and supply the drugs for their customers.
The notice emphasises only doctors or nurse practitioners can buy the injectables and warns “doctors and nurse practitioners cannot buy stock for a place that they do not practice from, which includes locations for which telehealth is provided”.
Amid significant industry confusion this week, several operators told The Australian they had been unable to gain clarification about the “discrepancy between the guidance and current practices” from Queensland Health.
But a spokesman for Queensland Health said the information in the guidance was not new and emphasised the fact sheet “was produced to support the beauty industry to better understand existing legislative requirements.
“Queensland Health has received inquiries from clinic owners and will continue to work closely with them. While many non-surgical cosmetic businesses are already compliant with the legislation, our focus is on supporting all businesses to achieve full compliance.”
To ensure clarity surrounding the current legislative requirements, the notice includes separate sections detailing the specific legal requirements relating to:
- Authorisations for prescribing and administering S4 cosmetic injectables
- Standing Orders
- Buying S4 cosmetic injectables
- Supplying S4 cosmetic injectables
- Storage of S4 medicines including cosmetic injectables
- Advertising of S4 cosmetic injectables
- Buying and administering S2 and S3 medicines
- Infection control requirements
With nurse-run cosmetic injectables clinics now widespread across Australia, speculation has become intense whether other state jurisdictions will follow the Queensland lead.
The confusion also includes whether insurance companies will change or update their requirements – potentially declining insurance if clinics don’t formally meet these specific criteria and guidelines.
Full coverage of this emerging debate will be published in the next issue of Aesthetic Medical Practitioner.
