Queensland’s updated rules for cosmetic injectables have thrown many nurse-led clinics into financial uncertainty. While some experts welcome the changes, others warn they could do more harm than good.
Until recently, nurse-run cosmetic clinics in Queensland could legally hold prescription-only injectable drugs like Botox or fillers—provided a doctor or nurse practitioner, often working via telehealth, had prescribed them.
However, a new fact sheet issued last month by Queensland Health clarified that only prescribers—doctors or nurse practitioners—can purchase and hold these Schedule 4 (S4) medicines as clinic stock. They must also be physically present at the clinic and maintain direct control of the medication. Registered nurses are now only allowed to possess these medicines at the time they are administering them.
This means clinics must either employ an on-site doctor or nurse practitioner, or require patients to visit an outside pharmacy to get their injectables before returning to the clinic for the procedure. Both options are expected to increase costs significantly.
Hiring a prescriber to be on-site adds major overhead expenses. Meanwhile, sending patients to individual pharmacies reduces clinics’ ability to buy products in bulk—making treatments like Botox and fillers more expensive for patients.
The regulation changes highlight a broader tension in healthcare: Are people seeking injectables medical patients, or are they consumers demanding convenience?
“It’s not a small industry by chance,” said Sheri Lee Knoop, president of the Cosmetic Nurses Association, in an interview with The Medical Republic. “This industry has grown because people want these treatments, regardless of how we feel about them.”
Knoop warned that if accessing legal and safe treatment becomes too costly, more people may turn to underground providers.
“When there’s strong public demand for something, someone will find a way to offer it—legally or not,” she said. “Our biggest fear is that pushing up costs will lead to a fast-growing black market.”
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