One of the well announced measures in last night’s budget is to allow some medications to be prescribed in 60 days supply instead of 30, but local leaders are concerned the move may have unintended consequences.
The measure, set to begin in September this year and expected to save $1.6 billion, will cut the medication bill for some living with chronic illness who take long term medication in half. If their medications are on the approved list, patients will pay the same dispensing fee they do now for twice the amount of medication. However, the Pharmacy Guild – a peak body that represents smaller pharmacy businesses – launched a significant campaign against the measure, claiming that it would lead to pharmacies closing and widespread medication shortages, negatively impacting patients, because they would also have their dispensing fees for those medications cut in half. The Royal Australian College of General Practitioners (RACGP) says the move is a win for patients that would also will also help ease pressure on practice waiting lists and mean GPs can devote more energy to caring for patients and less time re-writing scripts.
Speaking to the measure in last night’s Budget speech, the Treasurer Jim Chalmers said many people with common, chronic illnesses will be able to get 2 months’ worth of treatment for over 300 different medicines.
“This change will save people up to $180 a year.”
“For millions of Australians, the cost of medicines will be cut in half.”
New England woman Sonya says she cried when she heard about the reform. Sonya is a pensioner who lives with a number of chronic illnesses, and needs to take five different medications every day. She does not yet know which, if any, of her medications will be eligible for the 60 day prescribing, but says she will take any win she can get.
“Some of my medications I’ve been taking for many years. It always seems so dumb to have to go to the pharmacy every month, and back to the doctor for more scripts every couple of months.”
“I spend more on health care than I do on anything else other than food and rent – so anything that gets that cost down is really welcomed.”
However, local federal Member for New England Barnaby Joyce and neighbouring Member for Parkes Mark Coulton, have expressed concern about the “unintended consequences” of the measure, with the National Party being swayed by the Pharmacy Guild’s lobbying that the reform would adversely affect regional pharmacies more than city ones.
“This proposed requirement for pharmacists to supply two months-worth of medications demonstrates a lack of awareness of how pharmacies operate, particularly in rural towns,” Mr Coulton said.
“Pharmacies in small towns rely on the regularity of prescriptions and contact with their customers to operate.”
“The current system also allows them to provide extra support such as blood pressure checks, blood sugar testing and other services which make a difference for people managing chronic illnesses.”
“Many pharmacists across the Parkes electorate have written to me in recent weeks expressing their concerns about sustainability and the ability to provide their services once these measures come into effect.”
“Allowing 60-day dispensing is not a quick-fix solution to cost-of-living pressures if it hamstrings our local pharmacies and results in medication supply shortages for our most vulnerable,” Mr Coulton said.
Mr Joyce was more nuanced and reflective in his comments, acknowledging confusion about the measure, and saying the principle of “First, do no harm” should apply.
“Pharmacists are medical professionals who are at the coldface of our community, they see everyone in the community, often at our darkest hour, and in our poorest of health.”
“They see families trying to manage chronic illnesses such as asthma and epilepsy, and often are part of the prescription for healing, providing a safe place to talk and confide in how they are coping with their condition and how that is impacting their life broadly.”
“When I have our community pharmacists, in the electorate of New England telling me that a proposed legislative change, will in fact, do harm, we need to listen.”
“We need to listen because pharmacists understand the full impact of the changes – they know that some people need to see a pharmacist regularly and to have that human interaction and routine so the consistency with medicine administration is achieved.”
“They know that already there is a lot of medical waste, and when medicine is returned to a pharmacy, when people pass away or medicine changes, it is not able to be redispersed and goes into our waste systems.”
“They also know for their business operations, that purchasing more for larger quantity supply will mean costing more, and for small community pharmacies, they will have to make tougher decisions on what they can afford to stock, and this will in turn, increase costs for other over the counter medicines.”
“All of this combined means one thing for sure, the bigger companies will thrive and the community pharmacies will feel the pinch,” Mr Joyce said.
Mr Joyce said there are many questions the Government needs to answer on the measure.
“How will they ensure that regional and rural communities are able to access the required supply of medications?”
“How will they ensure that small pharmacists are able to access the required supply of medications?”
“How will they ensure that medicines are not stockpiled?”
“Can they guarantee that community pharmacies and consumers will not be negatively impacted or businesses forced to close because of this announcement?”
Health Minister Mark Butler has dismissed the campaign against the measure as a “scare campaign“, criticising the Pharmacy Guild for conflating medication shortages – largely due to other changes in the PBS or normal manufacturing issues, as well as some residual supply chain issues due to the pandemic – with the prescribing changes. He says only 7 of the 300 plus medications that will be eligible for 60 day prescribing are also on the list of nearly 500 medications currently experiencing supply issues.
The first tranche of about 100 medications will be listed for 60 day prescribing in September of this year, with further expansions of the list expected in March and September next year. The savings from the measure are slated to be reinvested in community pharmacies in other ways, including higher fees for services provided by pharmacists such as vaccinations.
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