A review of pharmacy funding and practice is timely, says SHPA CEO Kristin Michaels
Federal Health Minister Sussan Ley has stated on a number of occasions that one of the Federal Government’s primary goals is to ensure that ‘every dollar spent on health lands as close to the patient as possible’.
The aim is admirable: the effectiveness and cost of health care must be seriously reviewed from time to time and, within that context, opportunities to explore new approaches to medicines management must be evaluated. It is only through the implementation of new paradigms of pharmacy that we can improve the quality use of medicines, and make inroads into the 230,000 medicines related hospital admissions each year.
The Review of Pharmacy Remuneration and Regulation (the King review) is a legitimate and well-considered undertaking to deliver efficient purchasing of key services. It is the largest and most wide‑ranging review any government has attempted in the 26‑year history of the bilateral Community Pharmacy Agreements between the Federal Government and the Pharmacy Guild of Australia. As such, is deserving of widespread engagement and support.
SHPA’s primary recommendation to the King Review is that funding for services provided by pharmacists should focus on the achievement of good health outcomes for patients, rather than simply funding the dispensing processes. This change in focus is imperative if we are to provide effective support for Australia’s ageing population and the growing incidence of chronic disease.
Underpinning the SHPA submission is rejection of the proposal that all pharmacists are ‘medicine specialists’. Rather, SHPA believes that pharmacists, working in a range of settings, achieve expertise in medicines post registration through professional experience and advanced training, preferably recognised with relevant credentialing. This applies to all pharmacist, regardless of whether they work in hospitals, community pharmacies or general practice.
SHPA members operate at the highest levels of pharmacy and healthcare. They demonstrate the greatest expertise in the design and development of professional pharmacy services to support positive patient health outcomes in hospitals, where over 20% of the PBS expenditure is incurred.
Many government funded clinical pharmacy services today, such as the Home Medicines Review program, have been scaled from hospital-led innovations. This continues with evolving services such as smoking cessation clinics, anticoagulation clinics and opioid de‑escalation clinics in the outpatient setting.
The management of hospital pharmacy departments is made more complex by the multiple funding programs and associated rules necessary to access Commonwealth subsidised medicines.
Outside of the PBS, hospitals also have their own formulary, Individual Patient Usage drugs for advanced and complex conditions, Special Access Scheme drugs for therapies not available in Australia, and the list goes on.
The more time spent on bureaucracy means less time afforded to deliver patient-centred care and cognitive pharmacy services to achieve improved health outcomes for all Australians. SHPA has always believed that a single funder for all medicines, regardless of the patient setting, would be optimal.
SHPA has also called for the separation of remuneration for the supply of a medicine and professional pharmacy services. The funding model for professional pharmacy services must accurately reflect contemporary pharmacy care and the needs of patients and consumers.