Where are the 6CPA pharmacy services trials?


confused health professional

The health sector urgently needs to get moving on the trial pharmacy programs negotiated as part of the Sixth Community Pharmacy Agreement, says David Quilty.

Writing in this week’s edition of Pharmacy Guild newsletter Forefront, Quilty says that pharmacists are worried about the whereabouts of the 6CPA trials.

“A core objective of the 6CPA is to enable community pharmacies to transition from relying on trading terms from the supply of PBS medicines to delivering primary healthcare services,” Quilty writes.

“The PBS Access and Sustainability Package that was negotiated in tandem with the 6CPA continues to have a significant impact on the viability of community pharmacies, making it imperative that the additional 6CPA funding to trial pharmacy programs ($50 million) and for new and expanded community pharmacy programs ($600 million) is delivered on time and in full.

“It is now 16 months into the five-year 6CPA and there is an urgent need to progress these elements of the agreement, with community pharmacies increasingly concerned about the slow rollout of the $50 million Pharmacy Trial Program and whether they will be able to access the $600 million for new and expanded pharmacy programs from 1 July 2017.

“The 6CPA stipulates that patients in rural and remote areas and Aboriginal and Torres Strait Islander people are a particular focus for the $50 million PTP and the $600 million for new and expanded pharmacy programs.

“These patients will lose out if these commitments are not delivered upon.”

Quilty points out that the $50 million trial program is supposed to be delivered over the first three years of the 6CPA.

It is one of two gateways through which pharmacies can access the $600 million for new and expanded programs during the 6CPA’s last three years.

“To date, no PTP trials have been rolled out, although there is some tangible progress this week with pharmacies being invited to participate in the Pharmacy Diabetes Screening Trial.   

“There is an urgent need to expedite the PTP, by removing any impediments holding back the implementation of the first three trials announced in March (diabetes screening, post hospital discharge medicines reconciliation, Aboriginal and Torres Strait Islander medicines reviews) and by expediting additional trials in areas where there is an existing strong evidence base.

“Two such areas are a new medicine service, which has been trialled and evaluated in the United Kingdom, and an asthma management service which was trialled in the Fourth Agreement.”

Quilty writes that another issue is putting the timely delivery of that $600 million at risk: the slow progress in conducting the cost-effectiveness reviews of existing programs.

“Under the 6CPA, all existing programs must be subject to a cost-effectiveness review before they can be expanded utilising the $600 million from 1 July 2017,” he explains.

“These cost-effectiveness reviews are yet to be completed meaning there is a real risk that existing pharmacy programs that are shown to be cost-effective, will not be able to be expanded from1 July 2017.”

He called for a process to be put in place so that existing programs that are found to be cost-effective can be expanded from 1 July 2017. 

“The 6CPA identifies dose administration aids and staged supply as two programs with an established evidence base where there is a very high likelihood they will be found to be cost-effective and recommended for further expansion,” he writes.

The timely rollout of 6CPA pharmacy services funding would allow community pharmacies to be fully utilised in the Health Care Home trials, which they are currently not, Quilty says.

“The current HCH trials do not sufficiently recognise the vital role of the patient’s community pharmacy. 

“The Government should stipulate that HCH trials connect with the patient’s regular community pharmacy.

“This will enable these high-needs patients to receive the highest quality medication-related care, with any issues identified by the community pharmacy communicated to the patient’s GP at the earliest opportunity. 

“If the pharmacy services investment in the 6CPA can be used to help meet the medicine needs of patients participating in the HCH trials, there is a real opportunity to optimise their health outcomes as well as integrate community pharmacies into the broader primary care system.”

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