A mixed bag

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Here’s how hospital pharmacy, industry and other medical groups reacted to the 2019/20 Federal Budget

The Society of Hospital Pharmacists of Australia (SHPA) has welcomed focus on embedded pharmacy positions in aged care, investment in equal access to new medicines and improvements to hospital infrastructure and services after the release of the 2019-20 Federal Budget.

SHPA Chief Executive Kristin Michaels says the adding of new cancer medicines to the Pharmaceutical Benefits Scheme and investment in clinical pharmacists in aged care are welcome aspects of the Budget.

“As outlined in SHPA’s 2018-19 Federal Budget submission, preliminary Australian evidence indicates a return on investment of $1.54 for every $1 spent embedding clinical pharmacists in aged care and we welcome the Federal Government’s allocation of $7.7 million in funding to help ensure greater access to their expertise regarding the use of medication, in particular inappropriate use of psychotropics and antibiotics.

“As part of the $331 million over five years from 2018-19 for new and amended listings on the PBS, our members and their broader healthcare teams will enthusiastically welcome the addition of medicines to treat breast, blood and skin cancers and SHPA welcomes additional investment into the PBS-adjacent Life Saving Drugs Program, which is wholly managed by hospital pharmacists.”

Hospital pharmacists now facilitate more than 20 per cent of PBS expenditure and play a crucial role managing the introduction of cutting-edge medicines and the overall sustainability of this essential mechanism that improves equity of medicines access for all Australians.

Ms Michaels says it is surprising, given the increasing importance of medicines to the health of Australians, to see signs of proposed changes to hospital pharmacy pricing arrangements.

“We are concerned at the short timeline of 1 July 2019 for potential implementation of any new pricing approach,” she said. 

“The proven efficiency and efficacy of hospital pharmacy stewardship of Australia’s growing medicines budget reaffirms the need for transparent negotiations and broad consultation with the whole pharmacy profession, given the potential impact of any such changes.”

Ms Michaels welcomed the announcement of $107.8 million over seven years from 2018-19 to be invested into health infrastructure and services and $70.8 million for additional infrastructure and services to support the diagnosis, treatment and therapy for cancer patients.

“The medicines management expertise of hospital pharmacists is pivotal in the effort to keep people out of hospital and SHPA also welcomes $1.3 billion over seven years for the Community Health and Hospitals Program, aiming to support patient care while reducing pressure on community and hospital services.”

Australian Medical Association (AMA) President, Dr Tony Bartone, said the Government’s Budget announcements have set up a genuine health policy competition for the upcoming election.

“The Health Minister, Greg Hunt, has listened closely to the AMA and delivered a strong Health Budget, with a particular emphasis on primary care, led by general practice,” Dr Bartone said.

“Australia’s hardworking GPs will be happy to see a commitment of almost $1 billion to general practice. This includes matching Labor’s promise to bring forward by a year the lifting of the freeze on rebates for a range of Medicare GP items.

“Overall, the Government has delivered a much-needed significant investment to general practice – the driving force of quality primary health care in Australia.”

The GP package includes:

  • $448.5 million to improve continuity of care for patients over 70 with chronic conditions;
  • Quality Incentive Payments for general practices ($201.5 million);
  • $62.2 million for rural generalist training; and
  • $187.2 million for lifting of the freeze on GP items.

The AMA also welcomed:

  • Funding for new Pharmaceutical Benefits Schedule (PBS) medicines;
  • Retention of the Aged Care Access Incentive (ACAI); and
  • A rural workforce program.

Dr Bartone said there are obvious gaps in mental health, prevention, Indigenous health, pathology, and public hospital funding to improve all hospitals.

“We expect to hear more on these key areas from all parties before the election,” Dr Bartone said.

“Health Minister Hunt has worked closely with the AMA, especially on the primary care element of this Budget.

“We look forward to the Opposition making health a real contest when they roll out all their policies.”

The Australian Self Medication Industry (ASMI) welcomed key budget measures in health but called for more to be done on health literacy and increasing access to medicines.

“Preventive health, physical activity and healthy eating are key pillars of greater Self Care. Greater investment and focus on these areas is welcomed, but more needs to be done.

ASMI is disappointed that health literacy is not a major focus of this budget given that 60% of Australians have less than adequate health literacy levels. Greater health literacy empowers Australian consumers and leads to greater Self Care.

It is promising that there is additional funding for medical research. ASMI will be advocating for research projects that build the evidence-base for Self Care to be included within its scope.

A focus on the safety and quality use of medicines in aged care is welcomed by ASMI and we support the trial placement of part-time pharmacists in ACT Aged Care Homes.

Pharmacists play a key role in the quality use of medicines by Australians. The government’s announcement tonight that they will provide additional support to pharmacies to help people manage their medication is welcomed and should include a focus on health literacy.

The government also announced measures to improve access to medicines. A key element of this, in our opinion, is the provision of data protection for ‘switch’ applications to increase access to medicines. We will continue to advocate for the greater incentivisation of ‘switch’ applications on behalf of the consumer healthcare products industry”.

National Rural Health Alliance CEO Mark Diamond said the budget was a mixed bag for
rural health.

“We’ve had a big and much-needed focus on medical services and we welcome that but comprehensive health care needs paramedics, pharmacists, nurses and a whole range of
other health professionals too. There was nothing in the budget to address this critical
workforce shortage or to get them where they are so badly needed,” Mr Diamond said.

“And we were disappointed to see that major population health issues – obesity, maternity services, stillbirths or a national alcohol prevention strategy, all of which are well overdue for investment – were missing in the budget.”

Boosts for mental health including $15m for indigenous suicide prevention, $114.5m for Adult Mental Health Centres, $263m for additional Headspace network sites and an $11.5m National Mental Health Workplace Initiative ($11.5m) sounded good but there was no indication these funds would be spent in the bush.

Some good news items for rural areas include $9.6m for alcohol and other drug treatment and support services, an expansion of the rural health outreach fund to increase access to pain management specialist services and train providers ($4.3m); a new Ambulatory Care Centre in Alice Springs ($25m); and other local service improvements including a new CT scanner for Bowen Hospital, an Early Psychosis Youth Centre in Darwin and new radiology, pediatric and chemotherapy services on the Bass Coast.

“We welcome an additional $160m for Indigenous medical research. It’s long overdue and we support it being targeted at rheumatic heart disease, and blindness and deafness in Aboriginal and Torres Strait Islander children and youth,” Mr Diamond said.

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