Bearing the cost burden


Why Hep C medicines have opened a can of worms for medicine supply

A range of issues relating to the supply of medicines in Australia have been brought to light by the case of expensive Hepatitis C medicines, members of the Pharmacy Remuneration and Regulation Review panel believe.

Speaking on the Department of Health webinar yesterday, panel members said the Hepatitis C immunisation program had been a public health success, but had highlighted flaws in supply and remuneration arrangements.

Former Pharmacy Guild of Australia (Victoria) president Bill Scott said more than 20,000 immunisations had been undertaken in six months since the medicines were PBS listed, compared with 2,000-3,000 over the previous two years.

“It’s totally changed lives and been a terrific public health success, but from a pharmacy perspective it’s costly – in terms of arrangements with banks, wholesalers and GST costs,” he said.

Jo Watson, from the Consumers Health Forum agreed there had been “an absolutely profound impact on population health” from the program, and it was a key driver in showing what community pharmacy could provide in terms of services.

However, Professor Stephen King, panel chair, said the program, while an “outrageous success” had “highlighted a range of supply issues. Wholesalers aren’t happy with terms of trade, banks aren’t happy, and pharmacists are forced to bear a heavy risk.”

If a patient doesn’t collect their medicine or it is incorrectly dispensed, there is a liability for a $22,000 medicine that pharmacies are reimbursed $70 for dispensing, he said.

The Hep C case was important as medicines are bifuricating when it comes to price, Prof King said, with the vast majority decreasing in price, while new very high-cost medicines come on the market.

“We will need to seriously consider how arrangements for supply and cost of these medicines are met,” he said.

When discussing wholesaler CSO remuneration arrangements, which he said had “dropped in real terms” in the 6CPA, Prof King said there was a case for manufacturers assuming a greater obligation for ensuring supply of vital medicines.

“They derive immense benefit from these medicines being PBS listed, should they therefore have a greater obligation in terms of supplying these medicines?”

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