The benefit of buying in bulk

Should pharmacists be offering advice to chronically ill patients to use bulk non-PBS prescriptions?

The cost burden of PBS medicines is such that prescribers and pharmacists should consider making chronically ill patients aware of the benefit of bulk non-PBS prescriptions, says a health economist.

Writing in the latest Medical Journal of Australia, Associate Professor Susanne O’Malley says: “I am aware that it is not the responsibility of prescribers or pharmacists to give cost-saving advice when prescribing or dispensing medications.

However, considering the growing number of self-funded retirees, perhaps chronically ill patients could be made aware of the potential to mitigate some of the financial burden of their prescription medications by using bulk non-PBS prescriptions”.

“It may also be time for a review of PBS prescriptions for pharmaceuticals used by the chronically ill to allow these drugs to be dispensed in amounts covering more than a single month’s supply,” adds Associate Professor O’Malley, a health economist at Macquarie University, Sydney.

Using calculations on the cost of four long-term medications she takes – prednisone, beclomethasone dipropionate, salbutamol and pantoprazole – she calculates an annual saving of $396.17 by not using the PBS.

This is “more than a dollar a day” she says, and “does not include the savings from unnecessary trips to the pharmacy.”

“Although this annual saving is based only on my own medication regimen, any patient who is on any long term medication that has a maximum price to consumer below the current safety net can also save by using bulk non-PBS prescriptions.”

Use of these bulk prescriptions was subject to a number of caveats such as patients having an established, ongoing clinical need to avoid wastage and money, also the expiry date of the medications needs to allow for the time required to use up the supply.         

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