Call for more support for HMRs

Many AJP readers believe caps on HMRs should be increased or removed completely, and the program should be given more funding – preferably through the MBS

According to an AJP poll on funding for HMRs/RMMRs, over half of respondents (60% of 317 voters) believe medicines review programs should be given more funding.

The same amount are convinced MedsChecks are not an equivalent service to, or replacement for, HMRs.

Of the total, 58% believe HMRs should be funded through the MBS, while just 5% of respondents believe HMRs already get enough funding.

Nearly one quarter were happy that MedsChecks got more funding in the recent announcements.

Over half (51%) think other measures to prevent rorting are better than caps.

About 42% say HMR/RMMR caps should be increased, while 35% think caps should be removed completely.

Just 8% of respondents think the caps on HMRs/RMMRs are good and should continue as they are.

About half (51%) of respondents are happy with the current direct referral system from consultant pharmacy, while a further 24% believe HMRs should be clearly linked back to community pharmacies.

And 34% agree that eligibility criteria for HMRs should be more targeted based on need – a move that is anticipated to be rolled out early next year as part of the Pharmacy Guild’s $600 million funding allocation for community pharmacy programs.

Nearly a quarter are hopeful there will be an expansion of the HMR program in the future, while a more pessimistic 7% think there won’t be.

PSA agrees that more spending and support needs to go into medication management programs.

“Currently, we have too little investment in programs that deliver better health outcomes for patients associated with their medicines use,” PSA National President Shane Jackson told AJP this week.

“We should have a continuum of medication management programs available to pharmacists to utilise based on the presenting needs of patients. We need to have an evidence-based and informed debate about supporting pharmacists’ roles in various settings within the healthcare system.”

SHPA Chief Executive Kristin Michaels said it was “disappointing” that recent funding announcements left out the HMR program, saying it was a decision that will limit patient access to an under-resourced service.

“HMRs performed by independent pharmacists, including follow-up in the home where patients are most comfortable, are a proven and effective way to expanded medication management services for Australians who need additional assistance,” says Ms Michaels.

“HMRs, including hospital-initiated referral pathways for high-risk patients, have the strongest evidence base of all 6CPA programs—including many which have just been expanded – so it is disappointing to see them overlooked,” she says.

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  1. H Shan

    Guild will not allow increased funding for any program that will not benefit the community pharmacy.

    Eployee pharmacists are a cost component for them, and as an owner they will try to keep that cost under check.

    Independent HMR pharmacists are some professionals who takes money out of community pharmacy funding and Guild is not happy about that.

    Possibly Guild will agree to remove the cap on number of HMRs if it becomes mandatory that HMRs must be claimed through a community pharmacy and the owner will get at least 50-75% of the payment.

    • Wilson Tan

      Shan, you know, it is great to be passionate. At the same time criticising the Guild for our own ills and pushing the blame out to others seem to be the easy thing.
      Won’t it be fantastic to gather some strong leader within pharmacy and approach this with applying for rule change, funding through Medicare and creating a viable alternate career path for accredited pharmacists.
      Remember we should be pushing the envelope of our practice, funding model and even our practice model.
      Without the Guild, we won’t have a HMR today. Unfortunately HMR needs to be funded properly and legitimately through Medicare, like GP, optometrists, physiotherapist, practice nurse, and other healthcare professionals.
      Remember we are complementary. Don’t evil greedy this and evil this. Many pharmacist worked in both avenue, I trained in Monash M C before and FULLY APPRECIATE clinical pharmacist role to integrated healthcare. I also fully appreciate community pharmacists role in community primary healthcare setting.

      • H Shan

        I agree that without Guild, possibly introduction of HMR in Australia would have been delayed.

        I also keep in mind that it was the Guild who recommended a moratorium on HMR due to shortage of funding and at the same time started giving money to community pharmacies for selling Nurofen Plus in the name clinical intervention.

        Personally I have the experience of receving HMR money after 50% deduction by the pharmacy owner. And he said that that was his practice with all HMR pharmacists (I did not continue with him).

        I fully agree with you that HMR to be funded by Medicare. Also there should be severe punishment for abusing the system.

        I am less optimistic about this because two major political parties think anything about the pharmacy profession or communitu pharmacy will be handled by the Guild. No wonder we see a big exodus of pharmacists.

        • Willy the chemist

          Shan, I say this very honestly and candidly, the people I meet at the Guild, everyone almost to the person, every person I met are concerned about pharmacists and our profession. They are generally passionate. Well, I can say this mainly of the Victorian branch. In Victoria, community pharmacies face the most competitions. Some other states probably don’t know what competitions are until those hit them…states like WA and the ACT. It may come. Even in QLD, the competitions are not to the levels of Victoria.
          Again competition is not a measure of healthcare standards and efficiencies. If it is we will not have public healthcare.

          Hey, my experiences of HMR pharmacists, they usually charge us (pharmacies) up to $165 (one even a little more) and for the community pharmacists, it is not viable, after GST we get less than $15 sometimes. But we certainly support all our external HMR pharmacists because these are worthwhile endeavours and also what accredited pharmacists do is good for pharmacy.

          But what do you mean by the Guild start giving money to community pharmacies for selling Nurofen Plus in the name of CI?
          The Guild cannot give money. HMR was funded out of the Community Pharmacy Agreement – accredited colleagues, understand this please.
          Please. Please. Every accredited pharmacist understand this.
          We are all one.
          Accredited services being funded out of community pharmacy agreement is like a donation from Community pharmacy to Accredited pharmacists.
          Donations are good when we can all eat.
          In time, accredited pharmacists must come together and negotiate with the government for a separate funding envelope.
          Donations are donations by nature…but we need to develop a proper legitimate and sustainable business model. We have to get the public and government to value our services, and these services need to be funded from new money.
          CI are worthwhile interventions as well. For years we do this, and we discount ourselves by not “costing” these services in. We cannot continue to subsidise our services but more importantly, we have to get the Government and public to realise that pharmacists are valuable professionals and free is not valued.

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