Could MBS access be a step closer?


An MBS item should be established to allow pharmacists to access allied health items, a key reference group has recommended

The Allied Health Reference Group of the Medicare Benefits Schedule Review Taskforce has released a consultation document, which makes several recommendations including the establishment an item to allow pharmacists to provide medication management services to patients with complex care requirements.

These services would take place outside usual retail pharmacy operations as part of TCAs under M3 MBS items (up to twice a year).

The recommendation – the seventeenth in the document – is focused on improving access to medication education and management.

“Pharmacists are not included in the individual allied health services (items 10950–10970) for CDM items,” the document explains.

“An estimated 230,000 medication-related hospital admissions occur each year, with an estimated annual cost of $1.2 billion. These admissions are potentially avoidable.

“Pharmacy‐led medication reconciliation interventions were found to be an effective strategy to reduce medication discrepancies. Consultations undertaken by pharmacists located within primary health care clinics have been shown to be effective in identifying and resolving medication-related problems in patients with complex care requirements.

“Several submissions to the MBS Review supported funding for pharmacists to deliver medication management services as a way of improving health outcomes and reducing medication-related hospitalisations.

“This included submissions from the Northern Territory Government, the Pharmaceutical Society of Australia and the Australian Healthcare and Hospitals Association.

“The Australian Medical Association (AMA) and the Pharmaceutical Society of Australia (PSA) has released a proposal to make non-dispensing pharmacists a key part of the future general practice health care team, allowing potential of savings of public funds and avoidable hospitalisations.”

The PSA welcomed the recommendation as “an important investment in the safe and effective use of medicines”.

PSA National President Dr Chris Freeman said this recommendation, along with those made by the General Practice and Primary Care Clinical Committee to remunerate non-doctor health professionals to participate in case conferencing, will go a long way in supporting pharmacists to be better integrated with other healthcare providers in primary care.

“We have known for a long time that there are financial and structural impediments to pharmacist involvement in case conferencing, and these recommended changes will help overcome those barriers,” Dr Freeman said.

“These recommendations are a major leap forward, empowering pharmacists to practise to the full extent of their expertise and provide the best possible care for their patients.

“The recommendations could not be more timely, following on from PSA’s Medicine Safety report that revealed the extent of harms caused by medicines misuse in Australia and highlighted the need for pharmacists to be embedded wherever medicines are used.

“PSA has advocated over many years to diversify remuneration to reflect pharmacists’ extensive expertise and contribution to Australia’s health. Pharmacists have been calling for access to the MBS to reflect their skills, training and experience for longer than many of us can remember.

“PSA has advocated for pharmacists to be included in the list of eligible allied health practitioners and we have delivered this positive recommendation.

“In our 2019-20 Pre-budget submission we urged the Government to add pharmacists to the list of eligible allied health professionals that can deliver MBS services to patients with chronic diseases under the allied health chronic disease management items. We have now made this a reality.

“The MBS is a key funding mechanism to support innovative and collaborative models of care for chronic disease and complex conditions. We are delighted that both the Allied Health Reference Group and the General Practice and Primary Care Clinical Committees have listened to PSA and recommended allowing pharmacists to access these MBS items.

“Pharmacists should be able to deliver these services from any setting, including general practice, aboriginal health services and community pharmacies. This is about the right pharmacist, with the right skill set at the right time working as part of a multidisciplinary collaborative team.

“This is an innovative and cost-effective solution to address challenges in the health system and reduce harm caused by medicines.”

PSA’s Pre-budget submission also called for continued funding for integrating pharmacists in Aboriginal Community Controlled Health Services to improve chronic disease management.

Tthe Reference Group has recommended building and investing in an allied health research base to support evidence-based strategies for integrated or collaborative approaches to chronic disease management.

“This will help address health inequalities for Aboriginal and Torres Strait Islander peoples and rural and remote communities,” Dr Freeman said.

“We are excited that our advocacy is unlocking opportunities for pharmacists to realise their full potential. We look forward to working with the committees involved in the Medicare Benefits Schedule Review as they undertake their consultation on these recommendations, and finally when they will be presented to the Minister for Health.

“We also look forward to the Minister for Health making these recommendations a reality after the consultation process has been finalised to ensure pharmacists can do more with medicines for more Australians.”

The MBS Review Taskforce is undertaking a program of work that considers how more than 5,700 items on the MBS can be aligned with contemporary clinical evidence and practice and improve health outcomes for patients

The Allied Health Reference Group consists of 18 members from a variety of backgrounds, including consultant pharmacist Tim Perry.

Read the full report here.

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