Most pharmacists don’t believe they should ever be able to discount PBS-subsidised medicines, a King Review report has found

This week, the Review of Pharmacy Remuneration and Regulation released four externally-produced reports which were used to help inform the Panel’s interim paper.

One report included a Pharmacy Professionals Survey which examined attitudes towards pharmacist remuneration.

A large proportion of participants—39%—rejected the notion that pharmacists should be able to choose whether or not to charge consumers above the PBS-dispensed price for a medicine.

“An even larger proportion – 63% – rejected that pharmacists should ever be able to discount PBS subsidised medicines,” the report found.

Support for the concept was far higher among participants who worked at a large discount pharmacy (38%) than those in an internal pharmacy within a public and private hospital.

Pharmacy professionals in NSW (66%) were more likely to disagree with the concept of PBS medicines discounting in certain circumstances, compared to Victorians (57%) and South Australians (50%).

And 60% of participants disagreed with the idea that the current approach to remunerating community pharmacists appropriately rewards them for their dispensing expertise and advise.

Two in five (41%) agreed that providing pharmacists with a flat-fee payment supports undesirable outcomes, although almost one in four (23%) did support the status quo.

“Importantly, sub-group analysis reveals significant differences between types of pharmacists when it comes to preferred dispensing remuneration approaches,” the report says.

“While pharmacists who own a pharmacy (60%) were significantly more likely to prefer fees based on a combination of fixed and variable fees than all other participants (38% pharmacists not owners and someone working in the medicines industry and 44% pharmacy assistants or technicians), this preference changed when based on variable fees according to specific factors; 45% of pharmacy non owners chose this approach compared to 39% of pharmacy assistants or technicians.”

Preferred approaches to remuneration were significantly different among participants that worked in specific settings and areas: 56% of participants working in a banner group pharmacy preferred the current system, compared to 49% in independent and 43% in large discount pharmacies.

“Given the level of support among these participants for a variable or a fixed and variable dispensing remuneration system, pharmacy professionals were then asked to indicate by which factors they believe dispensing fees should vary and then to rank these in order of importance,” the report says.

“Across all types of participants, the most commonly given answer was that the complexity of the pharmacists’ involvement and the level of time or effort required should be a factor in dispensing fee variability – 80% indicated this is an appropriate factor.

“Overall, half (50%) were in favour of the manufacturer price of the medicine playing a role in dispensing fee variability. Just under four in ten (39%) saw whether the prescription being filled is an initial or a repeat prescription to be an appropriate factor to consider in determining dispensing fees.”

The data is based on a sample size of 1,489 respondents, including 51% non-owner pharmacists, 38% pharmacists who own a pharmacy, 6% pharmacy assistants or technicians, and 5% people who work in the medicines industry but are not a pharmacist.