‘Government, would you like to step in?’: Tambassis

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Greg Hunt says he may have worked out a temporary solution to the exclusive supply issue, although the details are yet to be ironed out

The Pharmacy Guild has backed the National Pharmaceutical Services Association (NPSA) in calling for PBS listing of medicines to be conditional on supply through CSO wholesalers.

“That’s been our public position for a long, long time,” Guild National President George Tambassis told AJP at APP2018.

“We went through the process of signing the 6CPA so the process of negotiating $2.77 billion for the supply chain – that’s excluding pharmacies, that’s the rest of the supply chain.

“Why are we negotiating $2.77 billion of taxpayers’ money and then allowing numerous big brand pharma companies to actually work around that system?

“Sure, you could argue that if these other guys work around it then some of that money won’t be used, but there’s a reason why we put that money in that pot – so we get an efficient supply chain, so we stop out of stocks, so we make sure there are 24-hour deliveries.”

And has the Guild heard of any problems pharmacies have had as a result of exclusive direct supply arrangements?

“Heaps,” said Mr Tambassis. “They’re all going straight back to the government, each and every problem.

“They’re all patient-centred problems because people have problems getting some of those medicines when there’s a hiccup.

“When we have those problems with a non-exclusive direct supply – they happen with that as well – but we’ve got at least three other options up our sleeve there and then on a real-time basis. Because it only takes a second to go to another wholesaler for solving it.”

He says what pharmacy needs to do is get government intervention, and “stop arguing that it’s a pharmacy problem, that it’s creating problems for us as pharmacists – it’s actually creating problems for our patients.

“We’ve been very persistent on this issue … now that [high-cost medicines] issue has been backdated [to July 2019] but we’re saying, we can’t push back on exclusive direct supply, that’s a ‘now’ issue. We’re still pushing hard on the exclusive issue,” said Mr Tambassis.

“Government, would you like to step in?”

Health Minister Greg Hunt told media at an APP2018 doorstop that his department has put together a solution that may help stem the issue for the meantime.

“I’m very aware that the exclusive supply issue is in some cases fundamental, if not existential, for some of the existing wholesalers,” said Minister Hunt.

“So we are now working with wholesalers, the Guild, the pharmaceutical companies on a solution to that problem.

“And I think we’ve got a temporary solution which is likely to be announced soon which will lead to a permanent solution.

“I think that threat has now abated, and we have a much more comfortable position from wholesalers, pharmacists and medicines suppliers. We’ve been working around the table with them.”

While not confirming whether direct suppliers would need to cease their current arrangements or not, Minister Hunt said: “Essentially we are likely to ensure that there’s space for others to be part of the CSO and we have the capacity to include them.”

However NPSA chair Mark Hooper does not agree that the threat has abated.

He told APP delegates that the spread of unregulated exclusive distribution arrangements, especially for select high-value medicines, is an ongoing major risk to the wholesale sector.

“If that model continues, the wholesale sector is not sustainable,” he said, adding that “supply chain sustainability is critical to community pharmacy.”

Meanwhile Minister Hunt also spoke on the government response to the Review on Pharmacy Remuneration and Regulation regarding high-cost medicines.

“One thing I didn’t mention is that the move to the change in the way the rebates are done and the high-cost medicines are processed will be in a position to support the uptake and the development of electronic tracking,” he told media.

“And so that’s something that we’ll work on in particular with the wholesalers but we’ve made provision for the Commonwealth to provide funds for that.”

Watch the video for George Tambassis’ explanation of what the government’s decision on high-cost medicines really means:

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