‘Jobs will be lost.’


Pharmacy group estimates average loss of $85k in gross profit per pharmacy if 60-day dispensing proposal goes forward

With the 60-day dispensing proposal still on the table, the Rural Pharmacy Network Australia (RPNA) has warned that the effects on the pharmacy industry will be “catastrophic” should it come to pass.

Health Minister Greg Hunt confirmed in recent months that PBAC recommendations to increase the prescription lengths of certain medicines from one to two months were still under consideration.

The proposal was “under careful review” by the Federal Government, Minister Hunt said on national television in September.

Fred Hellqvist, Chair of the RPNA, says: “There is no doubt that double dispensing, introduced in isolation, would have a devastating impact on rural communities.

“The effects will be catastrophic,” he says.

RPNA estimates the impact of this policy will be an average loss of $85k in gross profit per pharmacy, and it will also result in closures, increased patient costs for medications and pharmacy services, and reduced services due to reduced staff or reduced hours to compensate for the losses.

“Jobs will be lost especially amongst support staff like assistants and technicians. They will be collateral damage,” says the organisation.

It warns that non-concessional patients can expect an increase in medication prices, and argues that the proposal will push many scripts currently under the general patient co-payment above the general benefit price – therefore attracting a benefit and fee and costing the government more in the long run.

“Access to pharmacists will be vastly reduced under this proposal,” says RPNA.

“These losses will be particularly detrimental in rural communities where medical services are already under strain and patients are relying heavily on their local pharmacy for healthcare advice and triaging.

“In the worst case, some towns could lose their pharmacy altogether.”

However doctor and consumer groups such as the RACGP, AMA and the Consumers Health Forum (CHF) have argued that enabling patients to collect two months of scripts in a single visit to a pharmacy would be practical and convenient for patients.

AMA president, Dr Tony Bartone, said in a radio interview in September: “Where the patient is stable and having ongoing care delivered under the auspices of a treating family medical practitioner, they should be allowed to have longer term quantities prescribed, to ensure that they don’t have to go back and pay an extra dispensing fee, an extra component for their care, if it’s obviously working and being managed appropriately.

“The PBAC has made the recommendations. And we support the independent umpire,” Dr Bartone said.

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24 Comments

  1. B Farm
    04/11/2019

    I guess next time the polls are out asking about whether the Medicare rebate the likes of Dr E Ackerman receive for consults should be unfrozen I now know my answer will change to a resounding NO. I honestly don’t understand your agenda. I always advocate for my local GPs but if you are typical of who I am advocating for then I’m done with it. But then again you probably don’t want them to increase anyway as you don’t believe tax payers should foot the bill. Actually, how much of your income in the last financial year was from Medicare rebates Guru Ackerman?

  2. Fredrik Hellqvist
    05/11/2019

    This Australian study suggests that residents of small towns would actually prefer to have access to a community pharmacy rather than a dispensing doctor.

    https://anzhealthpolicy.biomedcentral.com/articles/10.1186/1743-8462-3-8

    Yes medications may be cheaper for some concessional patients under 60 day dispensing but this needs to be weighed up against many other factors – rural job losses, possibility of increased prices for some patients, possible pharmacy closures (not necessarily due to inefficiencies/poor management but a funding model not designed to suit the economic dynamics of rural communities), reduction in health services, reduced access to pharmacy care (when medical services are already under strain and noting that many smaller communities don’t even have access to a regular GP). Also from a QUM perspective there are many studies which show that more interaction between patients and pharmacists, not less, improves outcomes and reduces public health spend. We should be looking at ways of saving patients and the taxpayer money, but also ways to support pharmacies in delivering the healthcare services that rural patients want and deserve.

  3. ES_Ph
    05/11/2019

    The decision of 60 day supply will see disadvantaged rural communities, already receiving a lower quality of health service than their counterparts in urban communities, potentially losing a health service provider; their rural pharmacy.
    Among different health spend items funded by taxpayers, PBS is the most controlled.
    It defeats the purpose to save on already controlled PBS just to see rural communities losing timely access to their PBS medications and other pharmacy services.

  4. B Lee
    06/11/2019

    GPs ie, “middle” professions seriously need to mind their own business. Why don’t you improve the guidelines of clinical diagnosis that I received before that were wrong three times that were fixed by specialist? I always advise patients “if your GP is the one who is willing to solve your problems, that is the GP that you should avoid with your life. Go to GPs that knows when to refer.” and I think I am making the right advice here.
    Two months dispensing is not wrong but why change when 1 month dispensing is working? Dispensing 1 month means we can monitor monthly basis so will definitely have more chance to pick up issues when they rise. Convenient for patients? I would argue for their safety.
    Do you know how many times I pick up mistakes done by GPs in my pharmacy and how utterly amazing the kind of mistakes GPs make? Yet they are arrogant to talk to me and don’t want to get disturbed.. well why would I want to talk to you whom I totally don’t care about and do not want to know about you?? If it wasn’t your script, I would not even care about your existence..
    For pharmacists, please let’s stick to the things that we were trained to do.. Why go beyond the scope and risking patient’s life? I wasn’t taught in my university and if you argue that it should be within our knowledge, we must change things and the ways we get taught in uni..
    Let’s work as a team. Let’s keep patients happy and well being. Who knows we will end up like them in years later?

  5. Anthony Tassone
    07/11/2019

    I cannot say I have a thorough understanding of the margins of general practice, indicative gearing and other associated pressures they experience to maintain ongoing financial sustainability and a quality service to their patients.

    I imagine that Evan’s understanding of margins, cost structures and challenges of maintaining a sustainable pharmacy is similar to that of general practice – so I will not read too much into his comments of ‘catastrophising’ which is essentially an opinion and a subjective view.

    It’s been discussed on this site before that when similar concerns are raised by his medical colleagues and RACGP representatives, he does not seem to want to acknowledge any similarities or parallels.

    Evan feels that we should go further and have ’90 day dispensing’ like many other countries overseas.

    If overseas jurisdictions have so obviously got things right with their healthcare system, why don’t we just automatically replicate other elements such pharmacists practicing to their full scope with autonomous prescribing rights, pathology test ordering and disease state management?

    The argument of ‘they do it, so should we’ can really be used out of convenience when it suits it seems.

    The community pharmacy sector will contribute an estimated $20 billion in savings over the forward estimates since PBS reforms began in 2007 to the end of the 6CPA in 2020.

    PBS expenditure is flat-lining (backwards in real terms compared to a decade ago) whilst public spending on hospitals and Medicare are growing at double digits year on year. A reduction or lowering of the quality use of medicines risks saving in one part of the health portfolio only to increase spending inefficiently elsewhere.

    If it wasn’t for PBS reforms, we would not have headroom for PBS listings as recommended by the Pharmaceutical Benefits Advisory Committee (PBAC).

    With a community pharmacy network that has been asked to reform, take a significant cut in revenue of its own cloth for the public good and the PBS sustainability whilst having to do significantly more with less, the contemplation of a drastic sudden reduction in revenues from a single measure would be of great concern.

    Comments of ‘catastrophising’ are flippant and make no effort or regard to even want to understand the issue any more than the low base of the current state.

    Anthony Tassone
    President, Pharmacy Guild of Australia (Victoria Branch)

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