Looking inside the 7CPA


What is the total remuneration provided in the new Agreement? And how has the $1.2b of funding for community pharmacy programs actually been divvied up? Here are the numbers

Remuneration and funding of approved pharmacists and others in the pharmaceutical supply chain is estimated to be $25.3 billion over the five years of the new Seventh Community Pharmacy Agreement (7CPA) starting 1 July, according to the document sighted by AJP.

While the 7CPA signing was announced last Friday, the document itself has not yet been officially released by the government, although AJP has obtained a copy.

The total remuneration figure comprises Commonwealth contributions of $15.85 billion and patient contributions of $9.45 billion, covering pharmacy remuneration for dispensing, remuneration for wholesalers, community pharmacy programs, the CSO, and fees for pharmacy to distribute National Diabetes Services Scheme products.

We will breakdown these numbers over the coming days.

Meanwhile the Federal Government has promised to make $1.2 billion available in funding over the life of the 7CPA for professional pharmacy programs and services—an additional $100 million investment compared to actual expenditure in the 6CPA.

Indicative funding allocations for these programs has been written into the Agreement for the first financial year, from 1 July 2020 to the 30 June 2021.

“Then it’s up to the Guild and the government to work out the rest of the $1.2 billion that’s left in the Agreement. So there will be a lot of horse-trading going on in the first year, but the first year is actually locked in,” Pharmacy Guild national president George Tambassis told AJP.

Indicative funding allocations for continuing community pharmacy programs during the first financial year of the Agreement are written as follows:

  • Medication Adherence Programs – $105.5 million
    • Dose Administration Aids
    • Staged Supply
  • Medication Management Programs – $96.4 million
    • Home Medicines Review
    • Residential Medication Management Review
    • Quality Use of Medicines in Residential Aged Care Facilities
    • MedsCheck
    • Diabetes MedsCheck
  • Aboriginal and Torres Strait Islander Specific Programs – $12.6 million
    • QUMAX/S100 Support
    • Closing The Gap PBS Copayment Measure
    • Aboriginal and Torres Strait Islander Workforce Programs
  • Rural Support Programs – $24.6 million
    • Rural Pharmacy Maintenance Allowance
    • Rural Workforce Programs
  • E-health – $18 million
    • Electronic Prescription Fee
  • Other activity – $11 million
    • Program administration, oversight and assessment

This adds up to an indicative total of $268.1 million over the course of the first year.

As stated in the 7CPA, the Commonwealth and the Guild agreed that these programs will remain “largely unchanged” during the first financial year.

However the Federal government committed to a 10% increase of the Rural Pharmacy Maintenance Allowance – with the intention to increase this further in subsequent years; a doubling of the base cap for Dose Administration Aids (DAAs) during the first financial year; and providing uncapped access to DAAs for Aboriginal and Torres Strait Islander people.

Mr Tambassis said the increase of the cap for DAAs was a win for pharmacy.

“We want to make sure we capture as many pharmacies as possible, it’s been an outstanding success – the DAA remuneration – it’s been a long time coming,” he said.

The 7CPA includes a clause where the Commonwealth promises to maintain increased investment in those programs designed to support older Australians, particularly in the context of the Royal Commission into Aged Care Quality and Safety.

It is also written that the Department and the Guild will consult regarding possible implementation of new or enhanced initiatives for community pharmacy, covering areas such as e-prescribing, mental health, aged care and “any pharmacy program trial assessed as being suitable for ongoing funding”.

The cost of administering community pharmacy programs will be met from within the total pharmacy program funding, the Commonwealth highlighted.

Meanwhile any pharmacy trial program that is still in play will continue because that funding rolls over from the 6CPA.

 

More to come

Previous World news wrapup: 18 June 2020
Next New council for DDS

NOTICE: It can sometimes take awhile for comment submissions to go through, please be patient.

7 Comments

  1. Dr Evan Ackermann
    18/06/2020

    Does not seem to be a positive CPA for consumers.

    • Pete
      18/06/2020

      Are you sure? All of the things listed here look like they are done by pharmacies/pharmacists for consumers.

      • Dr Evan Ackermann
        18/06/2020

        Follow the $ Pete – where it comes from and who it goes to.

        Then check what benefit it provides and to whom. Those services listed in the article above Aboriginal and Torres Strait Islander Specific Programs give no benefit to patients or society. The Government has done the evidence reviews to confirm this.

        Even the Dose Administration Aids which Govt and Guild are crowing about – there is little/no evidence that it improves health outcomes.

        • Pete
          18/06/2020

          Certainly ‘CTG’ is something I’m sure you endorse on scripts when you have an eligible patient, No? If not, the GP’s in my area certainly do. I’m interested in the workforce programs, I’d like to see how I can engage here, seems like a good idea pending detail that neither of us know about. As for DAA’s. I’ve been dealing with hostel and patient supply for 30 years, from boxes to dosette boxes to websters to sachets. Certainly there are a few patients that don’t benefit – they need higher care. But for most, it keeps them independent, consistent with their meds and allows a regular discussion with the pharmacist. Most of the GP’s in my area send patients to me to discuss the options – so they can see the value even if you can’t. I Have close to 300 patients on packed medicines in our country town, they must see value in it too. Certainly the govt is sucking in the data, so if they are crowing about it – they see the value too. Mate, I think you are Robinson Crusoe on this one.

          • Dr Evan Ackermann
            19/06/2020

            My view – I think it is good that in this agreement (from info announced)-
            – Support for the Australian Government’s Closing the Gap initiatives continues

            – There is funding for greater access medicines for Australians in regional, rural and remote areas
            As for DAAs, there are many things in health that we think “should” help – but when studies are done – they do not. DAAs are an example of that – there is no evidence of benefit in health outcomes. I am not Robinson Crusoe on this – this is what the evidence says.
            There is evidence in Australia that error rates in DAA dispensing is in the order of 7-10%. There is evidence (small study) of extra adverse drug events with DAAs.

            If DAAs are used, the advice is to be very selective of patients in which they are used. What I see now is that many people are on them inappropriately and many are full of “supplements”.

          • Paul Sapardanis
            20/06/2020

            Dr Ackermann I believe that you are misinformed about the promotion of DAA in pharmacy. I financially would rather not take the fee payable for a DAA and for the patient to continue self administering. On top of the cpa fee I need to charge the patient a gap fee for it to be viable. I do agree with you though that I don’t believe they are a panacea for medication compliance

  2. Dr Evan Ackermann
    19/06/2020

    Did you notice – section on community pharmacy program funding (see 9.11 in 7th CPA) has dropped all requirements / references for community pharmacy programs to be “evidence-based” (compare with section 6.1 in 6th CPA). Sort of says it all.

Leave a reply