‘Non-evidence based detritus’ in ‘waning’ pharmacy market

Another GP has attacked the community pharmacy sector, while musing on whether the AMA should adopt similar lobbying tactics to the Pharmacy Guild

Writing in Australian Medicine about perceived “threats to independent, viable medical practice,” AMA national vice president Dr Chris Zappala has suggested that the challenges facing GPs are currently worse than usual.

He lists pharmacists working to the scope of their practice amongst these threats – and says that it is “sobering” to consider how effective stakeholder organisations such as the Guild have been in furthering their position.

“Pharmacists have dangerously encroached on the role of general practitioners in recent times with initiatives that are clearly unsafe and designed to predominantly fortify the waning retail pharmacy market,” Dr Zappala writes.

“Despite the ACSQHC clearly indicating that expanding prescription of antibiotics to non-doctors is misguided, some politicians think the problem would be improved if others were able to prescribe because the genesis of the difficulty relates to undisciplined prescribing by doctors.

“Clearly ridiculous, but how can such a nonsensical idea even be genuinely entertained? The largest out-of-pocket cost for patients (at 31%) is non-PBS medications and therapies – principally, all of the non-evidence based detritus that help retail outlets make money.

“But they do not genuinely improve anyone’s health (more than any other placebo perhaps would). Government seems blind to this and happy to continue to blame doctors whose contribution to out-of-pocket costs is only 13%!

“PBAC recommendations are always followed by the Government – it is an independent advisory group. It makes no sense then that the Government has not enacted the change to dispense more than one month of drugs at a time in order to improve convenience and reduce cost for patients.

“Take also the archaic, protectionist ownership rules that remain in place for pharmacies.”

Dr Zappala writes that perhaps the AMA should consider making political party donations, as the Pharmacy Guild does.

Earlier this year the AJP reported that the Guild was the 14th-largest donor entity in the 2017-18 financial year, donating a total of $139,542 to Labor (including national and state branches), $43,279 to the Liberal Party and $37,620 to the Nationals.

The Guild also drew mainstream media fire earlier this year for donating more than $15,000 to One Nation, though at the time it pointed out that this was for attendance at Party events, which is classified as a donation.

Now Dr Zappala writes that “it is not uncommon to see the Pharmacy Guild logo prominently placed at Government events, and the public register of political donors indicates the handsome payments made by the Guild to various political parties”.

“Presumably, this is all part of the Guild strategy to have influence,” he says.

“The key question is should the Federal AMA do the same? I know we never have, and we should not ever. Nor should any member advocacy body.

“I feel really strongly that you should not need to buy access, but instead argue on merit. If you can’t argue on merit, your argument is flawed.”

He concludes by asking what AMA members think about the way the AMA states its case towards Government and other decision-makers.

A spokesperson for the Guild said: “Unfortunately for the AMA, the secret of good advocacy is… a secret.

“We wish them well in their search.”

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