Pharmacy facing 10 years of dispensing famine: Quilty

pharmacist at POS machine with bottle of medicine

Community pharmacy is facing 10 years of real reductions in dispensing remuneration – and they need certainty in the 6CPA, writes Pharmacy Guild executive director David Quilty in this week’s edition of Forefront.

He says the 6CPA negotiations must be concluded and a new Agreement signed as quickly as possible.

“First and foremost, the Agreement must ensure that dispensaries are viable through to 2020 and that the flow-on impact of price disclosure on dispensing remuneration is addressed,” Quilty writes.

“During the Sixth Agreement, pharmacies will make an enormous contribution to arguably the largest and most successful structural reform across the entire health system, ensuring that the PBS is sustainable in the long term.

“The Sixth Agreement must financially recognise this contribution, which is helping deliver an estimated $13.9 billion in savings to the budget bottom line over the next five years.”

Pharmacies receive less to dispense a medicine today than they did in 2009, he points out.

“If this current downward trajectory is not addressed, pharmacies face 10 consecutive years of real reductions in their dispensing remuneration. This is unsustainable for any business.”

As president George Tambassis told delegates to the APP Conference, the Guild will only sign the Sixth Agreement if and when we are sure it is in the interests of our members, he says.

“George has also foreshadowed the need to de-link dispensing remuneration from the cost of PBS medicines.

“As the Government drastically reduces what it pays for PBS medicines, the flow-on impact on pharmacy mark-up is resulting in year-after-year of real reductions in dispensing remuneration.”

De-linking pharmacy remuneration from the cost of medicines would enable governments to continue reforming the PBS while ensuring that pharmacies are properly remunerated for their administrative, handling and infrastructure costs and their viability is not threatened, Quilty says.

“PBS reforms also mean that pharmacies can no longer cross subsidise core services like dose administration aids and staged supply from trading terms.

“These services, which are fundamental to the Quality Use of Medicines, need to be funded directly and transparently going forward.”

At the same time, there is a need for a more integrated, evidence-driven and patient focussed approach to medicine adherence and medication management, he says.

“Australia’s current $30 million a year investment in medication management services for a $10 billion PBS is clearly inadequate.

“The next Agreement needs to target areas such as post-hospital discharge medicine reconciliation and when patients are first prescribed a medicine where there is a high risk of non-compliance.

“There is also an opportunity to improve patient access and reduce the cost pressures on the wider health system by enhancing the role of pharmacies in areas such as the treatment of minor ailments and prescription renewal.”

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