Pharmacy in interesting times: a look back at 2015


George Tambassis from the Pharmacy Guild signs the Sixth Community Pharmacy Agreement as Health Minister Sussan Ley looks on

AJP takes a look back over the events of 2015, a turbulent year in the history of community pharmacy

“May you live in interesting times,” is purportedly an ancient Chinese saying; regardless of the rather more recent origin of the phrase, it’s meant to be a curse, as interesting times aren’t exactly the most stable to live through.

Australian community pharmacy has had a very interesting year. It’s withstood a barrage of mainstream media attacks on the rules governing it, and recommendations from a variety of quarters that the industry be deregulated.

Even after the Sixth Community Pharmacy Agreement was signed, uncertainty reigns, whether regarding the fate of OTC codeine products, how the Pharmacy Remuneration and Regulation Review will pan out, and what the $1 script copayment discount will mean in practice.

Here’s a look back over the year that was…

 

Early days

The year started well enough. Here at the AJP, we launched the full version of ajp.com.au. And the Guild released two pieces of consumer research that confirmed high levels of public trust in community pharmacies, showing that patients want to use their local pharmacies to access a wider array of health services, support and advice.

February saw some good news, as NPS MedicineWise released a report showing just how important community pharmacies are in improving medicines compliance. So far, so good.

 

March

March saw mainstream media outlets attack community pharmacy with ferocity. Community pharmacy was called a “protection racket” and a “cartel” which under the 6CPA was likely to “gouge” the public for another five years. The Fairlight Pharmacy on Sydney’s North Shore found itself suddenly in the crossfire, having been used to illustrate a story claiming pharmacists were millionaires. Industry slammed the attacks, with the Guild’s George Tambassis condemning the “bile and abuse” and PSA’s Grant Kardachi saying the comments were offensive to the profession.

Meanwhile, a highly successful APP Conference, where Independent Senator Nick Xenophon said pharmacy is in a crisis not of its own making, saw Kimberly Pharmacy Services named Pharmacy of the Year.

But the biggest news of March came in its dying days. The Competition Policy Review, also known as the Harper review, recommended the removal of the ownership and location rules, causing a storm of controversy within the sector.

The Guild slammed the recommendations, PPA welcomed them, and the PSA said the system wasn’t broken, so it didn’t need fixing. AJP spoke to panel member Peter Anderson, who said pharmacy might as well embrace competition, because it was coming.

 

April

April saw foreshadowing of the storm over OTC codeine, as the TGA asked for comments on the possibility of upscheduling it to prescription only. Meanwhile, discussion of the possibility of pharmacy deregulation hadn’t gone away.

Doctors got together to challenge pharmacy’s expansion into vaccination, but as more states joined the pharmacist vaccination bandwagon, it appeared to be a losing battle, as well as a rather baffling one, according to a pharmacist vaccination pioneer.

 

May

The biggest news of the year came in May, with the signing of the Sixth Community Pharmacy Agreement. Some aspects of the Agreement were widely hailed, such as the new Administration, Handling and Infrastructure Fee and funds for professional programs, while others, such as the optional $1 script copayment discount, weren’t receiving a lot of love. The Guild’s George Tambassis told us that the Guild would continue to oppose the $1 discount, and that uncoupling pharmacy markup remuneration from the cost of medicines was a key focus.

And the PBAC decided to consider “a” flagging biosimilars – something it would do later in the year.

 

June

The National Health Amendment (Pharmaceutical Benefits) Bill passed through the Senate, enabling the Sixth Community Pharmacy Agreement to be implemented from July. Joe Demarte was elected PSA president. And a new antimicrobial resistance strategy was launched.

And Sussan Ley launched a Global Access Partners report that said pharmacy should be a “health nexus,” encouraging responsible self-medication and reducing unnecessary GP visits.

 

July

Amid the aches, sneezes and fever of a particularly bad flu season, Choice released a report that showed pharmacies beat out supermarkets on price when it comes to a lot of OTC medicines. The Guild said the report exposed the fact that all those claims earlier in the year about pharmacy not being competitive were ideologically-driven.

The PSA urged Australia to follow Britain’s lead in introducing funding to incorporate pharmacists into general practices. It also held the first of its new conferences, PSA15, where Sussan Ley said she was keen to see the results of the review into pharmacy remuneration and location rules.

And the Pharmacist of the Year was named: remote pharmacist and advocate for improvements in Aboriginal health, Andrew ‘Robbo’ Roberts. Amy Page was named Young Pharmacist of the Year, and John Coppock received the Lifetime Achievement Award.

 

August

Still at PSA15, August saw the PSA unveil its Health Destination Pharmacy Program, which it said would help community pharmacy transition from reliance on a price-focused, discount model to a consumer-focused model.

Meanwhile, the Productivity Commission’s draft report into Australia’s Workplace Relations Framework recommended reducing penalty rates for the retail and hospitality sectors, and PPA attacked the Guild over its support for cutting penalty rates. eRx hit the milestone of its billionth script. And the PBAC “a” flagged its first biosimilar, infliximab.

 

September

All eyes were on Canberra as Malcolm Turnbull toppled Tony Abbott as Prime Minister; as the dust settled, the health sector welcomed its new top team, with Sussan Ley remaining as Health Minister, Fiona Nash taking on the mantle of Minister for Rural Health and Ken Wyatt as Assistant Health Minister.

And internationally, FIP used its Dusseldorf Congress to look at key issues facing pharmacy across the globe, such as lack of remuneration hamstringing professional services, diversifying roles for pharmacists, and why pharmacy needs to address women’s needs.

 

October

The month started with a surprise: OTC codeine-containing products were recommended to go S4, prompting widespread concern that genuine users would be disadvantaged while misuse would continue. Of all the communications received by the AJP—and there were a lot—only two supported the upschedule. That’s consistent with the submissions received by the TGA since its proposal: of 127 public submissions, 113 did not support the proposal.

In all the discussion about codeine, it would’ve been easy to miss another key reschedule: naloxone, to Pharmacist Only.

The TPP was finally signed—with some reservations from the health sector—and Erin Pavy became the first ACT winner of Pharmacy Assistant of the Year. Rounding out a big month, the Victorian Government announced it was to legalise medicinal cannabis.

 

November

Sussan Ley had a lot to say this month. First, she confirmed the delisting from the PBS of 17 types of OTC medicines. And she told the Guild dinner that she made no apologies for the $1 script copay, which she said “will help drive a more competitive sector”.

The TGA deferred its decision on codeine, and industry kicked into gear on the real-time monitoring system stakeholders prefer to a reschedule.

One voice of stability was the UTS Pharmacy Barometer, which showed confidence has sharply improved since 2015, but the view of the future is neutral rather than optimistic.

 

December

Now, it’s all about preparing for next year. The Guild NSW’s Paul Sinclair told an industry event a few days ago that while 2015 was a “watershed” year, 2016 is likely to be very challenging.

Chemist Warehouse has announced it plans to fully discount the $1 copayment, claiming it won’t affect access to the Safety Net; the Guild, meanwhile, has created resources to show how it will. The PSA is encouraging consumers to talk to their pharmacists about the delisting of those OTCs. The TGA has just called for more submissions on codeine.

And we’ve just met the finalists for Pharmacy of the Year 2016: all innovators and drivers of change.

Whatever happens in 2016, change in community pharmacy will be a big part of it. They won’t be the only pharmacies needing to not just face change in the industry, but to embrace it.

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