Push for two-month dispensing

Pharmacy should ready itself for a “crescendo of bad press” promoting two-month dispensing, the Guild’s Kos Sclavos has warned

Addressing delegates to the Pharmacy Assistant Conference in Brisbane, Mr Sclavos outlined a number of threats to community pharmacy – including not just the longer script lengths currently being promoted by doctor groups, but also the possibility that doctors could direct patients to a preferred dispenser.

However the bad press is not unexpected given negotiations for the Seventh Community Pharmacy Agreement have commenced, he told the audience.

“The Agreement years are always nervous. Many of you have obviously seen a lot of press and said, ‘Wow, pharmacy’s getting bashed in the press and the doctors are upset’,” he said.

Ms Sclavos said that in his long experience in pharmacy, negative mainstream media coverage is normal in the months leading up to a Community Pharmacy Agreement’s signing: and to expect more.

“It happens every five years in a cycle. So there’s a lot of negative media because pharmacy has enemies.

“There are people like grocers and others who’d love to be able to dispense medicines and have patients coming in with these chronic therapy conditions coming in six and a half times a year to their businesses.

“That’s why they fight so hard” to take pharmacy, he said.

It’s vital that the dispensing fee remains viable in the 7CPA, he said, and warned that the biggest issue in pharmacy right now is the threat of two-month dispensing.

“The Government secretly commissioned a report to say instead of people getting medicines once a month, what if they just came in every two months and we just gave everyone double the quantity.

‘Isn’t that a great idea. And there’s a whole bunch of health issues that are numbered there, and it’s not actually going to save the Government as much as they think, even if they implement it, because in overseas countries where you can write up to three months, doctors only write one-month prescriptions anyway.

“Once they do it, the damage will be done. So right now the Guild is negotiating something that’s got a major impact on our viability, which is two month dispensing.

“Now for many pharmacies… some of you are in the business of packing Websters… all that largely hinges on remuneration that’s in the Agreement. That’s up for grabs now.

He warned that the controversial optional $1 copayment discount was already a problem, and cited the experience of the New Zealand pharmacy sector, where pharmacies can discount the entire copayment. Following the entry of large discount groups into the market, existing groups such as Countdown as well as some independents have felt compelled to match this offer in order to stay competitive.

“It’s decimated pharmacy in New Zealand.”

If something similar happened in Australia, pharmacies in rural towns would die, as patients went to larger centres where pharmacies offer discounts, in order to make savings.

“No matter where you live in Australia, you shouldn’t have to be searching around for a cheaper pharmacy – medicines are a core and important part of health, and you should be able to pay the same price for those no matter where you go.

“So there’s probably going to be a crescendo of bad press on this two month dispensing, because there are forces at work who’d like to bring that in. That’s going to be bad for manufacturers, bad for pharmacy and bad for the health of Australians.

“So that’s one thing that they’re continuing to push… the Minister’s saying he has to follow through and look at those issues.”

Mr Sclavos also previewed a “major rewrite” for Quality Care, which will be a foundation for the Guild’s CP2025 strategy.

Electronic prescriptions will mean a huge change for pharmacy, he said,

“It’s because in some countries the doctor sends the scripts automatically to their preferred provider, and there are rorts and kickbacks and lurks for whoever the doctor’s favourite player is, and they get prescriptions sent and the patient has to follow wherever that prescription is sent.”

Australian stakeholders have worked very hard to ensure that the patient is in control and the prescription is in the cloud, so the patient can choose where to have it dispensed.

Mr Sclavos also said he doubted that paper scripts would be phased out by the end of the year, as the Government has aimed for – and that pharmacies would need to be wary that patients would choose to go online to “some massive mail order business,” as has happened in the UK.

“At the end of the day the core category, the core department in pharmacy is the dispensary… and we’ve got one big issue with price disclosure and discounting that is impacting the price per prescription.”

He said a crisis was looming for pharmacy assistants and other employees in that the impact on profitability could mean more work for pharmacy assistants and other employees, while wages remain suppressed.

“It’s happening in a lot of sectors,” Mr Sclavos told delegates, citing the example of a relative who has to cover 18 different point of sale stations at a major department store on Sundays.

“Now where’s the service gone in those retailers? And they wonder why people have gone online.”

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