How much income can GP pharmacists generate? Researchers make a financial case for the practice pathway in Australia
A pilot study led by pharmacy researchers at the University of Canberra has investigated the value versus cost of employing a pharmacist in general practice, finding positive value in some scenarios.
Pharmacists in Australia can generate revenue for general practices through medication reviews and other activities, said Associate Professor of Pharmacy Sam Kosari and his research team.
They collected and reviewed data from two part-time pharmacists in general practice over 19 weeks (May to October 2016).
Weekly totals were calculated and recorded for time worked by each pharmacist; number and time for Asthma Cycle of Care, HMR and Health Assessment claims; time saved for GPs; and face-to-face patient consultation with the pharmacist.
Meanwhile income generated by pharmacists was estimated by the sum of: value of MBS and Practice Incentives Program (PIP) claims resulting from pharmacists’ involvement; time saved for GPs due to pharmacist activities; and potential direct payment from patients to visit pharmacists.
Activities undertaken by the pharmacists that freed up time for GPs to conduct more patient consultations included: medication review; post-hospitalisation medication reconciliation; drug choice; patient education; review and act on blood test results from pathology; updating medication list in medical record; liaising with community pharmacy and aged care facilities; contacting patients about medication recall; and smoking cessation.
Over 19 weeks, Pharmacist A and B recorded 243.5 and 135.8 h of work over 19 weeks with corresponding salaries (AU$60 per hour, including on-costs) of AU$14,608 and $8,150, respectively.
During the same time period, the two pharmacists supported 47 and 23 Asthma Cycle of Care activities, generating income to the general practice of AU$4700 and AU$2,300, respectively. The pharmacists spent 36.4 and 24.1 hours on activities usually conducted by GPs, allowing additional time for GP-patient consultations.
The potential additional GP-patient consultations resulting from the activities of Pharmacist A and B could generate AU$8720 and AU$5616 in private clinics, AU$4038 and AU$2668 through MBS item 23 for standard 20-min level B consultations in bulk-billed clinics, or AU$5162 and AU$3442 through MBS item 36 for 30-min level C consultations in bulk-billed clinics.
The researchers calculated that AU$0.61 – AU$1.20 of income could be generated by the pharmacist for each AU$1 spent on wages.
Based on these results, “the value-cost ratio of employing pharmacists for a general practice business may be positive in some scenarios,” they said.
A greater return on investment per AU$1 of pharmacist salary was associated with the more experienced pharmacist with additional clinical qualifications, private practice and patients’ paying for consultations.
“Our pharmacists generated income from three services which are associated with financial reimbursement from the government. This finding builds on the research by Freeman et al., who demonstrated that one practice pharmacist in Queensland, Australia (working 0.6 full-time equivalent) could potentially generate AU$17,374 over 12 months by facilitating completion of government-funded HMRs,” the researchers highlighted.
Future work should focus on developing a robust business model that includes health care system savings resulting from practice pharmacist interventions, they added.
“Practice pharmacists have conducted other clinical activities (for example clinical audits, smoking cessation, post-hospital discharge medication review) that contributed to improving patients’ health and risk reduction; estimating the economic value of all these activities was out of the scope of this study.”
The GP pharmacist workforce is growing in Australia but is still relatively small.
PSA national president Chris Freeman told AJP in March this year that the PSA estimates the number of GP pharmacists to be excess of 100, up from nearly 50 in 2017. Most of these work part-time.
“We expect that this model will continue to grow year on year becoming a mainstream pathway for pharmacist practice,” Associate Professor Freeman said at the time.
See the full research article in Research in Social and Administrative Pharmacy here