Still on the wish list

Are two month prescriptions back on the government’s agenda?

Recommendations made by the Pharmaceutical Benefits Advisory Committee (PBAC) that prescription lengths be doubled to two months for a range of medicines may be back on the government agenda, new documents reveal.

The proposals appeared to have been scrapped before the 2019 Federal Budget was delivered, following intense criticism from the Pharmacy Guild of Australia.

However the release this week of Department of Health responses to Senate Estimates questions without notice seem to indicate the changes are still under consideration, citing savings to patients, improved adherence and choice for prescribers.

In response to a question from Senator Stirling Griff (SA, Centre Alliance) asking whether the “hit to pharmacy funding [was] the main driver for the reversal of this planned change?”, the Department of Health responded that: “The Pharmaceutical Benefits Advisory Committee recommendation is now the subject of consultation with consumers, the medical community, the pharmacy sector and other interested stakeholders.”

Senator Griff asked about evidence that providing patients 2 or 3 months’ supply would be any less
safe than the current regime, as had been claimed by Guild national president George Tambassis.

The Department’s response was that PBAC “selected only those medicines for chronic conditions that were considered clinically safe and suitable for a larger dispensed quantity. Medicines requiring regular adjustment (titration), close monitoring or with potential risk to safety if stockpiled, were excluded.

“Consumers would save money by paying less co-payments, which may also improve adherence to treatments”.

Senator Griff also asked about the “rationale” behind patients having to visit a pharmacy each month for a script that included multiple repeats.

“One month’s supply is current practice, and in the PBAC view it remains suitable for some but not all PBS medicines and patient circumstances,” the Department responded.

“PBAC confirmed that recommendations for PBS items with the increased dispensed quantities (two months’ supply) would be in addition to the current PBS items with one months’ supply and five repeats for the corresponding medicine.

“This would ensure prescriber choice, such that smaller quantities could still be prescribed for patients as clinically appropriate.”

“PBAC considered that there were some classes of medicines such as antibiotics and opioids
that were not suitable for dispensing in higher quantities,” the response added.

No answer has to date been provided for a question asking about the department’s modelling on the benefits of moving to 2 month scripts, or whether any variations such as 3 or 4 month scripts had been considered for medications for stable conditions.

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