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Pharmacist medication programs and DAA fees questioned during Senate Estimates hearings

Health Department officials were questioned about the costs and details of a number of pharmacy medication management programs during last week’s Senate Estimates hearings.

It was revealed that, since the start of the pandemic (and up to 14 October) there had been 1.3 million home medicines services delivered to “some 4670 pharmacies around Australia” at a cost of about $10.7 million.

Of these programs, around one million were in metropolitan areas and 200,000 in rural and remote areas, the bureaucrats said.

Greens Senator Rachel Siewert (Greens, WA) asked a series of questions about changings to funding levels for dose administration aids as part of the Seventh Community Pharmacy Agreement, and the fees that pharmacists could charge for this service.

In response, Ben Sladic, Assistant Secretary, Technology Assessment and Access Division, said: “the commitment in the first year of the Seventh Community Pharmacy Agreement is to increase the base caps for the dose administration aids that pharmacists can claim from the current level of 30 to 60”.

“That’s something we’re working through. We’ll be talking more to the guild and other stakeholders ahead of that planning to commence in January. That commitment was touched on at the announcement of the agreement,” he said.

Adriana Platona, First Assistant Secretary of the same division said “we have been allocated, as part of the Seventh Community Pharmacy Agreement, $1.2 billion over five years. Yes, there is a budget and that is the budget constraint, and we will try to manage within the budget”.

Senator Siewert then asked “Pharmacists get paid for doing this don’t they? Could you take on notice what that is? I presume it varies with the different aids and things or is just one fee?”

Mr Sladic responded that “I will take it on notice for the dose administration aids to confirm that I think it is a partial subsidisation of about $5.50, for each dose administration, that the pharmacist gets paid under the community pharmacy agreement.

But that doesn’t stop them charging private fees separately to that. For the actual patient the amount that is subsidised through the pharmacy agreement from the government is about $5.50, but I will confirm that on notice.”

When asked if pharmacists do charge an additional fee, Mr Sladic simply responded: “Yes”, before adding that he would look on notice to find out what size of additional fee they charge”.

Questioning then moved to the staged supply program, with Department officials unclear of whether medicines dispensed under the opioid dependency treatment were included.

“As far as the crossover between the opioid dependence treatment program and the community
pharmacy staged supply program, similarly, I would need to take that on notice and check. But my understanding is that the opioid dependence treatment program is probably separate to that and relates to money that goes to states and territories for the delivery of some of that,” Mr Sladic said.

“We will check the interplay between the two programs. They are separate pools of money, and
we’ll come back to you to confirm how they work together,” Ms Platona said.

 

 

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6 Comments

  1. Gobika Srikanthan
    03/11/2020

    There is a lot of work that goes on behind the scenes of providing the DAA service. You have to factor in the cost of the packing technician’s wages, the materials required, the pharmacist’s wages, software costs Furthermore, for patients that have frequent changes to their DAA, there is additional work including chasing up correspondence from the medical practitioner. With dispensary profits falling, there isn’t much to sustain the service. The subsidy received from the government makes a big difference, however I worked out within our pharmacy the cost of providing a single week’s DAA can be in excess of the amount received from the government.
    Furthermore some pharmacies (including ours) may be providing this service to a number of community members over the specified cap amount. Does this mean that you can charge for packing for some people and not others and is it fair to do so (especially in an area where there is a higher percentage of older Australians).
    I think it is time that our profession highlights the actual work conducted behind the scenes to the community so that it is valued.

    • The Cynic
      03/11/2020

      For years I have watched with frustration as pharmacy has chased extra revenue streams ( vaccination anyone?) while engaging in the labour intensive activity of preparing DAAs for next to nothing. Or free.
      Surely from the very beginning pharmacy could have and should have engaged in this QUM activity for an agreed and realistic fee from the government of the day. Of course DAAs gained popularity with pharmacy owners when super profits were being made from Lipitor 80mg and the rest. Keeping these scripts safely locked in the script file until the next profitable dispensing was made more sure by offering to pack a DAA.
      As we know the super profits disappeared but the heavy carcass of ‘free’ DAAs did not.
      Final point….if pharmacy cannot sell the obvious QUM benefits of organising elderly patient’s medications to a government which demands best possible practice then we have lost our way.
      Exit stage left….or right….

  2. Mimimomo
    03/11/2020

    DEAR POLITICIAN, MAY BE YOU SHOULD NOT BE GETTING PAID OR NOT THAT MUCH FOR THE LOVE OF THE COUNTRY. WE DON’T KNOW WHAT YOU DID TO DESERVE SUCH A HIGH PAYMENT AND ALL YOU TRYING TO DO IS TO REDUCE THE INCOME OF PHARMACY. INCOME REDUCE MEAN, MORE JOBS GOING TO BE LOST MORE UNEMPLOYMENT. THIS WILL EFFECT THE ECONOMY OF THE COUNTRY. DEAR POLITICIAN, ALL OF YOUR PAY SHOULD BE CUT 50% TO CONTRIBUTE TO MORE PROJECT AND INFRASTRUCTURE OF AUSTRALIA. HOW IS THAT? MAY BE SOMEONE NEED TO MAKE PUBLIC MORE AWARE OF HOW MUCH POLITICIAN ARE PAID, AND WHAT DO THEY DO? SIT AND TALK ONLY

  3. Paul Sapardanis
    03/11/2020

    I charge and claim for the DAA’S I pack. Financially I would rather the patient manage their medications themselves then for me to do it even though I charge and claim for packing. What does that tell you

    • The Cynic
      03/11/2020

      You lose money every time you pack a DAA????

      • Paul Sapardanis
        04/11/2020

        If you factor in labour costs i would hardly be making any money. I charge $7 per pack and get about $6 in 7cpa fees, so you tell me

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