Who pays for screening?


Government funding essential if pharmacy COPD screening is to be sustainable, as fears remain over charging patients  

While a number of clinical trials have revealed the efficacy of pharmacist-led COPD screening, there remain a number of barriers stopping the service being a wide-ranging success, researchers say.

The most common barriers identified by pharmacists who had participated in COPD screening trials included difficulty in recruiting patients, lack of support from GPs, time and funding.

Most pharmacists who were interviewed by the researchers felt the service should be remunerated by the government via some form of a practice incentive, such as MedsCheck.

“We need a vehicle for remuneration for professional services… we have to get the government on board saying, ‘Look, the hospital system is being burdened by this, if pharmacy comes in and intervenes it will save us so much a day so we’ll pay pharmacy,” one pharmacist said.

Very few of the pharmacists said that they were comfortable charging the patient directly for the service. This contradicted the researchers self-report questionnaire data, which revealed that 89%
agreed to charge their patients for service provision.

“Many pharmacists were hesitant to charge people for offering the screening service even though they felt charging was appropriate because of the expenditures for organising such as a service,” they said.

“Although they felt that such services might gain patient loyalty, the competitive environment of pharmacy was thought to be dependent on the government subsidising such services”.

A number of pharmacists also expressed concern about the lack of involvement of local GPs.

Although a few were satisfied with their local GP’s response, the majority felt that in the future, GPs should be provided with more information to create greater engagement with and awareness of pharmacy based services.

Despite pre-informing the local GP about the screening service, the GP did not always respond to the pharmacist referral as expected. As one respondent said: “I didn’t get much feedback from the GPs. Our GPs…across the road from us, didn’t know much about it and so he told the patient to go and ask me what we want him (the GP) to do.”

The study authors, from the University of Sydney, said that participating pharmacist who tested a novel COPD case-finding service were able to proffer valuable feedback.

“In particular, they provided positive examples for how site-specific adaptations of the service could
be beneficial for its future implementation by potentially increasing its sustainability and optimising benefit to patients”.

“Overall, their positive experiences demonstrated that if these challenges were managed strategically, implementation of such a service model and other similar models would be achievable”.

The study was published in Research in Social and Administrative Pharmacy

 

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