The hullaballoo over the introduction of 60-days' supply of eligible prescriptions has reached fever pitch as the Coalition and some cross-benchers tried to disallow the motion to implement the policy on September 1.
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They will try again, apparently, in the next sitting, even though it will be after the introduction date.
As with the Voice, there is much "fake news" happening in this space.
As a preliminary note - I love our pharmacists. They have helped me enormously over the years. Even the prime minister announced his great respect for his own pharmacist in the Parliament earlier in the year and as recently as this week when this thorny issue was being discussed.
But that love doesn't extend to giving unfettered access to dwindling personal bank accounts.
The quick summary is that patients who have chronic (long term) conditions and who take drugs that are on the approved pharmaceutical benefit scheme (PBS) will be able to obtain a 60-day supply instead of the current 30-day supply. This saves a co-payment that is made to the pharmacist - usually in the order of $30 per supply - leading to an overall reduction per drug of around $180 per annum.
It is the dispensing fee that is being saved if the drug is on the approved list because the pharmacist will only dispense it six times per year rather than the usual 12 (for monthly supplies). For high end users (including many in my family), these are significant savings that cannot be ignored.
The other win in this proposal is that those with well managed and stable chronic conditions will not need to visit the doctor for a prescription nearly as often. This will free up GP and other consultation time for those who are acutely ill.
According to the Australian Institute of Health and Welfare and the Australian Bureau of Statistics, nearly 50 per cent of the population has a chronic condition. If even half that number requires drugs regularly for the rest of their lives, there is a significant personal impost.
I've heard many reasons for not allowing this change including that it will create a shortage of high-demand drugs. The drugs that are on the initial list are not in short supply so this will not be a problem.
"Patients will kill themselves with access to a larger supply of drugs" is another furphy. The drugs on the list are for patients whose condition is stable and who don't require constant monitoring.
Doctors will also assess whether the patient in front of them should have access to a 60-day prescription rather than a 30-day prescription. The risk management here is significant.
Some dramatists have claimed that aged care residents will be required to pay more to have their pharmaceuticals packed into what are known as Webster packs - pharmacists compile daily dosages into a pack to assist patients in not missing a dosage or indeed doubling up on a dose. However, the aged care sector is already funded for this activity. This is yet another furphy.
Pharmacists have raised their concerns about the impact on their businesses. If they are relying solely on the dispensing income, then they are a business in trouble. However, the key problem is that the health and well-being of Australians continues to be compromised while many Australians do not have their prescriptions filled because they cannot afford to.
This must surely be paramount in any discussion about whether this is the right thing to do. I visit Benalla in north-east Victoria on a regular basis. There are four pharmacies within 50 metres of one another - all on the same side of the road. I doubt that any economic or financial analysis would sustain such a cluster for a population of around 14,000 people.
The dependence on the dispensing fee is surely propping up businesses that cannot be viable. I suspect that some pharmacies will end up closing, but others that are community focused and not duplicating the work of a pharmacy two doors away will continue to thrive.
Many individuals (including patients) and organisations in the health sector have had to adapt to working in different ways, especially since COVID. Pharmacies as businesses will need to come on board too - and the smart ones are already well on the way.
Pharmacies do not just dispense drugs. They vaccinate people, they provide certificates, the clever pharmacists have health promotion as a key target. And they sell other things including dressings, antiseptics, non-prescription drugs, and other paraphernalia to support health and wellbeing (including lipsticks and lollipops).
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Health Minister Mark Butler has told us that the savings generated because of this consumer-focused initiative will be re-invested in the pharmacy sector. We're talking over $1 billion here so that's a lot of re-investment.
This initiative is a godsend for Australian consumers with chronic conditions. It will likely save them 50 per cent of their current drug bill not to mention co-payments required to see a doctor to get prescriptions.
It will also free up time for doctors to see other sick Australians who have difficulty in seeing a doctor because of limited access. And it will free up funds to support the community pharmacy sector to be even more responsive to the needs of their patients.
I hope my pharmacist will still talk to me even though I won't hand over my PIN for my bank account. Sometimes difficult conversations are necessary and sometimes we won't always agree. But we cannot continue to ignore the many Australians who cannot afford to have their prescriptions filled.
- Anne Cahill Lambert AM is a consumer advocate and sometimes known as the patient from hell.