Sixty-day dispensing medication shortages yet to materialise

Before 60-day dispensing was rolled out on 1 September, pharmacy advocates waged a sustained public relations campaign that warned against everything from increased overdose rates to medication shortages.
 
The sustained effort was spearheaded by pharmacy owners, but also involved Australia’s largest pharmaceutical distributor, Sigma Healthcare, which pleaded with the Federal Government to stop the reform.
 
‘Common medicines … may be at risk of persistent supply shortages, further exacerbating a supply chain under enormous pressure,’ a message on its website said in May.
 
But on Wednesday, a Sigma Healthcare Half Year Results Briefing webinar revealed that these fears have, so far, been unfounded.
 
‘The regulatory change to implement 60-day dispensing of medicines commenced from 1 September 2023, and we have seen very little change in demand for the impacted products thus far,’ Sigma Chief Executive Vikesh Ramsunder said at the webinar.
 
‘We continue to engage with government via the NPSA [National Pharmaceutical Services Association] to ensure a commercially viable industry under the Eighth CPA [Community Pharmacy Agreement], which has been brought forward by 12 months.’
 
The ASX-listed company’s Head of Corporate Affairs Gary Woodford also confirmed ‘we’re not currently seeing much impact’.
 
With pharmacy operations in retail, wholesale and distribution, Sigma is well placed to assess the response to the new policy setting, given it works with more than 1200 aligned pharmacies, including around 500 branded pharmacies operating the Amcal, Guardian, Discount Drug Stores and PharmaSave brands.
 
In the six months to 31 July, it reported a profit of $11.2 million, compared to a $1.5 million loss the year before.
 
RACGP Vice-President Dr Bruce Willett told newsGP he has not noticed, nor heard of, any medication shortages since the reform’s commencement.
 
‘Milk comes in one-litre or two-litre containers and people drink the same amount of milk, it doesn’t create a shortage,’ he said.
 
‘It’s the same with 60-day prescriptions – people don’t take twice as much because they get twice as much when they go to the chemist.
 
‘If anything, I think it’s slightly better as we’re getting out of COVID and the supply chain issues are starting to abate a little bit.’
 
Years in the making, 60-day dispensing is now doubling the maximum number of medicines pharmacists can give out for a host of stable conditions identified listed on the Pharmaceutical Benefits Scheme (PBS).
 
It is set to impact around six million people, potentially saving them $180 a year, or more if they are taking multiple medications.
 
However, its progression was not a fait accompli, with some politicians opposing the move in line with the Pharmacy Guild of Australia – one of the country’s major political donors – whose President had warned of ‘guaranteed medicine shortages across the country’ resulting in ‘millions of patients’ being worse off.
 
‘I don’t want to see a Hunger Games stand-off in any community in Australia where some patients get double the medicine they need, while others get nothing,’ Professor Trent Twomey said.
 
But despite the best efforts of its opponents, the changes passed through the Senate and Dr Willett said he has not come across a patient since who is not interested in the longer prescriptions.
 
‘I don’t think anyone really accepted [a medication shortage] was going to be a problem and that has been shown completely – it was never a problem, and it is still not a problem,’ he said.
 
‘The Guild’s publicity might have backfired for them because it’s generated a lot more interest from patients who are coming in and asking for 60-day prescriptions.
 
‘Now that it’s in, it’s going to be very difficult for any government to unwind but I’m sure that the Guild have not given up the fight on this.’
 
When fully implemented on 1 September 2024, 60-day prescriptions will be available for more than 300 PBS medicines.
 
The medicines set to be made available in stages two and three are still being finalised.
 
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60-day dispensing extended dispensing PBS Pharmaceuticals Benefits Scheme prescriptions