Sixty-day dispensing: What GPs need to know

Michelle Wisbey

31/08/2023 3:07:28 PM

After a long and hard-fought push, the landmark changes will finally be in place from September. Here’s what to expect when the reform goes live.

Woman paying for prescription at pharmacy.
The addition of 60-day dispensing is predicted to impact around six million people, potentially saving them $180 a year.

It is a change years in the making, but on 1 September, the first tranche of medicines eligible for 60-day dispensing will be in place.
With the major reforms set to impact general practice, a dedicated RACGP webpage has been developed to provide specific information to members about what those changes mean for them and how they will be rolled out.
The online resource includes specific information for GPs, how the changes came to be, and answers to frequently asked questions, which will all be updated as more information comes to light.
The Department of Health and Aged Care (DoH) has also created an information booklet for prescribers.
The changes will double the maximum amount of medication pharmacists can dispense for stable conditions 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.
It will also free up GP appointments for patients who do not need to pick up scripts.
So, what exactly can GPs expect?
Patients will need to be written a new prescription to obtain a 60-day supply of their current medication.
GPs will retain full clinical discretion over what quantity of medicine is prescribed for their patients, meaning a one-month prescription can still be supplied where deemed appropriate.
Prescribers will also retain the choice to select a PBS item for a specific medicine with a smaller dispensed quantity where clinically appropriate.
The DoH is working with Services Australia and software providers to update medical software to accommodate the changes.
Medication shortages are not anticipated, with overall demand set to remain unchanged.
Regulation 49 is also unchanged, which permits, in certain circumstances, a PBS prescription to be endorsed by the prescriber for ‘one supply’ to allow the quantities for the original prescription and repeats to be supplied at the same time.
RACGP President Dr Nicole Higgins describes the reform as a progressive policy that puts patients first.
‘Sixty-day dispensing will make a big difference for some of the most vulnerable people in our communities, who are struggling with rising costs,’ she said.
‘Thirty-day dispensing has been an unnecessary financial pain, and a real burden for people who have a long drive to their nearest pharmacy or who find it difficult to leave their homes.’
The dispensing change was first recommended by independent experts at the Pharmaceutical Benefits Advisory Committee (PBAC) in 2018 but took until just weeks ago to be passed.
Facing fierce opposition from the Pharmacy Guild of Australia, the battle for and against those changes spilled over into a chaotic and complicated Parliamentary debate, which ultimately ended in the proposed reforms passing.  
That change paved the way for 90 PBS-listed medicines to qualify for 60-day dispensing’s first of three stages, beginning 1 September this year.
Those first medicines include treatments for cardiovascular disease, Crohn’s disease, gout, heart failure, high cholesterol, hypertension, osteoporosis, and ulcerative colitis.
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.
Those additions will likely include treatments for asthma, breast cancer, chronic obstructive pulmonary disease, constipation, chronic renal failure, depression, diabetes, endometriosis, endometrial cancer, epilepsy, glaucoma and dry eyes, hormonal replacement and modulation therapy, and Parkinson’s disease.
Dr Higgins said it is a ‘long overdue’ reform.
‘Australia needs a strong and sustainable primary care sector, with GPs working in teams with other specialists, pharmacists, allied health and nurses, for the best outcomes for our patients,’ she said.
‘Because everyone needs access to high quality care, no matter where they live or what they earn.’
On 1 August, Dr Higgins spoke at a DoH webinar on 60-day prescriptions, it can be viewed here.
Online resources include:

Work is also underway at the RACGP to develop a prescriber kit to be handed to the DoH in the future.
However, the opposition has already warned it will try to overturn the change when Federal Parliament returns on 4 September.
Pharmacists are likewise expected to descend on Canberra on Monday for a ‘Truth Campaign Rally’, protesting the changes.
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Dr Abdurragiem Gassiep   1/09/2023 8:55:57 AM

A great win for patients; and a great win for social equity and for more efficient utilization of public funds for public health

Dr Michael Charles Rice   1/09/2023 4:54:29 PM

"It will also free up GP appointments for patients who do not need to pick up scripts" is disappointing from RACGP (unless there ARE patients who are literally just picking up scripts"

No-one comes to "pick up scripts" even if that's what they say.

They come for a checkup, monitoring, investigations, planning, updating family histories, opportunistic risk factor management, appropriate referrals and more.

I have no problem with half the frequency of visits if they pay me double; because the hard work of primary care will get compacted

Dr Neil Warren Donovan   3/09/2023 1:13:11 AM

Just to clarify, it looks like this means I can supply 12 months with these scripts ? . Is that not important or mentioned , That’s a big change too, not all good for us.
Would I write 60 and 3 rpt to ensure regular review of CVS. Meds ?
Any help Ta