Close the Gap PBS Co-payment changes a ‘positive step forward’

Aboriginal and Torres Strait Islander patients registered under the Close the Gap (CTG) Pharmaceutical Benefits Scheme (PBS) Co-payment program will now have easier access to subsidised medicines.
 
Changes that came into effect on 1 July mean eligible patients will have access regardless of their geographical location, their chronic disease status, or whether their prescriber is enrolled in the Practice Incentive Program.
 
Professor Peter O’Mara, Wiradjuri man and Chair of RACGP Aboriginal and Torres Strait Islander Health, welcomed the changes as a ‘positive step forward’.
 
‘Expanding access to Close the Gap scripts for all patients regardless of where they live, where they got the prescription from and their chronic disease status will make a real difference,’ he said.
 
‘It is much more straightforward and that can only be a good thing.’
 
A centralised patient registration database has been developed to support the changes. Managed by Services Australia, the database allows for a one-off registration of patients via Health Professional Online Services (HPOS) and will cover the patient even if they move to a different clinic.
 
The system will also be automated – no longer requiring prescribers to write ‘CTG’ on the script – as the new system will ensure the PBS Co-payment is automatically reduced for CTG-registered clients when scripts are dispensed at pharmacies.
 
The change to the CTG program was among the recommendations to come out of the 2017 Indigenous Pharmacy Programs Review, and has had strong support behind it, including from the RACGP.
 
Professor O’Mara noted that sound implementation of the changes is vital, saying he has heard reports from the pharmacy sector about issues implementing the program, ‘including problems with communication with pharmacies’.
 
‘It is not my place to comment on the specifics of that; however, I certainly hope any issues are resolved quickly because I think these changes can do a lot of good,’ he said.
 
As part of the changes to the Indigenous Pharmacy Policy, a new national quality use of medicines program has been established.
 
Funded by the 7th Community Pharmacy Agreement (7CPA), the Indigenous Health Services Pharmacy Support Program (IHSPSP), an amalgamation of the Quality Use of Medicines (QUMAX) and s100 Support Allowance programs, will fund all eligible ACCHOs and government-run Aboriginal Health Services to commission pharmacy services that suit their needs.
 
‘In a lot of ways it’s conceptually similar to QUMAX,’ Mike Stephens, Director of Medicines Policy and Program at the National Aboriginal Community Controlled Health Organisation (NACCHO), told newsGP..
 
‘The ultimate aim is to be responsive to ACCHOs’ needs and be broad enough that there’s self-determination in the pharmacy services that they’re procuring.
 
‘It can relate to home medicine reviews, or it could be stock management of medications. It could be GP medication training, it could be buying asthma spaces. So there’s a range of things.’
 
A separate Indigenous Dose Administration Aid (IDAA) program has also been established, which will entitle pharmacies to $11.60 per DAA without permission to ask patients or ACCHOs for additional funds.
 
‘In general these are positive changes,’ Mr Stephens said.
 
‘But we really need to focus on the implementation in the next 3–6 months.
 
‘There is a commitment from the Department of Health to review. The 7CPA can be dynamic to some degree, and that’s probably the principal way that ongoing program reform can happen if we need to change things.’
 
Professor O’Mara said practical incentives such as these are needed to address health disparities impacting Aboriginal and Torres Strait Islander patients.
 
‘If we can increase access, we can encourage preventive healthcare and enhance wellbeing,’ he said.
 
More information

• Fact sheet for Aboriginal and Torres Strait Islander people
• Fact sheet for Prescribers, Aboriginal and Torres Strait Islander Health Practitioners and their peak bodies
• FAQs – for all stakeholders
• Medicare Australia online training on the Close the Gap PBS Co-Payment program

Aboriginal and Torres Strait Islander health Close the Gap PBS co-payment program